猴头健胃灵联合莫沙必利治疗老年人功能性消化不良的临床观察

目的探讨猴头健胃灵联合莫沙必利治疗老年人功能性消化不良(FD)的临床疗效。方法选择符合罗马Ⅲ诊断标准的老年人功能性消化不良患者100例,随机分为对照组50例和治疗组50例,对照组给予莫沙必利5 mg 3次/d口服,治疗组在对照组的基础上联用猴头健胃灵胶囊4粒日3次,疗程均为4周,观察两组患者用药后上腹痛、上腹烧灼感、腹胀、早饱症状改善程度。结果①两组在治疗4周后上腹痛、上腹烧灼感、腹胀、早饱评分以及症状总评分均下降,治疗组优于对照组,差异具有统计学意义(P0.05);②治疗组总有效率为92%,对照组总有效率为70%,治疗组明显优于对照组,P0.05。结论猴头健胃灵联合莫沙必利治疗老年人功能性消化不良可有效改善患者上腹痛、上腹烧灼感、腹胀、早饱临床症状,且不良反应少,安全性高,为临床治疗老年人功能性消化不良提供新的药物选择。     

针刺足少阳胆经穴对功能性消化不良患者脑葡萄代谢的影响

目的:观察针刺对功能性消化不良(functionaldyspepsia,FD)患者脑功能的影响,探讨针刺治疗FD的中枢机制.方法:以肝郁型FD患者为研究对象,以正电子发射计算机断层扫描技术为研究手段,以疏肝解郁常用的足少阳胆经穴为电针刺激点,观察针刺治疗FD患者的临床疗效及针刺前后患者脑葡萄糖代谢的变化.采用尼平消化不良指数(nepean dyspepsia index,NDI)评价针刺治疗效应,采用统计参数图软件分析针刺治疗前后患者脑功能的变化.结果:与治疗前相比,针刺治疗后患者NDI症状积分显著减低(32.30±13.17 vs 52.10±14.69),NDI生活质量评分显著增高(88.57±11.59 vs 75.45±17.52,P<0.05);患者双侧小脑、前扣带回、海马、海马旁回以及左侧脑岛等边缘系统脑区的葡萄糖代谢显著降低(P<0.005).结论:针刺足少阳胆经穴可以有效改善肝郁型FD患者临床症状,其治疗效应的发挥可能与改善FD患者边缘系统为主脑功能活动异常,调节与病情相关的脑岛、前扣带回和小脑功能有关.     

足阳明胃经经穴揿针治疗配合增强型体外反搏改善心衰患者食欲减退的疗效观察

目的 探讨足阳明胃经经穴揿针治疗配合增强型体外反搏在改善心衰患者食欲减退方面的疗效。方法 将80例研究对象按照随机数字表随机分为干预组与对照组,每组40例。对照组给予心衰的常规治疗护理措施包括常规的药物治疗、心理护理、饮食指导、体位指导、控制液体入量、社会支持及活动与休息等的指导。干预组在对照组的基础上给予足阳明胃经经穴揿针治疗配合增强型体外反搏,在入院后第2天遵医嘱进行揿针治疗配合增强型体外反搏。两组均干预7天,比较两组患者治疗前后临床症状评分,包括嗳气、早饱、腹胀、食欲下降及恶心等症状的评分及临床疗效。结果 两组患者临床症状评分包括嗳气、早饱、腹胀、食欲下降及恶心等症状的评分比较,干预组明显低于对照组(P<0.05),临床症状评分比较差异有统计学意义。两组患者临床疗效方面,干预组有效率为95%,对照组有效率为80%,干预组明显高于对照组(P<0.05),两组患者临床疗效比较差异有统计学意义。结论 足阳明胃经经穴揿针治疗配合增强型体外反搏在改善心衰患者食欲减退方面疗效显著,是一种安全、有效、患者依从性高的治疗方法,有助于提高患者的生活质量及预后,值得推广。     

针刺少阳经特定穴对偏头痛患者脑动脉血流速度的影响

目的 观察针刺手少阳三焦经和足少阳胆经特定穴对偏头痛患者脑血流速度的影响,并探讨其可能的作用机制.方法 将60例偏头痛患者随机分为两组,少阳经特定穴组30例,非经非穴组30例,均采取同样的针刺治疗方法,进行对照观察.在TCD的显示下,分别记录针刺前后的脑动脉血流速度.结果 针刺少阳经特定穴组的患者脑血流速度明显改善,而非经非穴对照组未见有明显改变,经统计学处理两组有统计学意义(P<0.05).结论 针刺少阳经特定穴对偏头痛患者的脑动脉血流速度有较好双向调节作用.     

