| Liver cirrhosis is a progressive disease. Cirrhosis can be subdivided into several post-hepatitic, alcoholic or schistosomiasis cirrhosis. In China, majority of the cases are post-hepatitic cirrhosis. In the early stage of the disease, patients may not experience any symptoms as any damage in the liver at this stage could be reversed by its self-compensatory function. As the disease progress, symptoms appear due to portal hypertension. Further liver damage with other organs being involved. At the late stage of the disease, hypersplenism may occur with secondary infection, hepatic encephalopathy, gastrointestinal bleeding, ascites, cancer as well as other serious complications. Patient’s quality of life will be affected significantly. In the scope of clinical manifestations of Chinese medicine, liver cirrhosis may refer as "hypochondriac","jaundice","accumulation" or "bulging ". Since the disease pathogenesis and pathophysiology remains unknown with a lack of effective control measures and treatment. We as an innovator would like to propose the use of "Jin’s three-needle" as a treatment for cirrhosis and the gastrointestinal motility disorders. We would also include the serum gastrin and plasma somatostatin content as part of our research investigation as well.PurposeThe aim of this research is to investigate the changes of serum gastrin and plasma somatostatin on gastrointestinal motility disorders. The data would then be used as a theoretical basis for the clinical application of acupuncture.Methods1. Patients were grouped according to Child-Pugh classification of liver function using a stratified random method.90patients were divided into3groups (Basic, Domperidone and Acupuncture group). Total of25cases were identified in the Basic treatment group,26cases in the Domperidone group and26cases in the Acupuncture group.2. Routine treatment were given to the patients present in the Basic group and the Acupuncture group. In addition to that patients in the Acupuncture group were also given the "feet3-needle" in position Zusanli, Sanyinjiao and Taichong daily. The disposable sterile acupuncture needles were used. We acupunctured the position of Zusanli with the1.5-inch needles (0.35mm X40mm) with piercing about1.2inches subcutaneously. We then used the1-inch needles (0.35mm X25mm) for positions Sanyinjiao and Taichong with piercing around0.8inches subcutaneously. After obtaining the Qi, we tonified the position of Zusanli and Sanyinjiao in order to make the Qi balance in the position of Taichong. The duration of treatment last30minutes daily. The reinforcing and reducing techniques were used every10minutes throughout the treatment. Patients present in the Domperidone treatment group would have oral Domperidone10mg three times a day in additional to the basic treatment. Patients were asked to take the Domperidone30minutes before meals. The pharmacological intervention was lasted for two weeks.3. Observation and indicators detection1) Gastrointestinal symptom score of bloating, belching, nausea, vomiting, early satiety and anorexia symptoms were recorded using the symptomatology statistical method before and after treatment. No symptoms, mild, moderate or severe were scored by using0,1,2or3points respectively. There were six symptom scores with a sum of18points able to be recorded. The effectiveness of treatment were scaled according to the response: Remarkable (symptom score reduced≥80%), Effective (symptom score reduced between50%and80%) or Invalid (any symptom scores≤50%) may be recorded according to the clinical outcome. The total effective rate=(Number of Remarkable cases+Effective cases)/Total number of cases X100%.2) The patients’serum gastrin and plasma somatostatin were tested before and after treatment. Patients were fasted after dinner and the following morning.5ml of the venous blood was collected for assay. For detection of somatostatin, EDTA was added into the blood samples to prevent coagulation occur. The plasma and serum were then separated and stored in the20℃control medium. Radioimmunoassay techniques were used to detect the serum levels of gastrin and plasma somatostatin.4. SPSS16.0software was used. Measurement data was processed with t test, grade data (statistical effect) was processed with Ridit analysis.Results1. Gastrointestinal Symptoms ScoreThe Domperidone group and Acupuncture group were compared with Basic treatment group before treatment initiated. The difference was not found to be statistically significant. Acupuncture group was then compared with Domperidone group, the difference was not found to be statistically significant. Domperidone group was then compared with the Acupuncture group after treatment being initiated and statistically significant difference was found. The Basic treatment group, Domperidone group and Acupuncture group were respectively compared with each other before and after treatment. The difference was found to be statistically significant.2. Statistics on the effectivenessUsing Ridit analysis, the efficacy of Basic treatment group was compared with Domperidone group and the difference was found to be statistically significant. The efficacy of Basic treatment group was compared with Acupuncture group and the difference was found to be statistically significant. The efficacy of the Acupuncture group was compared with the Domperidone group. The difference was found to be statistically significant.3. Serum Gastrin LevelsDomperidone group and Acupuncture group were compared with the Basic treatment group before treatment being initiated. The difference was not found to be statistically significant. The Acupuncture group was compared with Domperidone group and the difference was not found to be statistically significant. Domperidone group was compared with Acupuncture group after treatment being initiated and the difference was found to be statistically significant. The Acupuncture group was compared with Domperidone group and the difference was found to be statistically significance. The Basic treatment group, Domperidone group and Acupuncture group were respectively compared with each other before and after treatment. The difference was found to be statistically significant.4. Detection of plasma somatostatin levelsThe Domperidone and Acupuncture group were compared with Basic group before treatment being initiated. There were no significant difference found between the groups. Acupuncture group was then compared with Domperidone group and there were no significant difference found between them. Domperidone group was compared with Acupuncture group after treatment being initiated and the difference was found to be statistically significant. Acupuncture group was compared with Domperidone group, the difference was found to be statistically significance. The Basic treatment group, Domperidone group and Acupuncture group were respectively compared with each other before and after treatment. The difference was found to be statistically significant.ConclusionsAcupuncturing the "feet’s3-needle" improves the gastrointestinal symptoms and increases serum gastrin levels with a reduction of plasma somatostatin levels in cirrhosis patients. |
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