哪个亚型的功能性消化不良患者对针灸的反应更好?随机对照试验的回顾性分析。

Forschende Komplementarmedizin Pub Date : 2015-01-01 Epub Date: 2015-03-11 DOI:10.1159/000380983
Tingting Ma, Fang Zeng, Ying Li, Chieh-Mei Wang, Xiaoping Tian, Shuyuan Yu, Ling Zhao, Xi Wu, Min Yang, Dejun Wang, Fanrong Liang
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引用次数: 22

摘要

背景:功能性消化不良(FD)亚组是否应该采用不同的治疗方法在研究中存在争议。鉴于我们之前的研究已经证实了针灸在FD治疗中的作用,我们现在进一步分析针灸治疗餐后窘迫综合征(PDS)和胃脘痛综合征(EPS)的疗效。方法:对465例PDS患者和241例EPS患者进行回顾性分析。4针刺组(A组:沿胃经特定穴位;B组:沿胃经的非特定穴位;C组:报警、转运穴位;D组:沿胆囊经的特定穴位)与非穴位假针组和依托必利组进行比较。患者每周连续治疗5次,连续4周,随访12周。研究的主要终点定义为消化不良症状指数衡量的缓解率和症状改善,而次要终点定义为Nepean消化不良指数衡量的生活质量(QoL)改善。结果:两组患者的消化不良症状和生活质量均较基线改善。在EPS患者中,有效率(p = 0.239)和症状改善(p = 0.344)差异无统计学意义;P = 0.465)。而针刺A组PDS患者的有效率更高(53.2% vs. 19.7%)。结论:FD PDS患者对针刺治疗有更好的疗效,特别是在胃经的特定穴位。针刺对PDS的积极治疗效果与改善餐后饱腹感相关。试验注册:ClinicalTrial.gov NCT00599677。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Which subtype of functional dyspepsia patients responses better to acupuncture? A retrospective analysis of a randomized controlled trial.

Background: Whether subgroups of functional dyspepsia (FD) should be treated with different approaches is controversially discussed in research. As our previous study has demonstrated the effect of acupuncture in FD treatment, we now further analyze the therapeutic effect of acupuncture in the treatment of postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS).

Methods: A retrospective analysis was conducted in 465 eligible PDS patients and 241 EPS patients. 4 acupuncture groups (group A: specific acupoints along the stomach meridian; group B: non-specific acupoints along the stomach meridian; group C: alarm and transport acupoints; group D: specific acupoints along the gallbladder meridian) were compared with a non-acupoint sham acupuncture group and an itopride group. The patients were treated in 5 consecutive sessions per week for 4 weeks and were followed-up for 12 weeks afterwards. Primary outcome of the study was defined as response rate and symptom improvement as measured by the Symptom Index of Dyspepsia, while secondary outcome was designated as improvement in quality of life (QoL) as determined by the Nepean Dyspepsia Index.

Results: Symptoms of dyspepsia and QoL were improved from baseline in all groups. In EPS patients, no statistically significant differences could be observed in response rate (p = 0.239) and symptoms improvement (p = 0.344 for epigastric pain; p = 0.465 for epigastric burning). In contrast, PDS patients of the acupuncture group A showed higher response rate (53.2% vs. 19.7%, p<0.001; 53.2% vs. 35.1%, p = 0.025) and score change in postprandial fullness (1.01 vs. 0.27, p<0.001; 1.01 vs. 0.57, p<0.001), early satiation (0.81 vs. 0.21, p<0.001; 0.81 vs. 0.39, p=0.001), and QoL (14.5 vs. 4.33, p<0.001; 14.5 vs. 8.5, p<0.001) compared to the sham acupuncture and itopride group.

Conclusions: FD patients with PDS responded better to the acupuncture therapies, especially at the specific acupoints along the stomach meridian. The positive therapeutic effect of acupuncture on PDS was correlated with the improvement in postprandial fullness.

Trial registration: ClinicalTrial.gov NCT00599677.

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Forschende Komplementarmedizin
Forschende Komplementarmedizin 医学-全科医学与补充医学
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