伊托必利治疗功能性消化不良重叠便秘型肠易激综合征疗效观察

目的 观察伊托必利治疗功能性消化不良(FD)重叠便秘型肠易激综合征(C-IBS)患者的疗效.方法 将符合FD标准及重叠C-IBS患者分为FD治疗组(40例)、FD观察组(20例)、FD重叠C-IBS治疗组(40例)和FD重叠C-IBS观察组(20例),FD治疗组和FD重叠C-IBS治疗组均给予伊托必利100 rag/次,每日3次,疗程8周.观察并记录4组患者上腹饱胀、早饱、腹痛等症状及C-IBS患者便秘改善情况.FD治疗组和FD重叠C-IBS治疗组于治疗前及治疗后2周进行胃排空试验.结果 FD治疗组和FD重叠C-IBS治疗组患者腹痛、上腹饱胀、早饱等症状均有不同程度改善,其中FD重叠C-IBS治疗组改善程度更为明显,且排便情况亦有显著改善.B超监测胃排空显示,与观察组相比,FD治疗组和FD重叠C-IBS治疗组患者治疗后胃窦收缩幅度及胃排空时间均有显著改善(P<0.05).结论 伊托必利治疗FD有效,尤其是对FD重叠C-IBS治疗组的疗效优于FD治疗组.     

曲美布汀联合乌灵胶囊治疗功能性消化不良的疗效观察

目的观察曲美布汀联合乌灵胶囊治疗功能性消化不良(FD)的疗效。方法选取150例FD患者随机分为两组,观察组80例,给予曲美布汀胶囊及乌灵胶囊联合用药治疗;对照组70例,单用曲美布汀治疗。比较观察两组的上腹胀满、餐后饱胀、早饱等症状的变化情况。结果观察组的疗效优于对照组(P<0.01),总有效率(88.8%)也高于对照组(55.7%)(P<0.01)。两组患者均无严重的不良反应,两组不良反应发生率比较差异无统计学意义(P>0.05)。结论曲美布汀联合乌灵胶囊治疗FD疗效好、耐受性好,是一种可靠可行的治疗FD的方案。     

西沙必利、多潘立酮治疗功能性消化不良

目的观察维持量西沙必利、多活立酮治疗功能性消化不良（FD）长期疗效比较方法选择分别经西沙必利、多潘立酮治疗4wb，症状完全消失的FD40例及32例，其中，西沙必利组40例，男21例，女19例，年龄19岁～72岁，平均38岁，病程1mo—13a，平均27mo，动力障碍型19例，反流型4例，溃疡型10例，复合型7例多潘立酮组32例，男17例，女15例，年龄19岁～74岁，平均39岁，病程1mo—14a，平均26mo，动力障碍型16例，反流型3例，溃疡型9例，复合型4例．分别给予西沙必利5mp，多潘立酮10mp，2次／d，维持治疗12mo，期间观察患者餐后饱胀、上腹痛、上腹胀、早饱、恶心、呕吐、厌食、嗳气及副作用出现情况，并进行比较分析．结果维持治疗12mo，西沙必利组：复发上腹痛1例，上腹胀1例，早饱回例，复发率7．5％多潘立酮组：上腹痛2例，上腹胀4例，早饱3例，烧心1例，复发率31．2％，且症状较重（P＜0．01）副作用：西沙必利组：稀便1例，大便次数增多1例，发生率5．0％．多潘立酮组：溢乳1例，月经紊乱1例，烦燥互例，嗜睡1例，稀便1例，心悸1例，发生率18．7％结论长期维持量西沙必利较多潘立酮能明显减少FD的复发．     

