针刺督脉背段治疗胃食管反流病的临床研究

目的:观察针刺督脉背部T3-T9段棘突下治疗胃食管反流病(GERD)的临床疗效。方法:60例GERD患者按就诊顺序随机分为针刺组和西药组,各30例。针刺组针刺督脉背段T3-T9段棘突下(含穴位及非穴位),隔日1次,每周3次,共治疗8周。西药组予奥美拉唑肠溶胶囊口服,每次20mg,每日2次,共治疗8周。两组治疗前后进行反流性疾病诊断问卷评分(RDQ)和GERD症状程度评分并评价疗效。结果:两组治疗后RDQ和GERD症状程度评分较治疗前均改善(P0.05),针刺组治疗后RDQ和GERD症状程度评分均显著低于西药组(P0.05),针刺组RDQ愈显率为70.0%(21/30),GERD症状程度评分总有效率为93.3%(28/30),西药组分别为43.3%(13/30)和66.7%(20/30),针刺组均优于西药组(P0.05)。结论:针刺督脉背段T3-T9段棘突下治疗GERD安全有效。     

针刺对围绝经期失眠患者内分泌轴的影响:病例系列研究（英文）

目的:探究针刺对围绝经期失眠患者的临床疗效及其对下丘脑-垂体-肾上腺轴(HPA)以及下丘脑-垂体-卵巢轴(HPOA)的影响。方法:对42例围绝经期失眠患者行针刺治疗,针刺时患者取俯卧位,穴位选取百会、四神聪、风府、安眠、神道、肝俞、脾俞、肾俞、神门、三阴交,隔日针灸一次,每周三次,每次留针30 min,共治疗4周。于治疗前后分别评估患者匹兹堡睡眠质量指数(PSQI)评分,HPA相关指标及HPOA相关指标。结果:治疗后患者PSQI评分低于治疗前,各分项评分如主观睡眠质量、入睡潜伏期、睡眠持续性、习惯性睡眠效率、睡眠紊乱、催眠药物使用、日间功能紊乱评分均低于治疗前,HPA相关激素指标均较前下降,HPOA相关激素指标均较前下降,E₂较前升高,以上结果均具有统计学意义(all P<0.05)。结论:针刺能改善围绝经期失眠患者的临床症状及激素指标,安全性高,值得临床推广应用。     

针刺督脉背段T3~T12棘突下治疗胃食管反流性胸痛临床研究

目的:研究胃食管反流性胸痛的患者针刺督脉背段T 3~T 12棘突下穴位及非穴位前后压痛变化规律,并观察其疗效。方法:根据纳入标准收集60例胃食管反流性胸痛患者,按照随机数字表法分为针刺组30例、西药组30例。针刺组予针刺督脉背段T 3~T 12棘突下穴位及非穴位治疗,隔日1次,西药组予雷贝拉唑钠肠溶胶囊口服,每次20 mg,1日两次,治疗疗程为8周。比较两组患者胃食管反流病问卷(RDQ)评分以及其中的胸痛评分在治疗前后的变化情况,比较T 3~T 12棘突下穴位及非穴位压痛阈值的变化情况,观察两组患者在治疗前后的临床疗效。结果:①治疗后针刺组与西药组RDQ评分以及其中的胸痛评分较治疗前均有明显改善(P<0.01),且针刺组较西药组改善更为明显(P<0.01);②西药组治疗后T 4、T 5、T 7、T 8、T 9棘突下的压痛阈值较治疗前降低(P<0.05或P<0.01),针刺组治疗后T 5~T 12棘突下的压痛阈值较治疗前明显提高(P<0.05或P<0.01),治疗后针刺组与西药组进行比较,针刺组在T 6~T 9棘突下的穴位压痛阈值高于西药组较明显(P<0.05);③针刺组愈显率为76.67%(23/30),西药组为30.00%(9/30),临床疗效针刺组优于西药组(P<0.01)。结论:针刺督脉背段T 3~T 12棘突下穴位及非穴位治疗胃食管反流性胸痛较西药雷贝拉唑钠肠溶胶囊更优,可以明显减轻胸痛程度。     

