针刺督脉背段T3～T12棘突下治疗胃食管反流病伴有睡眠障碍的临床研究
Clinical Research of Acupuncture on the Dorsal Segment of Governor Vessel for Gastroesophageal Reflux Disease with Sleep Disorders
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摘要: 研究伴有睡眠障碍的胃食管反流病（GERD）患者针刺督脉背段T3～T12前后压痛变化规律，以期客观评价针刺疗效。方法 按照随机数字表法将60例GERD患者随机分为针刺组和西药组，针刺组脱落2例，西药组30例，针刺组28例。针刺组针刺患者督脉背段T3～T12棘突下，隔日1次，每周3次。西药组患者口服奥美拉唑肠溶胶囊，每次20mg，每日2次。2组均治疗8周。2组治疗前后分别对患者进行反流性疾病诊断问卷评分（RDQ）、匹兹堡睡眠质量指数（PSQI）评分及T3～T12棘突下行压痛阈值评估。结果 58例患者睡眠障碍有其自身的特点。治疗后，2组RDQ评分、PSQI评分较治疗前明显改善（P<0.01），针刺组较西药组显著降低（P<0.01）。2组T4、T5、T6、T7、T8、T11压痛较治疗前明显减少（P<0.05~0.01）。治疗后针刺组在T4、T5、T6、T7、T8、T11处的压痛阈值显著高于西药组（P<0.05~0.01）。结论 胃食管反流病伴有的睡眠障碍有其自身特点，针刺督脉背段T3～T12棘突下治疗胃食管反流病伴有睡眠障碍的疗效优于西药组，并且针刺后的压痛阈值也比西药组显著升高。Abstract: OBJECTIVE To study the changes rules of pressure pain when needling governor vessel on the back (below the spinous process from the T3 to the T12 thoracic vertebra) for patients with gastroesophageal reflux disease (GERD) accompanied by sleep disorders， and to objectively evaluate the curative effect of acupuncture. METHODS 60 cases of GERD patients were divided into the acupuncture group (28 cases) and the western medicine group (30 cases) by random number table， and 2 cases were drawing out from the acupuncture group. So， there were 30 cases in the western medicine group and 28 cases in the acupuncture group. Patients in the acupuncture group were needled below the spinous process from the T3 to the T12 thoracic vertebra， once every other day， three times a week. Patients in the western medicine group were treated by orally taking Omeprazole (20mg)， twice a day. Patients in both groups were treated for 8 weeks. Before and after treatment， reflux disease questionnaires (RDQ)， Pittsburgh sleep quality index (PSQI)， pain threshold value and tenderness along governor vessel from T3-T12 were detected before and after the treatment. RESULTS The sleep disorders of 58 cases have specific characteristics. After the treatment， RDQ and PSQI scores were significantly improved in two groups (P<0.01)， and the acupuncture group were significantly decreased than the western medicine group (P<0.01). The tenderness of T4， T5， T6， T7， T8， T11 were decreased than those of the pre-treatment (P<0.05，P<0.01). And the pain threshold values in T4， T5， T6， T7， T8， T11 of the acupuncture group were significantly increased than those of the western medicine group (P<0.05，P<0.01). CONCLUSION As the sleep disorders associated with gestroesophageal reflex disease has its own specific characteristics， the effect of acupuncture on the dorsal segment of the governor vessel from T3-T12 for the treatment of sleep disorders associated with GERD is better than that of the western medicine group， and pain threshold is increased after acupuncture comparing with the western medicine group.
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