Observation on clinical effect of tuina plus Western medication for functional dyspepsia due to liver qi stagnation and spleen deficiency

Objective

To observe the clinical effects of tuina plus Western medication for functional dyspepsia (FD) due to liver qi stagnation and spleen deficiency.

Methods

total of 72 patients in conformity with the inclusion criteria of FD were randomly divided into an observation group and a control group based upon the random number table, 36 cases in each group. The control group was treated with mosapride citrate dispersible tablets, and the observation group was treated with the same tablets plus tuina. Before the treatment and 4 weeks after the treatment, the clinical symptoms, quality of life (QOL) and depression severity were observed by the scale, and were followed up two months later after the treatment for assessment of the clinical effects.

Results

After the treatment and at the follow-up, the symptom scores of FD and the sores of Hamilton depression rating scale (HAMD) in both groups decreased, and the scores in Chinese version of quality of life questionnaire for functional digestive disorders (Chin-FDDQL) increased, with statistically significant differences in comparison with the same group before the treatment (all P<0.05). In comparison between the two groups at the same time point after the treatment, the scores of FD symptoms, HAMD and Chin-FDDQL were improved better in the observation group than those in the control group, with statistically significant differences (all P<0.05). The total effective rates at the follow-up were 91.7% in the observation group and 75.0% in the control group, without statistical difference between the two groups (P>0.05). The rate of clinical cure and remarkable effect was 66.7% in the observation group, higher than 41.7% in the control group, it is higher in the observation group than that in the control group, with a statistically significant difference between the two groups (P<0.05).

Conclusion

Tuina plus Western medication is precise in the therapeutic effects for FD due to liver qi stagnation and spleen deficiency and can effectively relieve clinical symptoms, elevate the QOL and alleviate depression severity of the patients. Moreover, it’s better than the treatment by Western medication alone in the long-term therapeutic effects.

     

不同灸量隔姜灸对脾虚证大鼠三叶因子1、粘蛋白5AC及表皮生长因子受体的影响（英文）

目的:观察不同灸量隔姜灸对脾虚证大鼠血清三叶因子1(TFF1)和粘蛋白5AC(MUC5AC)含量,以及胃黏膜表皮生长因子受体(EGFR)蛋白表达的影响,探讨隔姜灸治疗脾虚证的可能作用机制及量效特征。方法:将75只SPF级Sprague-Dawley(SD)大鼠按随机数字表法分为空白对照组(A组)、模型组(B组)、隔姜灸3壮组(C1组)、隔姜灸6壮组(C2组)和隔姜灸9壮组(C3组),每组15只。除A组外,其余各组大鼠采用200%的大黄浓缩液4℃灌胃制作脾虚证大鼠模型。造模成功后,B组大鼠不予治疗;C1、C2和C3组大鼠分别接受3壮、6壮和9壮隔姜灸足三里和中脘治疗,连续治疗8 d。观察大鼠一般症状评分,采用酶联免疫吸附法(ELISA)检测血清中TFF1和MUC5AC含量;免疫组化法检测胃黏膜EGFR蛋白表达。结果:干预结束后,与A组比较,B组大鼠脾虚症状积分增高,C1、C2和C3组大鼠血清TFF1、MUC5AC含量及胃组织EGFR蛋白表达明显升高(均P0.01);与B组比较,C1、C2和C3组大鼠脾虚症状积分降低,血清TFF1、MUC5AC含量及胃组织EGFR蛋白表达升高(均P0.01);与C1组比较,C2和C3组大鼠脾虚症状积分降低,血清TFF1、MUC5AC含量及胃组织EGFR蛋白表达升高(均P0.01),但C2组与C3组差异无统计学意义(均P0.05)。结论:隔姜灸能改善大鼠脾虚症状,促进脾虚证大鼠胃黏膜的增殖修复,其作用机制可能与提高血清TFF1和MUC5AC含量,激活EGFR蛋白的表达相关,且灸9壮和6壮的疗效优于灸3壮,但灸9壮和灸6壮的效果相当。     

申时针刺对缺血性中风偏瘫患者运动功能的影响

目的观察申时针刺对缺血性中风偏瘫患者运动功能的影响。方法将50例缺血性中风偏瘫患者按随机数字表法分为治疗组(申时针刺)和对照组(非申时针刺),每组25例。治疗组给予基础治疗、康复训练和申时(下午3~5时)针刺治疗,对照组给予基础治疗、康复训练和非申时针刺治疗。观察两组CSS评分、BI指数评分及FMA评分的变化,进行比较分析。结果治疗后两组CSS评分均下降(P0.01),BI指数评分、FMA评分均升高(P0.01),组间比较差异无统计学意义(P0.05)。结论申时和非申时针刺均能改善缺血性中风偏瘫患者的神经功能、肢体功能及日常生活能力。     

针灸治疗缺血性中风偏瘫30例疗效观察

目的:观察针灸治疗缺血性中风偏瘫的临床疗效. 方法:将60例本病患者随机分为治疗组和对照组各30例,对照组予西医基础治疗和常规针刺,治疗组在对照组治疗的基础上加灸关元、中脘,观察并比较两组临床疗效、CSS评分及Barthel指数评分.结果:总有效率治疗组为86.67％,对照组为63.33％,两组比较,有显著性差异(P＜0.05);两组治疗前后CSS评分及Barthel指数比较均具有统计学意义(P＜0.05). 结论:针灸治疗缺血性中风偏瘫疗效确切,并能促进肢体神经功能恢复,提高患者生活质量.     

