發(fā)布時(shí)間：2018-08-11 13:28

【摘要】：目的:觀察針灸結(jié)合整脊治療非糜爛性反流病(Non-erosive Relux Disease,NERD)的臨床有效性,探討其理論依據(jù),以便更好地在臨床上推廣。方法:將60例非糜爛性反流病患者隨機(jī)分為治療組、對(duì)照組,每組各患者30例。治療組采用針灸配合整脊治療,對(duì)照組使用單純針灸治療。兩組治療取穴:督脈經(jīng)陽性反應(yīng)點(diǎn),至陽,靈臺(tái),神道,大椎,百會(huì),每2天治療一次,一周3次,每次留針30min,觀察周期為6周。以RDQ、胃食管反流病生活質(zhì)量自評(píng)量表、SAS、SDS、GerdQ量表為評(píng)價(jià)指標(biāo),進(jìn)行治療前與治療后、組間與組內(nèi)臨床療效的比較。結(jié)果:1.經(jīng)治療后,兩組患者RDQ、GerdQ積分均較前降低,其燒心、反酸、胸痛及反食的發(fā)作頻次在治療前后有顯著差異(P0.05),說明兩組治療NERD均有療效;治療組治療后量表評(píng)分與對(duì)照組相比有明顯差異(P0.05),說明治療組更優(yōu)于對(duì)照組。2.治療后,兩組SAS、SDS、GERD-HRQL量表評(píng)分均顯著降低(P0.05),治療組治療后量表評(píng)分明顯低于對(duì)照組(P0.05),說明針灸結(jié)合整脊與單純針灸相比,更能改善NERD患者的焦慮、抑郁狀態(tài)和生活質(zhì)量的影響。3.經(jīng)治療后,治療組總有效率為93.33%,對(duì)照組總有效率為83.33%,P=0.2280.05,兩組無統(tǒng)計(jì)學(xué)差異;治療組愈顯率56.67%,對(duì)照組愈顯率26.67%,P=0.0090.05,有顯著差別。說明兩組在治療NERD有效率方面無明顯差別,但治療組愈顯率優(yōu)于對(duì)照組4.療程結(jié)束1月后隨訪,兩組復(fù)發(fā)率相比P=0.0150.05,差異有統(tǒng)計(jì)學(xué)意義,說明針灸結(jié)合整脊治療NERD遠(yuǎn)期療效優(yōu)于單純針灸。結(jié)論:針灸結(jié)合整脊治療非糜爛性反流病療效確切,優(yōu)于單純針刺治療。針刺結(jié)合整脊能激發(fā)督脈陽氣,不僅對(duì)NERD患者的反酸、燒心、非心源性胸痛、反食等臨床癥狀有很好的療效,而且對(duì)于改善患者的焦慮,抑郁狀態(tài)以及生活質(zhì)量也有明顯作用。值得在臨床上推廣和應(yīng)用。
[Abstract]:Objective: to observe the clinical efficacy of acupuncture and moxibustion combined with chiropractic in the treatment of non erosive reflux disease (Non-erosive Relux disease). Methods: 60 patients with non erosive reflux disease were randomly divided into treatment group and control group with 30 cases in each group. The treatment group was treated with acupuncture plus chiropractic therapy, while the control group was treated with simple acupuncture and moxibustion. Two groups of treatment points: du meridian positive reaction point, to Yang, Lingtai, Shinto, Dazhui, Baihui, once every 2 days, 3 times a week, 30 mins each time, observation period is 6 weeks. The quality of life (QOL) of gastroesophageal reflux disease (GERD) was compared with that of the group before and after the treatment. The result is 1: 1. After treatment, the scores of RDQN GerdQ in the two groups were lower than those in the previous group. The frequency of heartburn, acid regurgitation, chest pain and food regurgitation were significantly different between the two groups before and after treatment (P0.05), indicating that the two groups were effective in the treatment of NERD. There was significant difference in the scale scores between the treatment group and the control group (P0.05), indicating that the treatment group is better than the control group. 2. After treatment, the scores of GERD-HRQL in both groups were significantly decreased (P0.05), and the scores of GERD-HRQL in the treatment group were significantly lower than those in the control group (P0.05), indicating that acupuncture combined with chiropractic could improve the anxiety, depression and quality of life of NERD patients better than that of acupuncture alone (P0.05). After treatment, the total effective rate of the treatment group was 93.33 and the total effective rate of the control group was 83.33. The total effective rate of the treatment group was 83.33 and the total effective rate of the control group was 83.33. There was no statistical difference between the two groups, and there was significant difference between the treatment group and the control group. The results showed that there was no significant difference in the effective rate of NERD between the two groups, but the curative effect rate of the treatment group was better than that of the control group. At the end of one month follow-up, the recurrence rate of the two groups was 0.0150.05, the difference was statistically significant, indicating that the long-term effect of acupuncture combined with chiropractic therapy on NERD was better than that of pure acupuncture. Conclusion: acupuncture combined with chiropractic therapy is more effective than acupuncture alone in the treatment of non-erosive reflux disease. Acupuncture combined with chiropractic can stimulate the Yangqi of du pulse. It not only has a good effect on the clinical symptoms of NERD patients, such as acid regurgitation, heart-burning, non-cardiogenic chest pain and reverse eating, but also has obvious effect on improving the anxiety, depression and quality of life of the patients. It is worth popularizing and applying in clinic.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R246.1

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