针刺胃食管反流病人督脉背段压痛变化的临床观察

目的 观察针刺胃食管反流病（GERD）患者督脉背段第3~9胸椎棘突下的压痛变化及其临床意义。方法 将60例GERD患者，随机分为针刺组和西药组，每组30例。针刺组取T₃（身柱）、T₄（非穴位）、T₅（神道）、T₆（灵台）、T₇（至阳）、T₈（非穴位）、T₉（筋缩），隔日治疗1次，1周3次；西药组口服奥美拉唑肠溶胶囊，20mg/次，每日2次，疗程均为8周。2组在治疗前后填写反流性疾病诊断问卷（RDQ）并在T₃~T₉棘突下进行压痛程度评价和压痛阈值评估。结果 针刺组愈显率70%，对比西药组43.3%，差异有显著性意义（P＜0.05）；针刺组治疗后在T₃~T₉段的压痛程度缓解优于西药组（P＜0.05）；在T₅~T₇段的压痛阈值提高大于西药组（P＜0.05）。结论 针刺督脉背部T₃~T₉段棘突下治疗GERD的疗效优于西药组，并且针刺后的压痛阈值也比西药组显著升高，因此可以将督脉背段压痛作为评估针刺治疗GERD效果的指标。 

Clinical Observation on Changes of Pressing Pain Along Governor Vessel on the Back by Acupuncture in Patients with Gastroesophageal Reflux Disease

OBJECTIVE To observe changes of pressing pain along governor vessel on the back(below the spinous process from the 3rd cervical vertebra to the 9th cervical vertebra) in patients with gastro-esophageal reflux disease(GRED) after acupuncture treatment as well as its clinical meaning. METHODS 60 cases of GRED were randomly divided into acupuncture group and medication group， with 30 cases in each group. In the acupuncture group， such acupoints as Shenzhu(GV12)， Shendao(GV11)， Lingtai(GV10)， Zhiyang(GV9)， Jinsuo(GV8) and non-acupoints(T4， T8) were needled once every other day， three times a week. While those in the medication group were given Omeprazole(20mg/time) twice a day， with the treatment course lasting for eight weeks. Reflux disease questionnaires (RDQ) were answered in both groups before and after the treatment， then pain degree and pain threshold and pressing pain along governor vessel from T₃~T₉ were assessed. RESULTS The effect rate was 70% in acupuncture group and 43.3% in medication group with significant differences between the two groups (P<0.05). After treatment， the relief of pressing pain below the spinous processes from T3 to T9 in acupuncture group was better than that in medication group(P<0.05)， and the increasing of pain threshold from T5 to T7 in acupuncture group was much higher than that in medication group(P<0.05). CONCLUSION Acupuncture stimulation along governor vessel on the back is more effective than medication， and the pain threshold after acupuncture was significantly higher than medication. Therefore， the changes of pressing pain along governor vessel can be considered as an index to estimate the effect of treating GRED by acupuncture.