中西医结合治疗对胃食管反流病食道动力及酸反流的影响

目的: 探讨气滞胃痛颗粒和木香顺气丸联合奥美拉唑镁肠溶片及盐酸伊托必利片的治疗对胃食管反流病(GERD)食道动力及酸反流的影响. 方法: 90例GERD患者采用随机按数字表法分为西药组和观察组各45例.西药组服用奥美拉唑镁肠溶片,20 mg/次,早、晚各1次;盐酸伊托必利片,50 mg/次,3次/d.观察组在西药组治疗的基础上加服气滞胃痛颗粒,5 g/次,3次/d;木香顺气丸,6 g/次,3次/d.两组疗程均为8周.进行治疗前后反流性疾病问卷(RDQ)量表评分;进行治疗前后食管测压和24 h食管pH监测. 结果: 治疗后两组上食管括约肌(UES)和下食管括约肌(LES)静息压较治疗前增高,观察组增高更为显著(P<0.01),两组湿咽成功率较治疗前提高,观察组高于西药组(P<0.01);观察组酸反流总次数、酸反流>5 min的次数、总计pH<4的百分比、卧位pH<4的百分比、最长反流时间和DeMeester评分均较治疗前减少(P<0.01),治疗后观察组酸反流总次数和DeMeester评分少于西药组(P<0.01);观察组反流性疾病问卷(RDQ)量表烧心、反流、非心源性胸痛、反酸评分及总分均低于西药组(P<0.01). 结论: 中西医结合治疗能增强食管体部蠕动功能、改善食道动力及减少酸反流,从而减轻GERD临床症状,疗效优于单纯的西医治疗.     

督灸联合走罐治疗过敏性鼻炎28例（英文）

目的:观察督灸联合走罐治疗过敏性鼻炎的临床疗效。方法:选取符合纳入标准的28例过敏性鼻炎患者。先于患者背部行走罐治疗,然后行督灸治疗,治疗6次后对患者症状、体征变化情况进行疗效评定。结果:显效14例,有效12例,无效2例,总有效率达92.86%。结论:督灸联合走罐疗法可有效治疗过敏性鼻炎,值得临床借鉴。     

和胃降逆汤加减治疗胃食管反流病64例

目的:观察和胃降逆汤加减治疗胃食管反流病(GERD)(肝胃郁热证)的近期和远期疗效及对生活质量的影响。方法:随机按数字表法将128例GERD患者分为西药组和观察组各64例。西药组服用奥美拉唑镁肠溶片,20 mg/次,早、晚各1次;枸橼酸莫沙必利片,5 mg/次,3次/d。观察组服用奥美拉唑镁肠溶片同西药组,并采用和胃降逆汤加减治疗,1剂/d。两组疗程均为8周。进行治疗前后肝胃郁热证评分、食管黏膜内镜和反流性疾病问卷(RDQ)量表及生活质量评价;对痊愈患者进行6个月的随访观察,计算复发率及复发时食管黏膜内镜评分。结果:观察组中医证候疗效总有效率为93.75%,优于西药组的81.25%(P<0.05);观察组胃镜下炎症疗效总有效率为90.62%,优于西药组的75.0%(P<0.05);观察组治疗后肝胃郁热证评分、食管黏膜内镜评分和RDQ量表评分均低于西药组(P<0.01);治疗后观察组SF-36健康量表除身体疼痛维度外其他维度评分均高于西药组(P<0.01);随访6个月,观察组复发率为23.5%低于西药组的64%,观察组复发时食管黏膜内镜评分也低于西药组(P<0.01)。结论:在质子泵抑制剂治疗的基础,和胃降逆汤加减能减轻GERD(肝胃郁热证)近期症状,提高治愈率,提高患者生活质量,并能降低远期复发率。     

Treatment of insomnia in suboptimal health status with Zhuang medicine herbal-thread moxibustion: A randomized clinical trial 壮医药线点灸疗法治疗亚健康失眠的疗效观察-随机临床研究

