世界中医药

目的:探究内关穴位按压配合生姜敷贴法对妊娠剧烈呕吐患者胃动素水平的影响。方法:选取2017年1月至2019年3月张家港市中医医院收治的妊娠剧烈呕吐患者70例作为研究对象,按照治疗方案不同分为对照组和观察组,每组35例。对照组予以常规对症治疗,观察组在此基础上引入内关穴位按压配合生姜敷贴法进行治疗,2组患者治疗时间均为7 d。观察2组患者临床疗效以及呕吐清水、食入即吐、头晕厌食、恶心呕吐等中医症候积分;记录2组患者呕吐次数、止吐时间、住院天数、妊娠恶心呕吐生命质量量表(NVPQOL)、妊娠专用恶心呕吐量化表(PUQE),并分别于治疗前后采用放免测试法检测患者血清中胃动素,采用试带法检测2组患者尿酮体水平,同期比较2组患者上述指标的差异。结果:观察组临床疗效(94.29%)明显高于对照组(74.29%）(χ2=5.285,P=0.022);经过治疗后,2组患者呕吐清水、食入即吐、头晕厌食、恶心呕吐等中医症候积分均出现显著降低,且观察组低于对照组(P<0.01);2组患者尿酮体均显著降低,且观察组低于对照组(P<0.01);2组患者胃动素均显著升高,且观察组高于对照组(P<0.01);2组患者PUQE、NVPQOL评分均显著降低,且观察组低于对照组(P<0.01);观察组呕吐次数、止吐时间、住院时间等均明显优于对照组(P<0.05);此外,观察组复发率为5.71%(2/35),对照组复发率为22.86%(8/35),组间差异有统计学意义(χ2=4.200,P=0.040)。结论:内关穴位按压配合生姜敷贴法治疗妊娠剧吐疗效显著,能够有效改善机体尿酮体及胃动素水平,且可显著缩短患者呕吐时间及住院时间,减少呕吐次数,提高生命质量。

English Summary:

To explore the effects of Neiguan(PC6)acupoint pressing combined with ginger application on motilin level in patients with hyperemesis gravidarum.Methods:A total of 70 patients with hyperemesis gravidarum who were treated in Zhangjiagang Hospital of Traditional Chinese Medicine from January 2017 to March 2019 were selected and divided into a control group(35 cases)and an observation group(35 cases).The control group was given routine symptomatic rehydration support treatment.On this basis, the observation group was treated with Neiguan(PC6)acupoint pressing combined with ginger application.The treatment time of both groups was 7 days.The clinical efficacy and TCM symptom scores of vomiting clear water, nausea and vomiting after ingestion, dizziness and anorexia, nausea and vomiting were observed.The vomiting frequency, time to stop vomiting, hospitalization days, PUQE and NVPQOL were recorded.Serum motilin was measured by radioimmunoassay before and after treatment.The test strip method was used to detect the levels of uroketones in the 2 groups, and the differences in the above indicators were compared between the 2 groups at the same time.Results:The clinical efficacy of the observation group(94.29%)was significantly higher than that of the control group(74.29%)(χ2=5.285, P=0.022); after treatment, the scores of vomiting clear water, vomiting while eating, dizziness, anorexia, nausea and vomiting in the 2 groups were significantly decreased, and the observation group was lower than those in the control group(P<0.01); the levels of urea ketone body in both groups were significantly decreased, and the observation group was lower than those in the control group(P<0.01); motilin in both groups were significantly increased and the observation group was lower than those in the control group(P<0.01).The PUQE and NVPQOL scores in the 2 groups were significantly decreased and the observation group was lower than those in the control group(P<0.01); the vomiting frequency, antiemetic time and hospitalization time in the observation group were significantly better than those in the control group(P<0.05); in addition, the recurrence rate in the observation group was 5.71%(2/35)and that in the control group was 22.86%(8/35), with statistical differences between the 2 groups(χ2=4.200, P=0.040).Conclusion:Neiguan(PC6)acupoint pressing combined with ginger application is effective in the treatment of hyperemesis gravidarum.It can effectively improve the level of urinary ketone body and motilin, shorten the time of vomiting and hospitalization, reduce the number of vomiting, and improve the quality of life.

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