中医杂志

目的 观察针刺经穴治疗脾胃虚弱型功能性消化不良（FD）的临床疗效并探讨其可能作用机制。方法 将60例脾胃虚弱型FD患者随机分为针刺经穴组和多潘立酮组，每组30例。针刺经穴组取经穴足三里、内关、公孙、阴陵泉，平补平泻，单侧取穴，左右交替，每日1次，每次30 min,5次1个疗程，每个疗程间隔2日。多潘立酮组给予多潘立酮片，每次1片，每日3次，饭前15～30 min口服。两组疗程均为4周。比较两组治疗前及治疗4、8周后两组患者的临床症状（包括餐后饱胀不适、早饱感、上腹痛、上腹部烧灼不适）评分，检测血清中5-羟色胺（5-HT）、血管活性肽（VIP）及胰高血糖素样肽-1 (GLP-1)含量；治疗后评价临床疗效。结果 与本组治疗前比较，两组患者治疗4、8周后餐后饱胀不适、早饱感、上腹痛、上腹部烧灼不适评分均降低，血清中5-HT、VIP及GLP-1含量亦明显降低（P<0.05）；治疗4周后，针刺经穴组各症状评分，血清中5-HT、GLP-1水平明显低于多潘立酮组（P<0.05）；治疗8周后，针刺经穴组餐后饱胀不适、早饱感、上腹痛症状评分，血清中5-HT、VIP水平明显低于多潘立酮组（P<0.05）。治疗后针刺经穴组临床总有效率为96.67%(29/30)，优于多潘立酮组的86.67%(26/30,P>0.05)。结论 针刺经穴治疗脾胃虚弱型FD可显著改善临床症状，其机制可能与降低患者血清5-HT、VIP及GLP-1含量相关。

Objective To observe the effects of acupuncture at channel points in treating functional dyspepsia(FD) patients of spleen-stomach weakness syndrome and to explore its potential mechanism. Methods Sixty FD patients of spleen-stomach weakness syndrome were randomly divided into an acupuncture group and a domperidone group, with 30 patients in each group. Acupuncture group was given acupuncture at Zusanli(ST36), Neiguan(PC6), Gongsun(SP4), and Yinlingquan(SP9) using even reinforcing-reducing method. Unilateral points were selected alternately on the left and right sides, once daily, for 30 minutes each session, 5 sessions per course, and a 2-day interval between courses. Domperidone group was given domperidone tablets orally, one tablet each time, three times daily, 15～30 minutes before meals. The total course of treatment was 4 weeks in both groups. Pairwise comparisons of the symptom scores including postprandial fullness and discomfort, early satiety, epigastric pain, and epigastric burning discomfort, and the levels of serum 5-hydroxytryptamine(5-HT), vasoactive intestinal peptide(VIP), and glucagon-like peptide-1(GLP-1) were conducted at pre-treatment, 4, and 8 weeks post-treatment. The clinical efficacy was analyzed and evaluated after treatment. Results Compared with baseline, the symptom scores of postprandial fullness and discomfort, early satiety, epigastric pain and epigastric burning discomfort and the levels of serum 5-HT, VIP and GLP-1 of both groups were significantly decreased after 4 weeks and 8 weeks treatment(P<0. 05). At 4 weeks post-treatment, all symptom scores and the levels of 5-HT and GLP-1 of the acupuncture group were significantly lower than those of the domperidone group(P<0. 05). At 8 weeks post-treatment, the symptom scores of postprandial fullness and discomfort, early satiety and epigastric pain and the levels of 5-HT and VIP of the acupuncture group were significantly lower than those of the domperidone group(P<0. 05). The total effective rate of the acupuncture group(96. 67%, 29/30) was higher than that of the domperidone group(86. 67%, 26/30, P>0. 05). Conclusion Acupuncture at channel points shows good clinical efficacy in the treatment of spleen-stomach weakness syndrome FD, and its mechanism may be related to the decreased levels of 5-HT, VIP, and GLP-1 in serum.