马来酸曲美布汀与多潘立酮治疗老年功能性消化不良的疗效比较

目的探讨马来酸曲美布汀与多潘立酮治疗老年功能性消化不良(FD)患者的临床疗效。方法 160例老年FD患者按随机数字表法分为对照组和试验组各80例。对照组给予多潘立酮治疗,试验组给予马来酸曲美布汀治疗,两组均连续治疗4 w。比较两组临床疗效,评定并比较两组治疗前后的临床症状(早饱感、餐后饱胀感、上腹疼痛、上腹灼烧感)评分和水负荷量,观察并比较两组治疗期间口干、腹泻、腹痛、头晕等不良反应的发生情况。结果试验组总有效率明显高于对照组(P<0.05)。治疗后,两组各临床症状评分及总分均明显降低,且试验组降低更加明显(P<0.05)。试验组治疗后水负荷量明显增加,且明显高于对照组(P<0.05)。两组治疗期间不良反应发生率比较差异无统计学意义(P>0.05)。结论与多潘立酮比较,马来酸曲美布汀治疗老年FD患者的临床疗效显著,能够明显缓解临床症状,改善胃容受性扩张功能,不良反应发生率较低,值得临床推广应用。     

多潘立酮联合复方消化酶治疗功能性消化不良84例

目的: 观察多潘立酮联合复方消化酶胶囊治疗功能性消化不良的临床疗效和安全性.方法: 84例功能性消化不良患者随机分为两组, 每组42例, 两组均口服多潘立酮片, 三餐饭前30 min服用10 mg; 试验组加服复方消化酶胶囊, 三餐饭后30 min服用1粒. 4 wk后观察疗效.结果: 试验组治疗总有效率明显优于对照组,分别为85.7%和61.9%( P<0.05). 对上腹痛、餐后饱胀、早饱、上腹烧灼感症状改善情况进行比较, 试验组治疗前后的症状总积分及症状改善有效率较对照组有显著性差异( P<0.05),而且起效时间明显缩短. 两组患者均未发现严重不良反应.结论: 多潘立酮联合复方消化酶胶囊治疗功能性消化不良的临床疗效明显优于单用促动力药多潘立酮.     

马来酸曲美布汀联合沙棘干乳剂治疗功能性消化不良的疗效观察

目的 观察曲美布汀加沙棘干乳剂治疗功能性消化不良的疗效.方法 96例FD病人随机分为治疗组43例服用马来酸曲美布汀和沙棘干乳剂;对照组53例,仅服用马来酸曲美布汀(山西安特),疗程均为2周.观察两组临床症状变化.结果 用药2周后临床主要症状均明显缓解(P＜0.01).治疗组总有效率为97.7%,对照组为52.9%,两组相比.差异有显著性意义(P＜0.01).两组患者均无严重的不良反应.结论 马来酸曲美布汀联合沙棘干乳剂治疗功能性消化不良疗效好,是一种安全、有效的治疗FD的方案.     

Effect of electro-acupuncture at Foot-Yangming Meridian on somatostatin and expression of somatostatin receptor genes in rabbits with gastric ulcer

