Study Of Clinical And Neurological Mechanism In Treating Patients With Gastroparesis With Combination Of Co-acupoint Acupuncture And Abdomen Vibration Method To Promote Gastric Emptying

Objective:To observe the effect of different acupoint compatibility combined with vibration therapy on gastric emptying in patients with gastroparesis,and the difference of its effects on motilin,gastrin and brain imaging,to analyze the guiding role of acupoint compatibility theory in massage treatment of gastroparesis,to study the gastrointestinal neurological mechanism of massage treatment of gastroparesis,and to provide objective basis for the promotion and application of the combination of Hemu acupoint and vibration therapy for gastroparesis.Methods:This study is a small sample exploratory study.Thirty subjects with gastroparesis were randomly divided into treatment group 1,treatment group 2 and treatment group 3,with 10cases in each group.The treatment group 1 was treated by the combination point of vibration abdomen according to Zhongwan point,the treatment group 2 was treated by the combination point of vibration abdomen method according to Zusanli point,and the treatment group 3 was treated by the combination point of vibration abdomen method according to Zhongwan point and Zusanli point for 20 minutes/time,5 days as a course of treatment,2 days between courses of treatment,a total of 4 courses of treatment.Using13C-octanoic acid breath test,barium meal gastric emptying test,GCSI and its early satiety score,gastric distention score,postprandial satiety score and anorexia score as clinical evaluation indexes,the effects of different acupoints combined massage on gastric emptying in patients with gastroparesis were observed.Neurological mechanism of gastrointestinal tract in the treatment of gastroparesis.Results:1 GCSI:After 2 weeks of treatment,there were significant differences between treatment group 1 and treatment group 2（P<0.05）,treatment group 3 and treatment group 1（P<0.01）,treatment group 3 and treatment group 1（P<0.01）,treatment group 1 and treatment group 1（P<0.01）,treatment group 3 and treatment group 2（P<0.05）.2 The results of early satiety score,gastric distention score,postprandial satiety score and anorexia score were as follows:1.Early satiety score:after 2 weeks of treatment,the end of treatment and 2 weeks of follow-up,there were significant differences between the treatment group and the treatment group 1（P<0.01）.（2）Gastric distension score:After 2weeks of treatment,there was a difference between the treatment group 1 and the treatment group 2（P<0.05）.（3）Postprandial fullness score:After 2 weeks of treatment,there was a difference between treatment group 1 and treatment group 2（P<0.05）;after treatment and2 weeks of follow-up,there was a significant difference between treatment group 1 and treatment group 2（P<0.01）,and there was a significant difference between treatment group3 and treatment group 1（P<0.01）.（4）Appetite deficiency score:After 2 weeks of treatment,there was significant difference between treatment group and treatment group 1（P<0.01）,treatment group 1 and treatment group 2（P<0.01）;after 2 weeks of follow-up,there was significant difference between treatment group 3 and treatment group 1（P<0.01）,treatment group 1 and treatment group 2（P<0.05）.3¹³C-octanoic acid breath test results:1.Delayed gastric emptying time:after treatment,there were significant differences between the three groups,the treatment group 1and the treatment group 2（P<0.01）.（2）Gastric half emptying time:After treatment,there were significant differences between the three groups,the treatment group 1 and the treatment group 2（P<0.01）.4 Barium meal gastric emptying test results:After treatment,there was a difference between the treatment group 3 and the treatment group 2（P<0.05）.5 The expression levels of motilin and gastrin:1.Motilin:After treatment,there were significant differences between treatment group 3 and treatment group 1（P<0.01）,and between treatment group 1 and treatment group 2（P<0.05）.（2）Gastrin:After treatment,there was significant difference between treatment group 3 and treatment group 2（P<0.01）,and there was difference between treatment group 1 and treatment group 2（P<0.05）.6 The results of 6 fMRI showed that the difference of brain function between treatment group 2 and treatment group 1 was mainly in cerebellar area and central posterior gyrus;the difference between treatment group 3 and treatment group 1 was mainly in parietal lobe and central posterior gyrus;and the difference between treatment group 3 and treatment group 2 was mainly in putamen and thalamus.Conclusions:1 Through this study,the therapeutic scheme of Hemu point combined with vibration therapy is superior to non-acupoint group in promoting gastric emptying and regulating the expression of motilin and gastrin in patients with gastroparesis.It proves that acupoint compatibility plays an important guiding role in massage clinic.2 Gastric emptying experiment proves that Hemu acupoint combined with vibration method can improve gastric receptive relaxation,promote gastric emptying,improve gastrointestinal motility,regulate gastric acid secretion,alleviate gastrointestinal smooth muscle spasm,and improve the clinical symptoms of gastroparesis patients.3 Neurological experiments have proved that different acupoints combined with massage therapy have significant differences in the expression of motilin and gastrin in patients.Brain imaging studies have proved that the effects of different acupoint compatibility schemes on brain functional areas of patients are also significantly different,which provides a reference for similar research in the future.4 Through this study,on the one hand,it proves that acupoint combination has an important guiding role in massage clinic,and the combination of acupoint combination and abdominal vibration therapy has a good therapeutic effect on gastroparesis;on the other hand,it proves that the combination of acupoint combination and abdominal vibration therapy for gastroparesis is closely related to the adjustment of gastrointestinal nerve function.From the perspective of clinical and biological mechanism,the combination of acupoint combination and abdominal vibration therapy for gastroparesis is effective.The popularization and application provide objective basis.