| ObjectiveOur previous study found that patients with gastroesophageal reflux disease(GERD)have certain regularity in the tenderness of the T3 to T12 spinous processes in the dorsal ramus of the Governor Vessel.At the same time GERD complicated clinical manifestations,involving multiple systems,in addition to the symptoms associated with reflux,including sleep disorders which is a common but easily missed diagnosis of complications,and reflux and sleep disorders are often interwoven with each other seriously affect the quality of life of patients.In this trial,the in-patients were divided into two groups:acupuncture and western medicine.The acupuncture group was treated with acupuncture at the dorsal raphe T3 to T12 under the spinous process,and the western medicine group was treated with oral omeprazole enteric-coated capsules.To compare the therapeutic effects of the two methods on GERD patients with sleep disorders,summarize the characteristics of patients with sleep disorders,observe the changes in tenderness before and after treatment of T3?T12 spinous processes,in order to objectively evaluate the curative effect of the acupuncture treatment of GERD patients with sleep disorders.Through the characteristics of the patient's sleep disorders and the regularity of the T3-T12 spinous process tender points presented in the Governor Vessel back segment to assist in the diagnosis of gastroesophageal reflux disease with sleep disorders.At the same time,the improvement of sleep quality and the improvement and recovery of gastroesophageal reflux disease symptoms will help prevent the progression of chronic esophageal lesions and the appearance of anxiety and depression,which will reduce the likelihood of serious complications.MethodsFrom January 2016 to May 2017,60 cases GERD patients meeting the inclusion criteria were collected at the Guangji Hospital of Traditional Chinese Medicine in Beijing.After the informed consent was signed,the patients were divided into western medicine groups and acupuncture group according to the random number table method,and each group includes 30 patients.Among them,the acupuncture group included 2 patients with occult(silent)reflux disease.Since there were no typical symptoms of reflux,such as acid reflux,heartburn,chest pain,and anti-eating in the RDQ score scale,the score was 0,and therefore it was treated as shedding.Acupuncture group included 8 males and 20 females,aged 26 to 78 years;the longest duration of 30 years,the shortest 2 months.Western medicine group included 10 males and 20 females,aged 31 to 73 years,duration of up to 30 years,the shortest 2 months.The gender,age,and disease course of the two groups were statistically analyzed.The difference was not statistically significant(P>0.05).The two groups can be compared.The acupuncture group received acupuncture at the thoracic process from the T3 to T12 in the dorsal raphe of the patient,once every other day,and 3 times per week.Western medicine group patients take Omeprazole enteric-coated capsules,20 mg each time,twice daily.Both groups were treated for 8 weeks.The Reflux disease diagnostic questionnaire(RDQ),gastroesophageal reflux disease symptom scores,and Pittsburgh sleep quality index(PSQI)scores and efficacy were evaluated before and after treatment in both groups.To evaluate the degree of tenderness and tenderness threshold under the spinous process from T3 to T12.The characteristics of sleep disorders were summarized by the specific symptoms of sleep disorders in both groups.Results1.Two groups of RDQ scales were compared before and after treatment:30 patients in the western medicine group and 28 patients in the acupuncture group,there were 7 patients have been recovered in the western medicine group and 10 patients in the acupuncture group.There were 6 effective patients in the western medicine group and 10 effective patients in the acupuncture group respectively.The number of progressive patients was 9 and 3,respectively,and the number of invalid patients was 8 and 5,respectively.There was no worsening of patients in both groups.The more effective rates were 43.3%and 71.4%,respectively.By statistical comparison,the acupuncture group had better results than the western medicine group(P<0.05).2.Before and after treatment,the scores of the two groups of RDQ scales were compared:Before treatment,the difference between the two groups of RDQ scales was not statistically significant(P>0.05),and comparisons can be made.After treatment,the scores of the two groups of RDQ scales were significantly reduced(P<0.01).Differences were made between the two groups before and after treatment,and the results were statistically analyzed-The acupuncture group had a significantly lower RDQ score than the western medicine group(P<0.01).3.Two groups of patients with GERD symptoms rating scale effect before and after treatment were compared:Western medicine group(30 cases)and acupuncture group(28 cases)were cured in 0 and 1 cases respectively,and the markedly effective number was 4 and 8 cases respectively.The effective number of patients was 13 cases and 16 cases respectively.The invalid numbers were 13 cases and 3 cases respectively.The effective rates were 56.7%and 89.3%respectively.By statistical comparison,the acupuncture group had a