AIM: To discuss the protective effect of electroacupunc-ture at the Foot-Yangming Meridian on gastric muco-sal lesion, somatostatin (SS) and the expression of SS receptor genes (SSRimRNA ) in rabbits with gastric ulcer and to further explore the relative specificity of meridians and viscera at gene expression level. METHODS: Forty rabbits were randomly divided into control group (A), gastric ulcer model group (B), Foot-Yangming Meridian group (C), Foot-Shaoyang Meridian group (D) and Foot-Taiyang Meridian group (E). The gastric ulcer model was prepared by infusing alcohol into stomach. Groups C-E were treated with electro-acupuncture at points along the above meridians using meridian stimulating instruments for 7 days respectively. By the end of treatment, the index of gastric ulcer was determined, the amount of epidermal growth factor(EGF) and somatostatin was measured by radioimmunoassay (RIA). SS-RimRNA expression in gastric mucosa was determined by RT-PCR. RESULTS: The value of EGF in model group was obviously lower(73.6±14.8 vs 91.3±14.9 pg/mL, P<0.01) than that in control group. The index of gastric ulcer, content of SS and expression of SSRimRNA in gastric mucosa were significantly higher than those in control group (24.88±6.29 vs 8.50±2.98 scores, P<0.01; 2978.6±587.6 vs 1852.4±361.7 mIU/mL, P<0.01; 2.56±0.25 vs 1.04±0.36, P<0.01) . The value of EGF in Foot-Yangming Meridian group was higher than that in model group(92.2±6.7 vs 73.6±14.8 pg/mL, P<0.01). The index of gastric ulcer, content of SS and expression of SS-R1mRNA in gastric mucosa were significantly lower than those in control group(10.88±3.23 vs 24.88±6.29 scores, P< 0.01; 1800.2±488 vs 2978.6±587.6 mIU/mL, P<0.01; 1.07±0.08 vs 2.56±0.25mIU/mL, P<0.01). Compared to the model group, the content of SS and expression of SSRimRNA in gastric mucosa in Foot-Shaoyang Meridian group decreased (2441.0±488. vs 2978.6±587.6 mIU/mL, P<0.05;1.73±0.16 vs 2.56±0.25 mIU/mL, P<0.01). But the above parameters in Foot-Taiyang Meridian group did not improve and were significantly different from those in Foot-Yangming Meridian group (P<0.05) CONCLUSION: Electro-acupuncture at Foot-Yangming Meridian can protect gastric mocusa against injury. The mechanism may be releted to the regulation of brain-gut peptides and the expression of SSRimRNA.     

Effect of acupuncture at Foot-Yangming Meridian on gastric mucosal blood flow, gastric motility and brain-gut peptide

AIM： To observe the effect of acupuncture at Foot- Yangming Meridian on gastric mucosal blood flow （GMBF）, gastric motility and brain-gut peptide.
METHODS： Sixty SD rats were randomly divided into 6 groups： normal control group, model group （group with gastric mucosal damage, GMD）, Sibai group （with acupuncture at Sibai point ＋ GMD）, Tianshu group （with acupuncture at Tianshu point ＋ GMD）, Zusanli group （with acupuncture at Zusanli point ＋ GMD） and non-acupoint group （with acupuncture at non-acupoint ＋ GMD）. The GMD model group was induced by infusing pure alcohol into gastric cavity. H2 Gas Clearance Test （HGCT） was used to measure GMBF, the frequency and amplitude of gastric motility were measured by the method of aerocyst, the content of brain-gut peptide in sinus ventriculi and bulbus medullae were detected by radioimmunoassay.
RESULTS： Inhibitory effect of the frequency and amplitude of gastric motility were shown in model group, and the rates of frequency and amplitude changes were remarkably different from the normal control group （-19.41 ± 17.21 vs-4.71 ± 10.32, P 〈 0.05; -51.61 ± 29.02 vs 1.81 ± 14.12, P 〈 0.01）. In comparison with control group, the GMBF was 0.52 ± 0.161 mL vs 1.03 ± 0.255 mL per 100g tissue/min, P 〈 0.01, the content of motilin in sinus ventriculi and bulbus medullae was 63.04 ± 7.77 pg/mL vs 72.91 ± 8.42 pg/mL, P 〈 0.05 and 50.96 ± 8.77 pg/mL vs 60.76 ± 8.05 pg/mL, P 〈 0.05, but the content of somatostatin in sinus ventriculi and bulbus medullae was 179.85 ± 43.13 ng/g vs 90.54 ± 40.42 ng/g, P 〈 0.01 and 532.86 ± 122.58 ng/g vs 370.91 ± 76.29 ng/g, P 〈 0.05,respectively. In comparison with model group, the amplitude of gastric motility was 1.52 ± 20.13, -6.52 ± 23.31, 6.92 ± 25.21 vs -51.61 ± 29.02, P 〈 0.01 and GMBF was 0.694 ± 0.160 mL vs 0.893 ± 0.210 mL, 1.038 ± 0.301 mL vs 0.52 ± 0.161 mL per 100g tissue/rain, P 〈 0.01, respectively in Tianshu, Sibai and Zusanli groups, the content of moti     

