| Aims:In this study,we observed the therapeutic effect and safety of acupuncture points on gastrointestinal dysfunction in patients with chronic liver disease for providing clinical evidences for the chronic liver disease patients with acupuncture therapy in the treatment of gastrointestinal dysfunction and exploring its theoretical basis further through a randomized controlled trial. Methods This study choose chronic severe hepatitis B,cirrhosis and chronic liver failure patients who were diagnosed with chronic liver disease,and TCM belongs to tympanites, qi stagnation and dampness stagnation syndrome and blood stasis patients as the research object,all of the subjects were derived in liver disease department of hubei provincial hospital of TCM from March to November in 2015.A total of 46 cases were included, according to a random permutation table, subjects were divided into treatment group including 23 cases and control group including 23 cases, the treatment group: Western medicine foundation treatment combine with acupuncture therapy(main acupoints by bilateral Zusanli, Taichong, Sanyinjiao, Shangjuxu and xiajuxu and Zhongwan point),2 times / day, each time retaining the needle for 30 minutes, every 10 minutes twirling the needle a time,2 weeks for a course.The control group only used the basic treatment of Western medicine and Mosapride Citrate Tablets(brand name: Xinluona) 5mg oral,tid, for 2 weeks.At the end of the treatment period,the total clinical efficacy, the changes of clinical symptoms, abdominal distension recovery time and liver function related laboratory index change situation was observed in the treatment group and control group before and after treatment.To analyze the therapeutic effect; observing the occurrence of adverse reactions and blood, urine, feces, ECG and renal function indexes of safety evaluation.Results(1)The total clinical efficacy comparison of the two groups :in the treatment group, the clinical cure in 2 cases, markedly effective in 9 cases, effective in 7 cases, invalid in 5 cases, the total effective rate was 78.26%; in the control group, 5 cases were markedly effective, effective in 7 cases, 11 cases were ineffective, the total efficiency was 52.17%.Compare the two groups of clinical efficacy through the two independent samples of the rank sum test, the difference was statistically significant. The results showed that the treat method in treatment group was more effective than the control group.(2)Clinical symptom score change:compared the treatment group and the control group before treatment, the total score of TCM symptom in the two groups was not markedly different(P>0.05).after treatment, the TCM syndrome total score are decreased in two groups than that before treatment,compared to the control group,the symptom total score in treatment group decreased obviously,the difference is statistical significance(P<0.05),in improving the total score of clinical symptoms of Chinese medicine.the effect is more significant in the treatment group.Before treatment,compare the symptom score of the two groups in nausea,vomiting,dry mouth and bitter mouth,diet reduction,poor stool,the frequency of abdominal distention,the degree of abdominal distension,postprandial fullness discomfort,chest pain and fatigue,the difference was not statistically significant(P>0.05); after treatment,the symptom score of treatment group reduce in nausea,vomiting,dry mouth and bitter mouth,diet reduction, poor stool,the frequency of abdominal distention,the degree of abdominal distension,postprandial fullness discomfort obviously, the difference has statistical significance(P<0.05); but in chest pain and fatigue, the difference was not statistically significant(P>0.05).The efficacy in treatment group to improve patients with nausea,vomiting,dry mouth and bitter mouth,diet reduction,poor stool,the frequency of abdominal distention,the degree of abdominal distension,postprandial fullness discomfort is better than that of the control group; while the chest pain and fatigue did not remarkably changed in the two groups.(3)Comparison of abdominal distension stability of curative effect in two groups after the treatment period : before treatment,compared two groups of abdominal distension syndrome score,the difference was not statistically significant(P>0.05);after treatment, symptoms of abdominal distension in both of the two groups decreased,but the treatment group reduced more obviously,the difference was statistically significant(P<0.05),indicating that the treatment group in reducing abdominal distension has better effect than the control group;record the abdominal distension symptoms recurrence or exacerbation time after the treatment period,results suggest that the two groups had to stop recurrence with in one week of treatment,but in the treatment group,the recovery time was significantly longer than the control group,the difference was statistically significant(P<0.05),which indicats that the curative effect of the treatment group is better than that in the control group.(4)Indexes of liver function change:compared with the two groups of liver biochemical indexes like ALT, AST, TBIL, the difference was not statistically significant(P>0.05).After treatment,the changes of ALT, AST and TBIL were compared between the two groups, ALT, AST, TBIL in the treatment group and the control group were all decreased, but there was no significant difference between the two groups(P>0.05).The improvement of liver function was not significant in the acupuncture treatment method.(5)The patients in the two groups had no adverse reaction after treatment review of blood, urine, stool routine, electrocardiogram were not found abnormal changes in treatment group and the control group in the whole research process, which suggested that the safety of treatment in the two groups were good. Besides, the subjects did not lost to follow-up throughout the study.Conclusion :Acupuncture in treatment of chronic liver disease of gastrointestinal dysfunction and TCM is tympanites, qi stagnation and dampness stagnation syndrome and blood stasis patients have obvious curative effect.On the basis of routine treatment of Western medicine, although added with acupuncture treatment and the index of liver function in patients has not been improved,but the acupuncture treatment can lead to improvements in patients with chronic liver disease of gastrointestinal motility disorder of nausea,vomiting,mouth pain,dry mouth,diet,poor stool,the frequency of abdominal distention,abdominal distension, postprandial fullness discomfort symptoms.This study confirms that the application of acupuncture treatment can significantly improve the gastrointestinal dysfunction in patients with chronic liver diseases leading to gastrointestinal discomfort symptoms like abdominal distention.Moreover,the alternative therapy had reliable curative effect,simple operation, high compliance, low cost, and no adverse reaction.And the patients were willing to accept the method, which enrich the symptoms and improved treatment efficiency.It is worthy to conduct further research, discussion and clinical promotion. |
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