CAJ | 학술논문

目的：观察针灸配合穴位注射治疗顽固性膈肌痉挛（呃逆）的临床疗效，并寻求其规范化治疗方案。方法采用前瞻性研究方法，将新疆医科大学第一附属医院临床各科符合入选标准的86例顽固性呃逆患者按治疗方案不同分为观察组和对照组，两组均43例。观察组在治疗原发病的基础上，遵循宽胸理气，和胃降逆的法则，选取膻中、内关（双）、足三里（双）、三阴交（双）、太冲穴（双）行针灸治疗，每次留针20 min，针灸治疗结束5 min后，于双侧足三里穴各注射胃复安1 mL，每日1次；对照组在治疗原发病的基础上，肌肉注射胃复安10 mg，每日1次；两组均连续治疗7 d。观察两组治疗后3 d、5 d的临床疗效，以及治疗前和治疗后3、5、7d呃逆发生频率和呃逆持续时间的变化。结果与对照组比较，观察组治疗后3d、5d总有效率均明显高于对照组〔治疗后3 d：88.4%（38/43）比51.2%（22/43）；治疗后5 d：95.3%（41/43）比62.8%（27/43），均P＜0.01〕。随着治疗时间的延长，两组治疗后呃逆发生频率逐渐降低，呃逆持续时间逐渐缩短，治疗后7d为最低，且以观察组的变化更显著〔呃逆发生频率（次/d）：0.57±0.08比2.04±1.78；呃逆持续时间（min/次）：1.07±0.68比9.23±5.69，均P＜0.05〕。结论针灸配合穴位注射治疗顽固性呃逆效果明显好于单纯西医治疗者。
목적：관찰침구배합혈위주사치료완고성격기경련（애역）적림상료효，병심구기규범화치료방안。방법채용전첨성연구방법，장신강의과대학제일부속의원림상각과부합입선표준적86례완고성애역환자안치료방안불동분위관찰조화대조조，량조균43례。관찰조재치료원발병적기출상，준순관흉리기，화위강역적법칙，선취단중、내관（쌍）、족삼리（쌍）、삼음교（쌍）、태충혈（쌍）행침구치료，매차류침20 min，침구치료결속5 min후，우쌍측족삼리혈각주사위복안1 mL，매일1차；대조조재치료원발병적기출상，기육주사위복안10 mg，매일1차；량조균련속치료7 d。관찰량조치료후3 d、5 d적림상료효，이급치료전화치료후3、5、7d애역발생빈솔화애역지속시간적변화。결과여대조조비교，관찰조치료후3d、5d총유효솔균명현고우대조조〔치료후3 d：88.4%（38/43）비51.2%（22/43）；치료후5 d：95.3%（41/43）비62.8%（27/43），균P＜0.01〕。수착치료시간적연장，량조치료후애역발생빈솔축점강저，애역지속시간축점축단，치료후7d위최저，차이관찰조적변화경현저〔애역발생빈솔（차/d）：0.57±0.08비2.04±1.78；애역지속시간（min/차）：1.07±0.68비9.23±5.69，균P＜0.05〕。결론침구배합혈위주사치료완고성애역효과명현호우단순서의치료자。
Objective To observe the clinical efficacy of acupuncture combined with acupoint injection for treatment of patients with intractable hiccups and to seek its standard therapeutic regimen. Methods A prospective study was conducted. Eighty-six patients with intractable hiccups in various clinical departments in the First Affiliated Hospital of Xinjiang Medical University met the inclusion criteria of this study were selected,and according to the different treatment options they were divided into observation group and control group with 43 cases in each group. In the observation group,on the basis of treatment for their primary diseases,the rules of soothing the chest oppression and regulating the flow of qi(Kuanxiong Liqi)and regulating the stomach and sending down abnormally ascending qi(Hewei Jiangni)were followed in treatment,and acupuncture was carried out at Danzhong,Neiguan(double=bilateral acupoints),Zusanli(double),Sanyinjiao(double),Taichong(double)with the needle staying for 20 minutes each time,1 mL metoclopramide injection was injected at each of the bilateral Zusanli acupoints,once a day. In the control group,the patients received intramuscular injection of 10 mg metoclopramide once a day. Both groups were treated for consecutive 7 days. After treatment for 3 days and 5 days,the clinical efficacy was observed,and before treatment and after treatment for 3,5,7 days,the changes of hiccups frequency and persistent duration were investigated. Results Compared with the control group,the total effective rates in observation group on the 3rd and 5th day after treatment were significantly increased〔3 days:88.4%(38/43)vs. 51.2%(22/43),5 days:95.3%(41/43)vs. 62.8%(27/43),both P<0.01〕. With the prolongation of therapy,the hiccups frequency was gradually decreased and the persistent duration of hiccup was gradually shortened,reaching the lowest degree on the 7th day after treatment,and the changes were more significant in the observation group〔hiccups frequency(times/day):0.57±0.08 vs. 2.04±1.78,hiccup duration time(minutes/time):1.07±0.68 vs. 9.23±5.69,both P<0.05〕. Conclusion The therapeutic effects of acupuncture combined with acupoint injection for treatment of patients with intractable hiccups are superior to signal western medicine therapy.