电针穴位刺激对功能性消化不良患者的症状、心理状态和生活质量的影响

探讨电针穴位刺激对功能性消化不良患者的症状、心理状态和生活质量的影响。方法 60例符合罗马Ⅲ诊断标准的功能性消化不良的病人纳入研究,随机分为治疗组和对照组,治疗组用电针刺激内关和足三里,对照组服用多潘立酮,疗程均为2周,治疗前后对患者进行症状评分、心理状态及SF-36评分。结果治疗组经过电针治疗后,消化不良症状明显改善（P〈0.02）;与治疗前相比,治疗组病人SDS、SAS评分明显降低（P〈0.01）,对照组消化不良症状改善,SDS和SAS评分无明显改变;治疗后电针治疗组对生活质量相关的活力、社会功能和精神健康的改善较对照组明显（P均〈0.05）。结论电针刺激内关和足三里可以改善功能性消化不良患者的消化不良症状、焦虑抑郁状态和生活质量。     

电针足三里对胃肠功能性疾病作用的研究进展

电针人体穴位对胃肠动力产生重要影响,足三里是最常用穴位之一,其是足阳明胃经的合穴.在特定频率下电针足三里对胃肠功能性疾病发挥了重要的调节作用,如能改善胃食管反流、功能性消化不良和肠易激综合征等.尽管临床研究中未有定论,但更多证据支持电针足三里对胃肠功能性疾病的发挥重要的调节作用.本文就最近电针足三里对胃肠功能性疾病的调...     

Efficacy evaluation of acupuncture combined with Liujunzi Decoction in the treatment of functional dyspepsia: A protocol of randomized controlled trial

Background:Functional dyspepsia (FD) is a common and frequently-occurring disease in internal medicine. It is known that Liujunzi decoction and acupuncture are widely used in the treatment of FD, but there are few studies on the combination of Liujunzi decoction and acupuncture in the treatment of FD, and its safety and efficacy are still controversial. Therefore, the purpose of this study is to evaluate the efficacy and safety of acupuncture combined with Liujunzi decoction in the treatment of FD.Methods:We designed a prospective randomized controlled trial. The study protocol was approved by the Clinical Research Ethics Committee of our hospital. Patients with FD were randomly assigned to the treatment group of acupuncture combined with Liujunzi Decoction (the experimental group) and the treatment group of Liujunzi Decoction (the control group) in a ratio of 1:1. Outcome indicators were Nepean Dyspepsia Index, the MOS item short from health survey, and adverse reactions. Finally, SPSS 18.0 software would be used for statistical analysis of the data.Discussion:This study will evaluate the efficacy and safety of acupuncture combined with Liujunzi Decoction in the treatment of FD and provide clinical basis for the use of acupuncture combined with Liujunzi Decoction in the treatment of FD.OSF Registration number:DOI 10.17605/OSF.IO/67GKN     

Effect of acupuncture at different meridian acupoints on changes of related factors for rabbit gastric mucosal injury

AIM: To explore the regularity of multi-meridians controlling a same viscus (MMCSV). METHODS: The rabbit gastric ulcer model was established by ethanol intragastric instillation. Fifty-six rabbits were randomly divided into normal group, model group (MG), model plus acupuncture at Foot Yangming Meridian group (YMG), model plus acupuncture at Foot Taiyin Meridian group (TYG), model plus acupuncture at Foot Shaoyang Meridian group (SYG), model plus acupuncture at Foot Jueyin Meridian group (JYG), model plus acupuncture at Foot Taiyang Meridian group (TYMG), with eight rabbits in each group. Gastric mucosal nitric oxide (NO) and nitric oxide synthase (NOS) were assayed by the nitric acid reductase method, and prostaglandin E2 (PGE2) and epidermal growth factor (EGF) were measured by radioimmunoassay. The comprehensive effects were analyzed by weighing method. RESULTS: Compared to MG, SYG, JYG and TYMG, the rabbits gastric mucosal injury index (GMII) reduced very significantly in YMG (P<0.01). Compared to MG, the GMII also reduced significantly in TYG (P<0.05). NO, NOS, PGE2 and EGF increased very significantly in YMG (P<0.01). The EGF in YMG also increased significantly than that in TYG compared to those in MG, SYG, JYG and TYMG (P<0.05). The PGE2 and EGF also increased very significantly in TYG than those in MG, JYG and TYMG (P<0.01). While compared to SYG, the NOS increased significantly in TYG (P<0.05). NOS was the highest in YMG (P<0.01), and was higher in TYG than in MG (P<0.01). CONCLUSION: MMCSV is common. The Foot Yangming Meridian is most closely related to the stomach, followed by Foot Taiyin Meridian, Foot Shaoyang Meridian and Foot Jueyin Meridian. Foot Taiyang Meridian has no correlation with the stomach.     

