本文選題：功能性消化不良　切入點：餐后不適綜合征　出處：《湖北中醫(yī)藥大學》2016年碩士論文

【摘要】：目的觀察體表電刺激(TEA)聯(lián)合電針(EA)治療餐后不適綜合征型FD的臨床療效,建立一種科學有效的臨床治療FD的方法,并探索其可能的機制。方法根據(jù)已有的標準選取餐后不適綜合征型FD患者共30例,分為三組,每組10例。EA組(A組)單用EA治療,每周2次,每次30min;假性TEA聯(lián)合EA組(B組)采用EA聯(lián)合假性TEA治療,即每周2次的EA治療同時還需進行每天早晚各一次,每次45min的假性TEA治療;TEA聯(lián)合EA組(C組)采用EA聯(lián)合TEA治療,即每周2次的EA治療同時還需進行每天早晚各一次,每次45min的TEA治療。治療總療程為4周,研究期間共隨訪3次(分別為治療開始前、治療第2周末和治療第4周末)。觀測消化不良癥狀評分、生活質(zhì)量問卷(SF-36)、Zung氏焦慮及抑郁評分量表等指標,通過液體營養(yǎng)餐試驗評估胃容受性,通過胃電圖(EGG)和心率變異性(HRV)檢測分析胃電節(jié)律及迷走神經(jīng)活性。結果1.消化不良癥狀評分分析:與治療前相比,C組病例治療2周后、治療4周后的消化不良癥狀總積分及餐后飽脹、早飽、噯氣單項癥狀積分均有不同程度的下降,其差異均具有統(tǒng)計學意義(P0.05)。治療4周后,各組間進行比較,與A、B兩組相比,C組病例消化不良癥狀總積分及餐后飽脹、早飽、噯氣單項癥狀積分下降程度更為明顯,差異具有顯著性(P0.05)。2.生活質(zhì)量量表與Zung氏焦慮及抑郁量表評分分析:三組患者治療前、治療2周后、治療4周后焦慮抑郁量表評分無明顯變化(P0.05)。與治療前相比,A、B兩組生活質(zhì)量量表評分在經(jīng)過4周治療后,亦無明顯改變(P0.05),而C組患者在治療4周末的SF-36評分有一定程度的升高,其差異具有顯著性(P0.05)。3.患者胃容受性分析:三組組內(nèi)之間進行比較,相比于治療前,治療后患者的閾值飲入量有明顯的增大(P0.05),最大飲入量變化沒有統(tǒng)計學意義(P0.05)。三組組間進行比較,治療4周后,C組的閾值飲入量較A、B兩組有明顯的增大(P0.05)。4.胃電圖指標分析:與治療前相比,治療2周后三組患者的胃慢波比例無明顯變化,餐后/餐前主功比有不同程度的上升,其中A、B兩組的餐后/餐前主功比的差異無顯著性(P0.05),而C組餐后/餐前主功比的差異卻有顯著性意義(P0.05);與治療前比較,治療4周后三組患者胃慢波比例仍無明顯變化,但餐后/餐前主功比明顯升高,其中A、B組P0.05,C組P0.01。5.心率變異性分析:與治療前相比,C組患者治療2周后HF有一定升高,LF/HF有所下降(P0.05),治療4周后HF明顯升高,LF/HF明顯下降(P0.01)。結論TEA聯(lián)合EA的治療方法能減輕餐后不適綜合征型FD患者的臨床癥狀,改善其生活質(zhì)量,通過刺激迷走神經(jīng)活性,調(diào)節(jié)胃電節(jié)律,增加胃容受性而起到治療FD的目的。
[Abstract]:Objective to observe the clinical efficacy of body surface electrical stimulation (tea) combined with electroacupuncture (EA) in the treatment of postprandial discomfort syndrome (FD), to establish a scientific and effective clinical method for FD, and to explore its possible mechanism.That is to say, EA treatment twice a week should also be performed once a day in the morning and evening, and every time the pseudo-#en0# therapy of 45min plus tea combined with EA group C) should be treated with EA combined with TEA, that is, EA treatment twice a week should also be performed once a day in the morning and evening at the same time.Each time 45min was treated with TEA.The total course of treatment was 4 weeks and the study was followed up for 3 times (before the beginning of treatment, at the 2nd week of treatment and at the end of 4th week respectively).The symptoms of dyspepsia, the quality of life questionnaire (QOL) and SF-36 / Zung's anxiety and depression scale were measured. The gastric receptivity was evaluated by the liquid feeding test, and the gastric electric rhythm and vagus nerve activity were analyzed by electrogastrogram (EGG) and heart rate variability (HRV).Result 1.After 2 weeks of treatment and 4 weeks of treatment, the total score of dyspepsia and the scores of fullness after meal, early satiety, and single symptom score of belching were all decreased in group C, compared with those before treatment.The differences were statistically significant (P 0.05).After 4 weeks of treatment, the total score of dyspeptic symptoms and the scores of post-meal fullness, early satiety and belching were more obvious in group C than those in group A and B, and the difference was significant (P0.05. 2).Quality of life scale and Zung's anxiety and depression scale score: before treatment, 2 weeks after treatment, and 4 weeks after treatment, the scores of anxiety and depression scale had no significant change (P 0.05).After 4 weeks of treatment, there was no significant change in the scores of quality of life scale (QOL) between group A and group B, while the SF-36 score of group C increased to some extent at the end of 4 weeks of treatment, and the difference was significant (P 0.05 / 3).Analysis of gastric receptivity: compared with before treatment, the threshold drinking volume of patients increased significantly after treatment (P 0.05), and the change of maximum intake was not statistically significant (P 0.05).After 4 weeks of treatment, the threshold drinking volume in group C was significantly higher than that in group A and B (P 0.05. 4).Analysis of electrogastrogram: compared with before treatment, there was no significant change in the proportion of slow wave in stomach of the three groups after 2 weeks of treatment, and the ratio of principal work to main work before meal increased to some extent.There was no significant difference in postprandial / preprandial principal work ratio between group A and B, but there was significant difference between group C and group C in postprandial / preprandial ratio.But the postprandial / preprandial principal work ratio was significantly increased, among which P0.05C group P0.01.5.Heart rate variability (HRV): compared with that before treatment, HF in group C increased after 2 weeks of treatment and decreased after 2 weeks of treatment. After 4 weeks of treatment, HF increased significantly and decreased significantly in group C (P 0.01).Conclusion TEA combined with EA can relieve the clinical symptoms and improve the quality of life of FD patients with postprandial discomfort syndrome. It can be used to treat FD by stimulating vagus nerve activity, regulating gastric electric rhythm and increasing gastric receptivity.
【學位授予單位】：湖北中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R259

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