| Objective Chronic non-atrophic gastritis(CNAG)is a long-term chronic disease,characterised by inflammatory lesions of the gastric mucosa and reduced quality of life to patients.As there are no curative nor definitive medications specific for CNAG,external treatment methods such as traditional Chinese acupuncture has a role in managing the disease.Not only can it relieve symptoms,regulate the spleen and stomach,it can also prevent recurrences of the disease and improve the overall physical fitness of patients.In comparison,chiropractic treatment in Australia is another popular drug-free mode of treatment,with a recuperating effect on a number of visceral diseases.Therefore,among various treatment methods without drug intervention,this study compared the efficacy of single modality versus multimodal treatment.Methods The Traditional Chinese Medical(TCM)understanding of the condition is examined through literature review.Related discussions from TCM books and TCM literature were collected and analysed.Based on etiologic,pathogenesis,and treatment methods,it is understood that the pathophysiology of(CNAG)originates at the stomach and is affected by the liver and the spleen at the same time.Therefore,in addition to the pathological epigastric dysfunctions,the condition involves complicated factors such as phlegm dampness,blood stasis,qi stagnation and qi deficiency.Thus,CNAG becomes a complicated condition with multiple syndromes of deficiency interweaved with excess.Treatment methods include oral and external use of traditional Chinese medicine,and external treatment methods of TCM.Among them,the combination of acupuncture and massage is a safe,efficient,and minimally invasive external treatment widely used in clinical TCM.Based on the development of endoscopic and pathological techniques in contemporary western medicine examined in literature reviews,it is understood that the chronic non-atrophic nature of gastric mucosa is a multifactorial pathogenesis.It is primarily manifested by the appearance of lymphocytes and plasma cell infiltration,which may be accompanied by erosion and bile reflux.Among the pathogenic factors,Helicobacter pylori is associated in a portion of CNAG,and thus,symptomatic treatment via triple of quadriple therapy is the first line therapy.This involves concurrent dosing of bismuth,proton pump inhibition and antibiotics for the eradication of H.pylori to promote normal healing of the gastric mucosa.A randomized controlled trial method was adopted for the clinical research.90 patients eligible for inclusion were randomly divided into three groups: Electroacupuncture Therapy group(ET),Massage chiropractic Therapy(MT)group,and combined Electroacupuncture and Massage chiropractic therapy(EMT).The process was closely monitored,and observations were recorded.The groups were analyzed with regards to age,gender,course of illness,major symptom score,major and minor symptom scores of TCM,Hamilton depression scale score,and Hamilton anxiety scale score.The three groups were given two courses of treatment over 4weeks,and the efficacy was evaluated after the treatment.Results The major symptom scores of the three groups were reduced.From 14.00± 3.48 to 4.07 ± 3.95(ET),14.00 ± 3.32 to 5.53 ± 4.48(MT),and18.00 ± 3.21 to 2.80 ± 3.34(EMT).Through statistical analysis,the differences in scores before and after the treatment were statistically significant,indicating that in comparing the main symptom scores of all three groups,each group experienced improvement after treatment.Analysis between groups demonstrated the combined electroacupuncture and massage chiropractic therapy(EMT)is most clinically effective in improving the main symptom score.Comparisons of the major symptom score of TCM syndromes before and after treatment of the three groups were: 31.47 ± 9.45 to 14.13 ± 4.10 (ET),31.00 ± 7.64 to 16.47 ± 3.95(MT),and 31.87 ± 8.19 to 11.73 ±4.75(EMT).The scores of major symptoms of TCM syndromes among all groups after treatment were equally lower than the scores before treatment,thus demonstrating that all groups had benefited from treatment(P<0.05).Analysis between the groups show that the combined electroacupuncture and massage chiropractic therapy(EMT)had the most significant decrease,indicating its curative effect was the best among the three groups(P<0.05).Comparisons of the minor symptom score of TCM syndromes of the three groups demonstrated decline after treatment: 16.70 ± 4.35 to 7.50 ±2.15(ET),16.07 ± 4.01 to 8.00 ± 2.94(MT),and 15.83 ± 4.33 to 5.70± 1.99(EMT).After analysis,there was a significant statistical difference before and after the treatment(P<0.05),demonstrating that the modes of treatment were also effective in improving the minor symptom score of TCM.Comparisons between groups show that the combined electroacupuncture and massage chiropractic therapy(EMT)proved to be the most effective.In terms of depression and anxiety,the Hamilton depression scale of all groups was decreased: 15.37 ± 6.07 to 6.73 ± 2.36(ET),15.50 ±5.89 to 7.40 ± 2.71(MT),and 16.03 ± 5.80 to 6.17 ± 2.32(EMT).Analysis demonstrated that the scores of the three groups have uniformly significantly decreased after therapy(P<0.05),indicating that the treatments have an effective therapeutic effect in improving the depression scale score of patients.The scores of three groups show no significant statistical differences after treatment(P>0.05),indicating the three methods were equally effective in improved the depressive symptoms of patients.The Hamilton anxiety scale score were: 13.67 ±5.76 to 6.00 ± 1.97(ET),13.87 ± 5.65 to 7.07 ± 2.15(MT),and 13.83± 5.90 to 6.13 ± 2.11(EMT).Analysis also show a significant statistical difference before and after therapy for all groups(P<0.05),indicating that the methods had an effective curative effect in improving the Hamilton anxiety scale score.There was no statistical significance between the three groups after treatment(P>0.05),proving the three methods were equally effective in improving anxiety symptoms of patients.In terms of clinical efficacy,the ET group demonstrated 4 cured cases,14 markedly effective cases,6 effective cases,5 ineffective cases and 1 case was worsened after the treatment.The marked efficiency was 60% for electroacupuncture therapy.The massage chiropractic group demonstrates 2 cured cases,10 markedly effective cases,10 effective cases,6 ineffective cases and 2 cases were worsened.The marked efficiency was 40% for massage chiropractic therapy.With combined electroacupuncture and massage chiropractic therapy(EMT),8 cases were cured clinically,16 cases were markedly effective,4 cases were effective,1 case was ineffective,and 1 case was worsened.The marked efficiency was 80% for combined electroacupuncture and massage chiropractic therapy(EMT).The square test of all groups shows P<0.05,indicating the total effective rates between groups were statistically significant,and combined electroacupuncture and massage chiropractic therapy(EMT)was the most effective.Conclusion· Electroacupuncture group(ET),massage chiropractic group(MT),and the combined electroacupuncture and massage chiropractic therapy(EMT)proved effective in improving the major symptom score,major symptom score of TCM syndrome,secondary symptom score of TCM syndrome in patients with chronic non-atrophic gastritis.· ET,MT,and EMT all had therapeutic effects in improving depression and anxiety symptoms.· The curative effect of EMT was the most effective in terms of the main observation indicators of chronic non-atrophic gastritis.· The three groups have comparable effects in terms of secondary observation indicators of chronic non-atrophic gastritis.In conclusion,EMT was shown to give the greatest efficacy in terms of major observation indictors in the treatment of chronic non-atrophic gastritis(P<0.05).In further comparative analysis,EMT has better curative effect than MT,and the differences were statistically significant.However,there were no difference between the three groups with regard to minor symptom scores of TCM.Among the secondary observation indicators,the three groups have comparable curative effects,and the principles and mechanisms are worth further explorations. |
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