饶贞权　张教明　龚新宇

[摘要] 目的 观察针刀松解联合穴位埋线对慢性胃炎患者血清表皮生长因子（EGF）及前列腺素E2（PGE2）的影響。 方法 116例慢性胃炎患者均为2012年6月～2015年6月丹江口市中医院针灸科住院患者，将其随机分为观察组和对照组。观察组59例采用针刀松解术联合穴位埋线治疗，先用针刀松解T5～T10关节突关节囊，然后松解T7～T12肋横突关节囊，最后取中脘、肝俞、胆俞、脾俞及胃俞穴行穴位埋线治疗，每次治疗间隔1周。对照组57例口服西药治疗：铝碳酸镁片4次/d，1 g/次；枸橼酸莫沙必利片3次/d，5 mg/次；兰索拉唑肠溶片，2次/d，30 mg/次，共2周。观察比较两组治疗前后血清中EGF和PGE2的含量变化差异。 结果 两组治疗后血清EGF及PGE2含量均较治疗前明显升高（P < 0.01），且观察组治疗后血清EGF及PGE2含量明显高于对照组，差异有高度统计学意义（P < 0.01）。 结论 针刀松解术结合穴位埋线治疗慢性胃炎可明显提高患者血清EGF及PGE2的含量，增强胃黏膜保护作用，从而治愈该病。

[关键词] 针刀松解术；穴位埋线；慢性胃炎；表皮生长因子；前列腺素E2

[中图分类号] R573.3 [文献标识码] A [文章编号] 1673-7210（2017）01（c）-0173-04

[Abstract] Objective To observe the effect of acupotomy lysis combined with acupoint catgut embedding for serum epidermal growth factor （EGF） and prostaglandin E2 （PGE2） in patients with chronic gastritis. Methods One hundred and sixteen patients with chronic gastritis were all the inpatients in Department of Acupuncture and Moxibustion of Danjiangkou Hospital of Traditional Chinese Medicine from June 2012 to June 2015， they were randomly divided into observation group and control group. 59 cases of observation group were given acupotomy lysis combined with acupoint catgut embedding therapy， at first， zygopophysis and joint capsule of T5-T10 was loosed by acupotomy， then costotransverse joint capsule of T7-T12 was loosed， at last， acupoint catgut embedding was applied at Zhongwan （RN 12）， Ganshu （BL 18）， Danshu （BL 19）， Pishu （BL 20） and Weishu （BL 21）， once treatment every 1 week. 57 cases of control group were given oral western medicine： Aluminum Magnesium Carbonate Tablets， 4 times/d， once 1 g； Mosapride Citrate Tablets， 3 times/d， once 5 mg； Lansoprazole Enteric-coated Tablets， 2 times/d， once 30 mg， for 2 weeks totally. The changes of contents of serum EGF and PGE2 in the two groups before and after treatment were observed and compared. Results The contents of serum EGF and PGE2 in the two groups were all significantly higher than those before treatment （P < 0.01）， and the contents of serum EGF and PGE2 in the observation group were significantly higher than those of control group， the differences were highly statistically significant （P < 0.01）. Conclusion Acupotomy lysis combined with acupoint catgut embedding therapy in the treatment of chronic gastritis can significantly increase the contents of serum EGF and PGE2， strengthen the protection of gastric mucosa， thus cure this disease.

[Key words] Acupotomy lysis； Acupoint catgut embedding； Chronic gastritis； Epidermal growth factor； Prostaglandin E2

慢性胃炎临床发病率高，病程迁延反复，是胃癌演变的必经环节。临床治疗通常以服用抑酸护胃、抗Hp感染、改善胃动力等西药为主，但长期服用疗效有限且副作用明显[1-2]。本课题组前期研究发现，经针刀结合穴位埋线治疗后，胃炎患者胃电节律及胃电功率均明显降低[3]，血清胃泌素及血浆胃动素含量显著升高，结果优于西药组[4]。此外，该治法有效调节了患者血清超氧化物歧化酶（SOD）和丙二醛（MDA）水平，治疗后SOD含量显著增加，而MDA含量显著降低，提高了抗氧化酶活性，减轻了自由基损伤，抑制了脂质过氧化物反应，从而减轻或消除了慢性胃炎患者的胃黏膜损伤状态，效果优于西药组（P < 0.01）[5]，提示小针刀松解术结合穴位埋线可有效改善机体胃电活动，促进胃肠动力，加强胃排空能力，促使胃肠道对水、电解质等营养物质的运输，并调整其分泌功能，达到缓解并减轻慢性胃炎患者上腹部饱胀、疼痛，改善食少纳呆等症状的目的。胃镜检测评定炎症积分显示治疗后针刀结合穴位埋线组降低更明显（P < 0.01）[6]。以上结果均提示小针刀松解术结合穴位埋线治疗慢性胃炎有确切疗效，且优于口服西药治疗。本研究旨在探讨针刀松解术结合穴位埋线对慢性胃炎患者胃黏膜损伤修复过程中相关的表皮生长因子（epidermal growth factor，EGF）及前列腺素E2（prostaglandin E2，PGE2）血清含量的影响，现报道如下：

1 资料与方法