艾灸预处理对应激性溃疡大鼠胃黏膜HSP70蛋白及mRNA表达的影响

目的:观察艾灸足三里和梁门穴预处理对应激性溃疡大鼠胃黏膜热休克蛋白70(HSP70)及其基因表达的影响,探讨艾灸足阳明经穴保护胃黏膜的作用机制.方法:将60只大鼠完全随机分为空白组(A)、模型组(B)、艾灸足三里等穴组(C)和对照组(D)4组,采用水浸-束缚应激法(WRS)制备应激性溃疡模型.按Guth法计算胃黏膜损伤指数(UI),用免疫组织化学法、逆转录聚合酶链式反应(RT-PCR)法和放射免疫法分别检测处理后大鼠胃黏膜HSP70,HSP70mRNA的表达和内皮素(ET)、前列腺素E2(PGE2)的含量.结果:SU大鼠胃黏膜损伤指数B组与A、C组(P=0.000,P=0.001),D组与A、C组(P=0.001)有显著性差异,艾灸足三里等穴可使SU大鼠胃黏膜损伤指数明显下降.胃黏膜PGE2含量A组与B、D组比较差异显著(P=0.011,P=0.028),C组与B、D组比较差异显著(P=0.020,P=0.048),经艾灸预处理的大鼠胃黏膜PGE2含量均有不同程度升高.ET含量B组与A组之间有显著差异(P=0.040),经艾灸预处理的大鼠ET含量下降显著,B组与C组相比差异显著(P=0.020).造模后胃黏膜的HSP70蛋白和mRNA表达均有不同程度的增强,B组与A组相比有显著性差异(P=0.039,P=0.008);经艾灸预处理后HSP70蛋白和mRNA显著增强,C组与B、D组比较有统计学意义(蛋白:P=0.003,P=0.035;mRNA:P=0.000,P=0.001).结论:艾灸足三里、梁门穴能通过增强HSP70的蛋白和基因表达,达到对胃黏膜的保护作用,并有一定的穴位特异性.     

中西医结合治疗功能性消化不良72例

目的：探讨治疗功能性消化不良（ＦＤ）的理想方法。方法：对７２ 例ＦＤ患者应用加味柴胡汤和吗丁啉治疗,并与对照组疗效进行比较。结果：中西医结合组总有效率为９０．２８％ ,总体疗效明显优于对照组（８３．３３％ ）,两组比较有极显著性差异（Ｐ＜ ０．０１）。前者对改善症状有较好疗效。结论：加味柴胡汤与吗丁啉合用可作为临床治疗ＦＤ较为理想的手段之一。     

针刺足阳明经穴对兔胃粘膜损伤前后胃运动功能的影响

目的 :通过针刺足阳明经穴对兔胃粘膜损伤前后胃运动的观察 ,进一步探讨足阳明经与胃的相关规律。方法 :对 40只大耳白兔运用无水乙醇灌胃 ,造成胃粘膜损伤模型 ,然后观察针刺对胃粘膜损伤前后胃运动功能的影响。结果 :胃粘膜损伤造模前后 ,胃运动振幅指数百分率比较差异有显著性意义 ,造模后振幅指数显著下降 ,与造模前比较 P <0 .0 1,针刺四白、足三里穴能增强胃运动 ,针刺后比刺前胃运动振幅指数显著升高 (P <0 .0 1) ,尤以四白穴最为显著 ,且在胃粘膜损伤后 ,同样能增强胃的运动。结论 :胃粘膜损伤后 ,胃运动振幅指数显著下降 ,针刺足阳明经穴后可使胃运动振幅指数上升 ,提示足阳明经与胃具有相关性。