针灸治疗慢性萎缩性胃炎36例临床观察

目的 :观察针灸结合治疗慢性萎缩性胃炎的临床疗效。方法 :慢性萎缩性胃炎患者 3 6例 ,按中医辨证 ,分型施以针灸治疗。治疗前及治疗后均进行胃镜、体表胃电图、胃酸和胃蛋白酶血中胃泌素、血中前列腺素E及胃粘膜胃泌素细胞等理化指标检查。结果 :针灸治疗本病有较好的效果 ,显效好转率达 97.2 3 % ,临床症状消失率达 97.0 2 %。治疗后可使患者血中前列腺素E等防御性因子增强 ,使患者从胃内低酸转向正常状态 ,胃动力功能增强 ,胃电图幅值回升 ,并可促使胃泌素释放 ,有利于胃酸的分泌。此外 ,针灸治疗后G细胞数目和形态及胃镜组织活检病理结果也基本恢复至正常状态。结论 :针灸治疗萎缩性胃炎简便经济 ,无副作用 ,见效快 ,疗效肯定 ,可重复性强 ,具有一定的临床意义

Clinical Observation on Acupuncture Treatment of 36 Cases of Chronic Atrophic Gastritis

Objective: To observe the therapeutic effect of acupuncture therapy for treatment of chronic atrophic gastritis and to analyze its action mechanisms. Methods: According to the theory of TCM, 36 cases of chronic atrophic gastritis were divided into ①Deficiency of the spleen and stomach, Qi and blood stagnation,②Disharmony of the liver and stomach, depressed fire and dry heat,③Stomach Yin deficiency, blood stagnation in collateral, and ④Spleen deficiency and liver Qi stagnation, failure of descending of the stomach qi. Gastroscopy and electrogastrograph (EGG) of the body surface are recorded for examining changes of the gastric structure and functional activities after acupuncture treatment. The observed indexes: gastric acid and pepsin, blood gastrin, blood prostaglandin E (PGE), gastric mucosal cells and G cells. Main acupoints used were Pishu (BL 20), Weishu (BL 21), Geshu (BL 17), Zhongwan (CV 12), Zhangmen (LR 13), Neiguan (PC 6), Zusanli (ST 36) and Xuehai (SP 10). They were punctured and moxibustioned.Results:① Acupuncture therapy had a better effect in improving clinical symptoms, the markedly effective rate was 97.23% and the disappearing rate of clinical manifestations 97.02%; ②After the acupuncture treatment, the output of gastric acid and gastric pepsin reduced by 78% and 52% respectively in comparison with that of pre treatment ( P <0.01), while blood PGE concentration increased by 39% ( P <0.01).③After acupuncture, the gastric acid secretion increased by 92% ( P <0.01).④After acupuncture treatment, the gastric dynamics was enhanced and the amplitude of EGG raised by 45% ( P <0.05). ⑤Acupuncture could significantly facilitate secretion of gastrin (increasing by 56%).⑥Immunofluorescence technique showed that the abnormal number and structure of the antral mucosa gastrin cells G of epigastralgia patients became normal again after the acupuncture treatment. ⑦The EGG patterns of chronic atrophic gastritis patients were different in patients with different syndromes. In deficient type atrophic gastritis patients, the amplitude values of EGG were lower than those of normal people, and higher in excess type patients, while those of EGG of the mixed type of deficiency and excess patients were between the above mentioned 2 types, but the individual differences were significant. The patients in the present study belonged to the compound deficiency and excess type (with the deficiency being predominant), therefore, after acupuncture treatment, the amplitude of EEG was decreased in most of the cases. The acupuncture treatment could help it become normal. ⑧After acupuncture treatment, the glands were increased in the number, the mucosa became thicker and the muscular layer of the mucosa became thinner, blood vessels increased as well, and intestinal metaplasia or non typical hyperplasia disappeared; the color of mucosa became red or partially congested; the granular tuberosity disappeared and it bled easily during the biopsy examination.Conclusion: Acupuncture is a convenient treatment method for atrophic gastritis with quick effect and without side effects.