| Objective:This study collects clinical cases of refractory functional dyspepsia(RFD),analyzes the distribution of TCM Syndromes and related factors,and summarizes the clinical characteristics of RFD,in order to improve clinical efficacy.At the same time,minimal acupuncture(MA)is used as a control group to observe the effect of acupuncture on RFD,which will provid an scientific basis for acupuncture treatment of refractory functional dyspepsia.Methods:1.Collect 130 refractory functional dyspepsia patients,formulate clinical questionnaires,record demographic information(name,gender,age,height,weight),disease duration,main clinical symptoms,TCM syndrome types,diagnosis of TCM of "phlegm" syndromes,diagnosis of Anxiety and depression and the curative effect.2.70 patients with refractory functional dyspepsia were randomly divided into test group and control group.The test group was treated with acupuncture in Zhongwan(CV12),Zusanli(ST36),and Neiguan(PC6).At the same time,increased dialectical matching points according to clinical needs.The control group was treated with minimal acupuncture.3 times a week for 4 weeks in both groups.Dyspeptic symptom sum score,total scores of TCM syndromes,Hospital Anxiety and Depression Scale(HAD),Nepean dyspepsia Quality of Life Index(NDQLI),and safety evaluation were performed before and after treatment.Results:1.Analysis of TCM syndrome distribution and related factors in refractory functional dyspepsia(1)Among the 130 patients with refractory functional dyspepsia,there were 49 males and 81 females.The average age was48.71±10.58 years,the average BMI was 22.85±2.90 kg/m2,and the average disease duration was 4.67±2.17 years.The distribution of TCM syndrome types is in descending order:42 cases of phlegm-dampness due to spleen deficiency(32.30%)>31 cases of liver-stomach disharmony(23.80%)>17 cases of spleen-stomach damp-heat(13.10%)>16 cases of spleen-stomach weakness(12.30%)>13cases of cold and hot miscellaneous(10%)>11 stomach yin deficiency(8.50%).(2)There were no significant differences in gender,age,and duration of disease between RFD patients with different syndrome types(P>0.05).Among the different syndrome types,the patients' BMI of refractory functional dyspepsia was different(P <0.01).Among them,patients with phlegm-dampness due to spleen deficiency and spleen-stomach damp-heat were heavier,while patients with deficiency of gastric yin were thinner.(3)Among 130 patients with RFD,there were 84patients(64.5%)with anxiety and depression.There was a certain degree of anxiety and depression in patients with different syndromes,especially in liver-stomach disharmony and phlegm-dampness due to spleen deficiency.(4)Among 130 patients with RFD,a total of 63 patients(48.5%)who met the diagnostic criteria for "phlegm" syndrome of TCM.In addition to phlegm-dampness due to spleen deficiency,other types of syndromes,such as liver-stomach disharmony,spleen-stomach damp-heat,spleen-stomach weakness,and cold and hot miscellaneous,also have "phlegm syndrome".2.Observation on the therapeutic effect of acupuncture on refractory functional dyspepsia(1)Baseline analysis of RFD patients in the two groups:Comparison between the test group and the control group at baseline,the two groups of RFD patients were no statistically significant difference in gender,age,BMI,course of disease,Dyspeptic symptom sum score,total scores of TCM syndromes,hospital anxiety and depression scale(HAD),Nepean dyspepsia Quality of Life Index(NDQLI)(P>0.05).And the two groups were comparable.(2)Evaluation of the clinical symptoms of patients with RFD in two groups:compared with the baseline period,in the test group with RFD patients,Dyspeptic symptom sum score and TCM syndrome scores were significantly lower than before(P<0.01);Dyspeptic symptom sum score and TCM syndrome scores in the control group with RFD patients were not statistically significant than before(P>0.05).Between two groups:After 4 weeks of treatment,compared with the control group with RFD patients,the test group with RFD patients showed a more significant decrease in Dyspeptic symptom sum score(P<0.01),and in TCM syndrome score(P<0.05).(3)Evaluation of anxiety and depression in patients with RFD in two groups:compared with the baseline period,in the test group with RFD patients,HAD-A?HAD-D?HAD scores were significantly lower than before(P<0.01);while HAD-A?HAD-D?HAD sores in the control group with RFD patients were not statistically significant than before(P>0.05).Between two groups:After 4 weeks of treatment,compared with the control group with RFD patients,the test group with RFD patients showed a more significant decrease in HAD-A(P<0.05)?HAD-D(P<0.05)?and HAD(P<0.01).(4)Evaluation of the quality of life of patients with RFD in two groups:compared with the baseline period,in the test group with RFD patients,NDLQI total average scores and its interference areas,control areas,diet areas and sleep areas were significantly increase than before(P<0.01).NDLQI total average scores and its interference areas,control areas,diet areas and sleep areas in the control group with RFD patients were not statistically significant than before(P>0.05).After 4 weeks of treatment,compared with the control group with RFD patients,the test group with RFD patients showed a more significant increase in NDLQI total average scores(P<0.01)and in its interference areas(P<0.01),control areas(P<0.01),diet areas(P<0.01).(5)Safety evaluation :There were no serious adverse events in the two groups with RFD patients during the study,and Acupuncture treatment of RFD is highly safe.Conclusions:1.In refractory functional dyspepsia,the majority of TCM syndrome types is "phlegm-dampness due to spleen deficiency",and "Sputum syndrome" can also be combined in other syndrome types.Its refractory is closely related to "phlegm" syndrome.2.Acupuncture can significantly improve gastrointestinal symptoms,mental status and quality of life in patients with refractory functional dyspepsia,and it is highly safe. |
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