目的:探讨艾灸治疗慢性胃炎的疗效与机制,为艾灸治疗慢性胃炎提供客观依据。方法:将61例慢性胃炎患者分为隔药饼灸组和温和灸组。两组治疗均选双侧天枢、中脘、气海施灸。治疗前后所有入选病例均进行胃肠疾病中医证候评分、视觉模拟评分(visual analog score,VAS),并检测血清促生长素、生长抑素(somatostatin,SS)和胃动素(motilin,MTL)含量的变化。结果:隔药饼灸组与温和灸组治疗慢性胃炎总有效率差异无统计学意义(P〉0.05)。治疗后,两组胃肠疾病中医证候评分、V AS评分均明显降低,与本组治疗前均有统计学差异(均P〈0.01)。两组治疗后血清促生长素、M TL升高,SS降低,治疗前后比较均有显著性差异(均P〈0.01)。并且在治疗期间无不良事件发生。结论:隔药饼灸与温和灸均是治疗慢性胃炎的有效方法,两者在改善腹部不适和胃痛方面疗效相当。隔药饼灸与温和灸在抗炎、促进胃粘膜修复和改善胃动力方面起重要作用,该作用可能是其有效治疗慢性胃炎的重要机制。
Objective: To investigate the efficacy and mechanisms of moxibustion-based treatment of chronic gastritis (CG), and to provide an objective basis for treating CG using moxibustion. Methods: A total of 61 CG patients were divided into an herbal cake-partitioned moxibustion group and a mild-warm moxibustion group. In both treatment groups, bilateral Tianshu (ST 25), Zhongwan (CV 12) and Qihai (CV 6) were selected for moxibustion. Before and after treatment, all the enrolled patients' gastrointestinal disease-related traditional Chinese medicine (TCM) syndrome scores and visual analog scale (VAS) scores were measured, and the changes in the serum levels of the brain-gut peptides ghrelin, somatostatin (SS) and motilin (MTL) were observed. Results: There was no statistically significant difference between the two groups in the clinical efficacy rate (P〈0.05). After treatment, the gastrointestinal disease-related TCM syndrome scores and VAS scores were reduced to varying extents in both groups, the intra-group differences were statistically significant (all P〈0.01). In both groups, the serum levels of ghrelin and MTL increased and the serum levels of SS decreased after treatment (all P〈0.01). And there were no serious adverse events occurred. Conclusion: Both herbal cake-partitioned moxibustion and mild-warm moxibustion are effective for CG, these two therapies exhibited similar therapeutic efficacy of epigastric discomfort or pain. And both the two therapies act to anti-inflammation, promote the recovery of gastric mucosa and improve the gastric motility, which is possibly their crucial action mechanism in treating CD.