Controlled Clinical Study On The Acupuncture To Treat Functional Dyspepsia Of Spleen Deficient And Qi Stagnation

ObjectiveThis study based on the theory of evidence-based medicine of traditional Chinese medicine and modern western medicine pathology to observe the clinical curative effect and the plasma nerve decompression differences of the acupuncture,Xiangsha liujunzi decoction and western medicine in the treatment of functional dyspepsia(syndrome of spleen-deficiency and qi-stagnation.Based on those,We explored the mechanism of acupuncture in the treatment of functional dyspepsia,and provide reliable basisfor clinical acupuncture treatment of functional dyspepsia.MethodPatients with 60 cases,during June 2014 to August 2015 in wuhan traditional Chinese and western medicine hospital in acupuncture department and digestive department.ALL patients conformed to the Roman Ⅲ standards and the syndrome of spleen-deficiency and qi-stagnation which was stipulated in《the cooperation of Chinese and western medicine diagnosis and treatment of functional dyspepsia consensus opinions》.According to the random number method,Patients was divided into acupuncture group,prescription group and western medicine group.Stripping off cases,acupuncture group had 18 people,prescriptions group had 18 people and western medicine group had 16 people.Acupuncture group take St 36(double parapodum),S25(double parapodum)and Cv12,givng common acupuncture,by broken skin quickly with With a 1.5-inch sterile acupuncture needle,when geting de-qi sensation,we retainde needle 30 min.After 6 days for a period of treatment,the course of a day off,The course of treatment lasted 4 weeks.Group of patients taking Xiangsha liujunzi decoction,water a blunt,three times a day for six days,withdrawal a day in a period of treatment.All of these lastde four sessions.Western medicine group patients took domperidone tablets,10 mg at a time,three times a day,30 min before taking a meal,prescribed treatment 6 days,withdrawal a day to the next period of treatment,lasted four courses.Three groups of patients in the treatment of 0 day,28 day and 2 months after the treatment evaluatde each group total clinical curative effect,symptom integral,single symptom integral and SF-36 life quality score.Respectively in the beginning of treatment and the last day,we extractde each group of subjects fasting plasma,saved to-80 ℃ refrigerator,used enzyme-linked immunoassay(ELISA)nerve to detect the neurotensin in plasma.Finally,we used SPSS19.0 statistical software to analysis all data.Result1.Before the treatment,we compared age,gender,duration,general symptoms integral,individual symptom scores,SF-36 life quality score,and plasma NT content among the three groups of patients.All of those had no significant differences.(p>0.05).2.After treatment,(1)the clinical curative effect comparison: the acupuncture group total effective rate was 94.44%,the prescription group total effective rate was 90.00%,the western medicine group total effective rate was 87.5%.The total effective rate difference between three groups was not obvious,and had no statistical significance(p>0.05).(2)the total integral and individual symptom scores comparison: after the treatment,each symptom total score difference was not obvious(P > 0.05).But in the individual symptoms improvement,eat less,belching and agitated easy anxious symptoms improved significantly in the acupuncture group better than prescription group and western medicine group(P < 0.05),in addition,improvement of mental fatigue,limbs burnout aspects of acupuncture was superior to western medicine group(P<0.05).(3)SF-36 compare quality of life score: quality of life of each dimension score is different in each group,acupuncture to improve physical function,social function and emotional function quality of the prescriptions and western medicine has more advantages(all P<0.05).(4)the plasma NT content: after the treatment,acupuncture group and the plasma NT content formula group were significantly lower than that before treatment(p< 0.05),and western medicine group didnt change significantly(p > 0.05),Furthermore,the trend in the acupuncture group was more statistical than prescription group(p<0.05).3.Follow-up period,the acupuncture group and the prescription group in symptoms integral,single symptom integral,the total effective rate and quality of life scores were better than western medicine group.Conclusion1.Acupuncture,western medicine and prescription for functional dyspepsia of syndrome of spleen-deficiency and qi-stagnation had better near future curative effect.And the effect of acupuncture treatment was distinct and persistent,which was worth to be promoted in clinic.2.The regulation of acupuncture on plasma NT was better than the prescription treatment,beside that,western medicine on NT had no obvious regulation.Based on the evaluation questionnaire results,we speculated that acupuncture regulat the expression of NT may through give play to the role of hormone NT itself and/or mediated intestinal axis function to improve dyspepsia symptoms.Acupuncture regulating NT expression may be one of the mechanism of treatment of functional dyspepsia.The long-term efficacy difference between three groups,may be related to acupuncture regulating expression of brain gut axis to the regulation of gastrointestinal function.