better effect than the western medicine group(P<0.01).4.Compare two groups of patients before and after treatment the degree of GERD symptom rating scale:Before treatment,the scores of the two groups of GERD symptom scores were not statistically significant(P>0.05),and comparisons can be made.After treatment,the scores of GERD symptom scores were significantly lower in both groups(P<0.01).Differences were made between the two groups before and after treatment,and the results were statistically analyzed.Compared with the western medicine group,the acupuncture group's GERD symptom score significantly decreased(P<0.01).5.The efficacy of PSQI scores before and after treatment in the two groups was compared:Western medicine group(30 cases)and acupuncture group(28 cases)were recovered in 12 cases and 17 cases respectively.The markedly effective number was 2 cases and 6 cases respectively.The effective number was 4 cases and In 3 cases,the invalid number was 12 cases and 2 cases respectively,and the total effective rate was 60.0%and 92.9%respectively.Statistically,acupuncture group was superior to western medicine group(P<0.01).6.Comparison of PSQI scores before and after treatment in the two groups:Before treatment,there was no significant difference in PSQI scores between the two groups(P>0.05),and comparisons could be made.The PSQI scores of the two groups were significantly lower after treatment(P<0.01).Differences were made between the two groups before and after treatment,and the results were statistically analyzed.Compared with the western medicine group,the acupuncture group's PSQI score was significantly lower(P<0.01).7.Statistical analysis of sleep disorder symptoms in 58 patients with GERD.Accompanied with heartburn,saliva,cough percentage 86%,dream percentage 83%,midnight 0 a.m.to 3 a.m.awakening percentage 76%.Sleep may be accompanied by snoring.Percentage of smoothness 69%,easy to awaken 69%,shallow percentage of sleep 48%,36%normal left lateral decubitus,26%semi-recumbent,habitual right lateral decubitus 21%,no specific posture performance 17%.8.Comparison of tenderness before and after treatment between patients with GERD and sleep disorders:The degree of tenderness before and after treatment with T3 to T12 in the acupuncture group and the western medicine group was counted,respectively,by statistical non-parametric test,and before treatment In comparison,the degree of tenderness before treatment in the acupuncture group was significantly higher than that after treatment(P<0.01).The degree of tenderness before treatment in the western medicine group was stronger than that after treatment(P<0.05);the degree of tenderness was compared between the two groups after treatment.Relieving acupuncture group was better than western medicine group(P<0.05).9.The threshold value of pre-treatment and post-treatment tenderness in patients with GERD and sleep disorders was compared between the two groups:There was no statistically significant difference in the threshold value of tenderness before treatment between the two groups(P>0.05).After the two groups of treatment,the tenderness threshold value at T4 and T5 in the acupuncture group was significantly higher than that in the western medicine group(P<0.01),and the tenderness threshold value at the T6,T7,T8,and T11 in the acupuncture group was higher than that in the western medicine group(P<0.05).Compared with before treatment in this group,the T4 and T5,T6,T7,T8,and T11 tenderness thresholds value in the acupuncture group were significantly higher than those before treatment(P<0.01),and the T4 tenderness threshold value in the western medicine group was increased(P<0.05).There was no significant change in T3,T9,T10,and T12 pressure thresholds after treatment in both groups(P>0.05).Conclusion1.The results of this study show that acupuncture T3?T12 under the spinous process treatment of GERD patients with sleep disorders have a good effect,which is the embodiment of the "same disease with different treatment",breaking the past way that use western medicine suppression of gastric acid combined with anti-anxiety drugs or the pattern of acupoint selection based on syndrome differentiation in traditional Chinese medicine has opened up new ways for the treatment of GRED with sleep disorders.And clinically found that acupuncture group compared with western medicine group GERD patients with sleep disorders have overall,multi-directional conditioning effect,the treatment effect is more lasting.2.Sleep disorders associated with GERD have their own characteristics.After acupuncture treatment,the threshold value of tenderness in acupuncture group was significantly higher than that in western medicine group,and the degree of tenderness was obviously relieved compared with western medicine group,and had a certain regularity.Therefore,the characteristics of sleep disorders and the characteristics of the tenderness and back pressure threshold can be used as indicators for the initial diagnosis and acupuncture treatment of gastroesophageal reflux disease with sleep disorders.Moreover,acupuncture at the dorsal ramus T3?T12 treatment of GERD associated with sleep disorders is significant,safe and no side effects,it is worth promoting. |
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