ObjectiveThe objective of this study is to explore the clinical effect and safety of Zhuang medicine herbal-thread moxibustion therapy for the treatment of suboptimal health status-related insomnia through a randomized clinical trial.MethodsA total number of 60 patients with insomnia of suboptimal health status (SHS) were enrolled from the Clinic of Zhuang Medicine, Renai Branch of the First Affiliated Hospital of Guangxi University of Chinese Medicine and the Clinic of Zhuang Medicine, the First Affiliated Hospital of Guangxi University of Chinese Medicine, as well as Guangxi University of Chinese Medicine. According to the random number table method, they were randomized into a Zhuang medicine herbal-thread moxibustion therapy group (30 patients) and a western medication group (30 partients).The outcome assessors were blinded for patients allocation. In the herbal-thread moxibustion group, Zhuang medicine herbal-thread moxibustion therapy was provided once daily. In the western medication group, alprazolam tablets were prescribed for oral administration once daily. One course consisted of 10 treatments. After three consecutive courses of treatment, the score of the Pittsburgh sleep quality index (PSQI) was compared between groups, and both clinical effect and safety were assessed.ResultsSixty eligible patients were enrolled, and thirty were assigned to each group and included in the data analysis. After treatment, the score of each PSQI indicator (sleep latency, sleep duration, sleep efficiency, sleep disturbance, and daytime dysfunction) and total PSQI score were compared with those before treatment in both groups (all changes were statistically significant when P < 0.05). Scores in the herbal-thread moxibustion group were superior to those in the western medication group (all values were statistically significant at P < 0.05). The total effective rate was 93.3% in the herbal-thread moxibustion group and 80.0% in the western medication group (P < 0.05). During treatment, no adverse reactions were reported in the herbal-thread moxibustion group. In the western medication group, three patients reported dizziness and headache, and one patient reported dry mouth, the incidence of adverse reactions was 13.3%.ConclusionThe Zhuang medicine herbal-thread moxibustion therapy is a safe and effective management strategy for the clinical symptoms of suboptimal health status-related insomnia.     

通督调神针法配合中医护理对脑卒中后睡眠障碍的影响

目的:观察通督调神针法配合护理干预对脑卒中后睡眠障碍患者的影响。方法:将脑卒中后睡眠障碍患者76例分为对照组和治疗组各38例。对照组服用艾司唑仑改善睡眠,治疗组采用通督调神针法并配合护理干预。采用匹兹堡睡眠质量指数量表(PSQI)评定睡眠质量,并观察临床疗效。结果:治疗后2组患者PSQI评分比较差异有统计学意义(P0.05)。治疗组患者PSQI中的7个评分项目数值较对照组有所下降(P0.05)。结论:通督调神针法配合中医护理干预可有效改善脑卒中后患者睡眠障碍。     

手捻针干预重症抑郁障碍共病失眠:证据来自多导睡眠图及血清生物标志物

ObjectiveThis study is conducted to determine effects of manual acupuncture (MA) in patients with a diagnosis of major depressive disorder (MDD) and comorbid insomnia.MethodsA total of 67 participants who met the inclusion criteria were randomly enrolled in a two-arm randomized, placebo controlled, patients-blind trial and allocated to a real-MA group (patients = 34) and a sham-MA group (patients = 33). Patients in the real-MA group were treated on ‘Five-shen acupoints’, including Sìshéncōng (四神聪 EX-HN 1), Shéntíng (神庭 GV 24), Shéndào (神道 GV 11), bilateral Běnshén (本神 GB 13), and bilateral Shénmén (神门 HT 7). Though being punctured on the same acupoints, patients in the sham-MA group were treated by a placebo acupuncture approach (Streitberger Placebo-needle). Each group received corresponding interventions every other day, three times a week for total eight weeks. Both polysomnography (PSG) and testing of serum biological markers such as neuropeptide Y (NPY) and substance P (SP) were performed at pre- and post-treatment. Additionally, the global scores of Pittsburgh sleep quality index (PSQI) and the global scores of 17-items Hamilton Depression Rating Scale (HAMD17) were used for assessing the subjective sleep and emotion experience of patients, respectively. Meanwhile, adverse effects were monitored and recorded.ResultsAfter eight-week treatment, the global scores of PSQI and global scores of HAMD17 declined significantly (both P < 0.05) in the real-MA group but not in the sham-MA group (both P > 0.05). According to the parameters of PSG, striking decline were observed in sleep latency (SL) and wake after sleep onset (WASO) and striking climb were observed in total sleep time (TST) and sleep efficiency (SE) in the real-MA group after treatment (P < 0.05, respectively) but not in the sham-MA group (P > 0.05, respectively). Additionally, there were no significant differences in awakening times (ATs) and rapid eyes movement sleep latency (REM-SL) in both two groups after treatment (both P > 0.05). Meanwhile, the expression of NPY increased significantly and the expression of SP decreased significantly in the real-MA group after interventions (both P < 0.05) while those indicators only slightly fluctuated in the sham-MA group (P > 0.05). No serious adverse event was reported in either real- or sham- MA group.Conclusion(1) MA may be a potential alternative therapy for improving MDD and comorbid insomnia (particularly in extending total sleep time and shortening wake-up duration and sleep latency) via upregulating the expression of NPY and downregulating the expression of SP; more importantly, this efficacy of acupuncture can not be replaced by sham-acupuncture acting on the same acupoints with the same treatment frequency. (2) There is insufficient evidence to prove that MA can effectively reduce the number of arousals.