合募配穴灸法治疗慢性萎缩性胃炎临床观察

摘要

目的 观察合募配穴灸法治疗脾胃虚寒型慢性萎缩性胃炎(CAG)患者的临床疗效及对血清胃蛋白酶原及胃泌素的影响.方法 将符合诊断及纳入标准的63例脾胃虚寒型萎缩性胃炎患者,按照随机数字表法分为对照组(31例)和治疗组(32例),对照组给予胃复春片治疗,治疗组给予合募配穴艾灸法治疗,两组疗程均为12星期.分别评价两组临床疗效、中医症状积分及血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)及胃泌素(G17)的变化.结果 治疗组治疗后总有效率为93.8%,明显优于对照组(P<0.05);两组治疗后及随访时中医症状积分显著降低(P<0.01),且治疗组明显优于对照组(P<0.01);治疗组治疗后PGⅠ、PGR及G-17水平显著增高(P<0.01),PGⅡ较治疗前降低(P<0.05);对照组治疗后PGⅠ、PGR及G-17水平明显增高(P<0.05),两组治疗后PGⅠ、PGR及G-17组间比较,治疗组明显优于对照组(P<0.01),两组治疗后PGⅡ组间比较差异具有统计学意义(P<0.05),治疗组随访HP阳性率为3.1%,明显低于对照组(P<0.05).结论 合募配穴灸法能显著改善CAG患者临床症状,增加HP的清除率及降低复发率,其作用机制可能是通过上调PGⅠ、PGR及G-17和下调PGⅡ水平实现的.%Objective To observe the clinical efficacy of moxibustion at He-Sea plus Front-Mu points in treating chronic atrophic gastritis (CAG) due to deficient cold in spleen-stomach, and its effect on serum pepsinogen (PG) and gastrin. Method Sixty-three eligible patients with CAG due to deficient cold in spleen-stomach were divided into a control group (31 cases) and a treatment group (32 cases) by using random number table. The control group was intervened by Wei Fu Chun tablets, while the treatment group received moxibustion at He-Sea plus Front-Mu points, 12 weeks as a treatment course. Clinical efficacy, symptoms score of traditional Chinese medicine (TCM), serum PGⅠ, PG Ⅱ and gastrin levels were evaluated. Result The total effective rate was 93.8% in the treatment group, significantly better than that in the control group (P<0.05); the TCM symptoms scores dropped significantly in both groups after the treatment and in the follow-up study (P<0.01), and the treatment group was markedly superior to the control group (P<0.01); the levels of PG Ⅰ, PG Ⅰ/Ⅱ ratio (PGR) and gastrin-17 (G-17) increased significantly in the treatment group after the intervention (P<0.01), and PG Ⅱ dropped significantly (P<0.05); after the treatment, thelevels of PG I, PGR and G-17 increased significantly in the control group (P<0.05); after the intervention, the treatment group was significantly better than the control group in comparing the levels of PG Ⅰ, PGR and G-17 (P<0.01), and there was a significant difference in comparing the level of PG Ⅱ between the two groups after the intervention (P<0.05). The follow-up showed that the HP positive rate was 3.1% in the treatment group, significantly lower than that in the control group (P<0.05). Conclusion Moxibustion at He-Sea plus Front-Mu points can significantly improve CAG symptoms, enhance HT clearance and lower the relapse; its action mechanism is possibly through up-regulating PGⅠ, PGR and G-17 and down-regulating PG Ⅱ.