Patients With Gastroesophageal Reflux Study Law At Du Tenderness Back Section

Objective:By studying gastro esophageal reflux disease patients’ tenderness within Du channel in the back section (T1-T12segment within the region) to define a clear correlation between gastro esophageal reflux disease and tenderness in this region and provide reliable research data about sensitive points or areas, we will explore these possible prospects of tenderness points associated with auxiliary diagnose and troubleshoot gastro esophageal disease based on the results in this study. Also, according to the theory of acupuncture principle of "pain points", this research wishes to provide a theoretical basis and new treatment ideas for those who cure gastro esophageal reflux disease through acupuncture based on the tenderness points.Methods:Tenderness evaluation methods in two ways:the degree of tenderness evaluation:the patient prone, doctors touched the spine between two spinous process with the tip of thumb with continuous and even pushing, and push from the first thoracic spinous process to the twelfth thoracic spinous process in order. Doctors recorded tenderness Level in accordance with the following criteria:a. only complained of pain if the doctor asked during pressing exercise, no pain expression, mild tenderness, denoted "+"; b. complained of pain when pressed, suffering expression (frown), moderate tenderness, denoted "++"; c. complained of severe or stabbing pain when pressed, accompanied dodge, shouting and other reactions, severe tenderness, denoted "+++";. D when pressed those unconscious of pain and unable to clearly determine without pain or no pain cases were sentenced to tenderness negative reactions, denoted "-". Wherein, a, b, c were denoted tenderness positive and d was denoted tenderness negative. Tenderness threshold evaluation method:first, handed the remote control of the "ergonomic tenderness tester"(patent number:ZL200520142236.5, Wangjing Hospital of China Academy of Traditional research) to the patient, asked the patient to press the button when felt pain and put the pressure probe in painful sites(ibid.) with the slow force and gradually increased. When patients feel pain and press the remote control button on the display the value is locked, you can get the pressure threshold of the parts. When pressed maximum pressure should not exceed600kPa [](6kg/cm2, after conversion concluded pressing pressure should not exceed47N), if exceed would be defined as no reaction to avoid excessive force causing tissue damage. For the convenience pressure threshold shall be referred to as the statistical reaction50N when no reaction. Obtained measurement and count data by the two methods to analyze two groups’ data of tenderness threshold and tenderness level, using the SPSS statistical analysis software to complete statistical analysis, P<0.05was considered statistically significant.Results:The case group of the subject collected78cases and50cases in the comparison group. Statistics show that:the average pressure threshold:the average pressure threshold set at the minimum for13.65N in GERD T7spinous process and is most sensitive tenderness. While, Lower average pressure threshold were in T3-T8spinous process, and were lower than17N; average tenderness thresholds T1-T3spinous gradually reduced while T8-T12average pressure thresholds gradually increased, showing a trend of two high ends and middle low. The highest average pressure threshold point is T12for22.27N. The average healthy human tenderness thresholds in T1-T12group were higher than GERD. The average healthy person pressure threshold T5-T8segments were lower than21N, wherein, the minimum average pressure threshold in T6for18.68N. Comparison of the two groups in the average pressure can be found that threshold T3-T9average pressure threshold in GERD group was significantly lower than the comparison group. The biggest average pressure threshold difference between the groups was in T3, T4, T5and T7spinous process, greater than5.10N, where the biggest average pressure threshold difference of T7spinous process was6.80N. After SPSS statistical analysis in GERD group and comparison group, we could figure out whether there were differences in each T1-T12spinous process in pressure threshold. The difference in T3, T4and T5spinous process was P<0.05and the difference was statistically significant; the P values in other places were greater than0.05which did not have statistical significance. It can be considered that there were significant differences between the two groups at T3, T4and T5in average pressure threshold, i.e. the pressure threshold of GERD group was significantly lower than the comparison group at T3, T4and T5. Based on the evaluation of degree of tenderness to compare the two groups’tenderness differences at T1-T12spinous process, the degree of tenderness can be found that in the T3-T9spinous process were significantly different from T3-T9spinous process, i.e., tenderness degree of GERD group in this region was stronger than the comparison group.Conclusion:This research shows that, GERD patients have obvious tenderness reaction at Du channel in the back section and tenderness distributions have some regularity. Distribution of tenderness can be considered mainly in T3-T9segments. It is the degree of tenderness and the pressure thresholds of the two groups in the T5-T7segments (i.e., Shinto Temple, Ling-tai and Zhiyang acupuncture points) were significantly different that this region is the core area of tenderness reaction of GERD patients at Du channel in the back section; the differences among groups in T3, T4, T8T9spinous process only exist in tenderness degree and this can be described as a peripheral region of the tenderness reaction zone. Compared with T5, T6and T7spinous process tenderness positive rate, it can be seen that although patients with GERD T7spinous process tenderness sensitivity is significantly higher than the comparison group, both the tenderness positive rate is almost the same which indicates that the health also have a higher response rate in tenderness at T7while less sensitive to the GERD patients. It can be considered that in patients with GERD T7spinous process have strongly positive features; GERD patients not only have high sensitivity of tenderness characteristics at T5spinous process, but also have big difference in the positive rate from the healthy men, indicating that its tenderness is more specific. T6spinous process is in between the T5and T7. T5, T6, T7spinous process all have acupuncture points:Shinto Temple, Ling-tai and Zhiyang. According to the results obtained in this research show that the tenderness positive rate of Shinto point in GERD group has biggest difference from the comparison group and it can be used as a reference point of choice for the diagnosis of GERD in order to reduce the possibility of false positive. The health men also have high tenderness positive rate at Lingtai and Zhiyang the two acupuncture points, but the degree of tenderness was significantly lower than GERD group. Therefore, the strong positive features of Ling-tai and Zhiyang acupuncture points can be used as the reference standard positive at diagnosis of GERD. In summary, if there is tenderness in the Shinto temple acupuncture point, the existence of a strong tenderness in Ling-tai and Zhiyang acupuncture points may be used to consider the possibility of GERD. In accordance with the treatment principle of "pain points" and combining the research results, the T3-T9region can be selected as acupuncture point’s area of treating GERD, while the Shinto Temple, Lingtai and Zhiyang acupuncture points can be selected as the focus point’s selection.