不同灸量隔姜灸对脾虚证大鼠胃组织丝裂原细胞外激酶和细胞外调节蛋白激酶表达的影响

目的观察不同灸量隔姜灸对脾虚证大鼠胃组织丝裂原细胞外激酶(MEK)1/2和细胞外调节蛋白激酶(ERK)1/2表达的影响,探讨隔姜灸治疗脾虚证的可能作用机制及量效特征。方法将75只SD大鼠按随机数字表法分为空白对照组、模型组、隔姜灸3壮组、隔姜灸6壮组、隔姜灸9壮组,每组15只。200%大黄浓缩液4℃灌胃制作脾虚证大鼠模型。造模成功后,隔姜灸组选取"足三里""中脘"予不同灸量治疗,连续8 d。HE染色镜下观察大鼠胃组织病理学改变,免疫组化检测大鼠胃组织MEK1/2及ERK1/2的蛋白表达。结果与空白对照组比较,模型组大鼠胃黏膜损伤明显,可见较大的破损、脱落;与模型组比较,隔姜灸3壮组大鼠胃黏膜表面有部分脱落、破损情况改善,隔姜灸6壮组和隔姜灸9壮组大鼠胃黏膜表面较完整、脱落及破损明显改善。与空白对照组比较,模型组胃组织MEK1/2及ERK1/2蛋白表达明显升高(P0.01);与模型组比较,隔姜灸各组胃组织MEK1/2及ERK1/2蛋白明显表达升高(P0.01);与隔姜灸3壮组比较,隔姜灸6壮组和隔姜灸9壮组胃组织MEK1/2及ERK1/2蛋白表达明显升高(P0.01),但二者作用效果相当,差异无统计学意义(P0.05)。结论隔姜灸通过提高胃组织MEK1/2及ERK1/2的蛋白表达,激活MEK/ERK信号转导通路,进而促进脾虚证大鼠胃黏膜的修复。     

Effects of different doses of ginger-partitioned moxibustion on trefoil factor 1, mucin 5AC and epidermal growth factor receptor in rats with spleen deficiency syndrome

Objective

To observe the effects of different doses of ginger-partitioned moxibustion on serum trefoil factor 1 (TFF1) and mucin 5AC (MUC5AC) levels, as well as the expression of epidermal growth factor receptor (EGFR) in gastric mucosa of rats with spleen deficiency syndrome, therefore, to explore the possible mechanism and the dose-effect characteristics of ginger-partitioned moxibustion in spleen deficiency syndrome.

Methods

Seventy-five SPF grade Sprague-Dawley (SD) rats were randomly divided into a blank control group (group A), a model group (group B), a 3 moxa-cone ginger-partitioned moxibustion group (group C1), a 6 moxa-cone ginger-partitioned moxibustion group (group C2) and a 9 moxa-cone ginger-partitioned moxibustion group (group C3) using random number table method, 15 rats in each group. Except group A, rats in the other groups received intragastric administration of 4 °C 200% concentrated Da Huang (Radix et Rhizoma Rhei) to prepare spleen deficiency syndrome model. After successful modeling, rats in group B received no treatment; rats in group C1, C2 and C3 were treated with 3, 6 and 9 moxa-cone ginger-partitioned moxibustion at Zusanli (ST 36) and Zhongwan (CV 12) respectively for 8 continuous days. The general symptom score of rats was observed. The serum levels of TFF1 and MUC5AC were detected by enzyme-linked immunosorbent assay (ELISA). The expression of EGFR protein in gastric mucosa was detected by immunohistochemistry.

Results

After the treatment, compared with group A, the spleen deficiency symptom score was increased in group B, the levels of serum TFF1 and MUC5AC, the EGFR protein expression in gastric tissues of group C1, C2 and C3 were significantly increased (all P<0.01); compared with group B, the spleen deficiency scores were decreased in group C1, C2 and C3, and the serum levels of TFF1 and MUC5AC, as well as EGFR protein expression in gastric tissues were increased (all P<0.01). Compared with group C1, the spleen deficiency scores were decreased in group C2 and C3, the serum levels of TFF1 and MUC5AC, and the expression of EGFR protein in gastric tissues were increased (all P<0.01), however, there was no significant difference between group C2 and C3 (all P>0.05). The mechanism may be related to the increase of serum TFF1 and MUC5AC levels and activation of EGFR protein.

Conclusion

Ginger-partitioned moxibustion can improve the symptoms, as well as promote the proliferation and repair of gastric mucosa in rats with spleen deficiency. The therapeutic efficacy of 6 or 9 moxa-cone ginger-partitioned moxibustion is better than that of 3 moxa-cone ginger-partitioned moxibustion, while the efficacies are equivalent between 6 and 9 moxa-cone ginger-partitioned moxibustion groups.