Non-medicine Methods of Treatment of Gastroesophageal Reflux Disease

M. Efendiyeva
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Abstract

Few decades away a problem of throwing of acidic gastric content into an esophagus was reduced to the concept of reflux-esophagitis. In-depth study of pathogenesis of a disease resulted in “gastroesophageal reflux disease” (GERD) term which is acknowledged as leading disease of digestive system in terms of frequency and dangerous complications. GERD formation is determined by influence of numerous factors, however, it is generally accepted, that it is mainly related to insufficiency of lower esophageal sphincter (LES). Also, role of vasoactive intestinal peptide (VIP) in regulation of functional state of LES is determined. In spite of success in field of pharmacology, number of GERD patients has no downward trend which mainstreams search for non-medicine treatment methods. Physical factors affecting pathological processes by influencing regulatory processes are among these methods. Goal of this study is elaboration, scientific justification and clinical implementation of natural and preformed physical factors and acupuncture in treatment of patients with gastroesophageal reflux disease. Materials and Investigation methods: Randomized placebo-controlled study included 137 patients with gastroesophageal reflux disease, 63 (46%) men and 74 (54%) women, at the age of 18 to 65. Investigation included patients with no contraindications for physiotherapy. Patients with Barrett’s esophagus, stricture of esophagus, esophagus ulcer have also been excluded from investigation. Patients were divided into 3 groups: Ist group – 40 GERD patients, including high-frequency electromagnetic field effect and general iodine bromine bathes. II nd group - 67 GERD patients passing acupuncture treatment course. Control group was comprised of 30 GERD patients, receiving placebo MEF therapy. Treatment was carried out without medicines. Therapeutic effectiveness of complex influence of microwave electromagnetic field therapy (MEF-therapy) applied to collar area alternated with general iodine-bromine bathes on clinical manifestations of GERD is determined. Treatment course contributed to reliable decrease of increased count of VIP – a neurotransmitter, regulating LES tonus. In term, it contributed to improve of functional state of LES, reliable decrease of reflux index, and, as a result, improvement of clinical and functional indicators. Estimation of clinical manifestations of a disease among patients of 2nd group displayed positive dynamics of clinical and functional indicators. Round-clock pH-monitoring of stomach and esophageal content shows reliable decreaseof transitory relaxations of LES during single acupuncture procedure and increase of pH of gastric content. Acupuncture course also resulted in decrease of elevated VIP numbers.
胃食管反流病的非药物治疗方法
几十年前,胃酸进入食管的问题被简化为反流性食管炎的概念。对一种疾病发病机制的深入研究导致了“胃食管反流病”(GERD)这一术语的产生,这一术语在发病频率和并发症危险方面被公认为消化系统的主要疾病。GERD的形成受多种因素的影响,但目前普遍认为主要与食管下括约肌功能不全有关。血管活性肠肽(VIP)在调节LES功能状态中的作用。尽管在药理学领域取得了成功,但胃食管反流患者的数量并没有下降的趋势,主流寻求非药物治疗方法。物理因素通过影响调节过程来影响病理过程就是这些方法之一。本研究的目的是阐述、科学论证和临床实施自然和预先形成的物理因素和针灸治疗胃食管反流病患者。材料和调查方法:随机安慰剂对照研究纳入137例胃食管反流病患者,男性63例(46%),女性74例(54%),年龄18 - 65岁。调查纳入无物理治疗禁忌症的患者。Barrett食管、食管狭窄、食管溃疡患者也被排除在调查之外。患者分为3组:1组- 40例GERD患者,采用高频电磁场效应和普通碘溴浴。第二组:67例通过针灸疗程的胃食管反流病患者。对照组为30例胃食管反流患者,给予MEF安慰剂治疗。治疗在没有药物的情况下进行。研究了微波电磁场治疗(MEF-therapy,简称MEF-therapy)交替应用于领区与普通碘溴浴对反流胃食管反流临床表现的综合影响。治疗过程有助于可靠地降低VIP -一种调节LES张力的神经递质计数的增加。从临床角度来看,它有助于改善LES的功能状态,可靠地降低反流指数,从而改善临床和功能指标。第二组患者对某一疾病的临床表现的估计在临床和功能指标上表现出积极的动态。胃和食管内容物的24小时pH监测可靠地显示,单针过程中LES的短暂性松弛减少,胃内容物的pH增加。针刺疗程也可降低VIP数升高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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