| ObjectiveIn addition to the two typical symptoms of acid reflux and heartburn in the clinical manifestations of gastroesophageal reflux disease,the symptom of chest pain often occurs.Because the location of gastroesophageal reflux chest pain is close to the painful site of cardiogenic chest pain,clinical Often misdiagnosed,and traditional Chinese medicine is the main treatment,and there are few reports of acupuncture treatment of this disease.One of the purposes of this study is to search for thoracic paralysis,chest pain,chest ruff,chest fullness and other words through the Chinese Medical Dictionary.Analyze the history,pathogenesis and pathogenesis of this disease name,and put forward your own views.The other is to divide the subjects into acupuncture group and western medicine group through clinical trials.The western medicine group was treated with rabeprazole enteric-coated capsules for oral treatment,and the acupuncture group was given T3-T12 subspinous process acupuncture points and non-points For acupuncture treatment of acupoints to dredge Du meridian to lower adverse Qi,observe and evaluate the clinical efficacy of acupuncture at the back of Dumai T3-T12 for gastroesophageal reflux chest pain using RDQ scale.The law of tenderness of gastroesophageal reflux chest pain,objectively evaluate its therapeutic effect,verify the law of tenderness of Dumai points and non-points of patients with gastroesophageal reflux disease in the previous group,conduct a questionnaire on chest pain symptoms of the subjects,and understand the gastroesophageal reflux Characteristics of chest pain symptoms in patients with fluid chest pain to distinguish cardiogenic chest pain,to avoid unnecessary waste of medical resources and misdiagnosis and treatment in the clinic.MethodsAccording to the inclusion criteria,60 subjects who met the criteria were included.The subjects were all patients with gastroesophageal reflux chest pain diagnosed and treated by the Department of Acupuncture and Moxibustion,Guangji Chinese Medicine Hospital,Beijing Guangci Chinese Medicine Research Institute,January 2018 to June 2019 According to the random number table method,the included cases were randomly divided into acupuncture group and western medicine group,30 cases in each group.In the acupuncture group,there were 11 males and 19 females,with a minimum age of 29 years and a maximum age of 67 years,with an average of(48.17±11.16)years;the course of disease was 1 year to 18 years,with an average of(6.23 ± 4.07)years.In the western medicine group,there were 14 males and 16 females,with a minimum age of 27 years and a maximum of 71 years,with an average of(54.03± 11.93)years;the course of disease was 2 years to 19 years,with an average of(8.23±4.99)years.There was no statistically significant difference in baseline data such as gender,age,and course of disease between the two groups(P>0.05),which was comparable.The western medicine group gave patients rabeprazole sodium enteric-coated capsules for oral treatment(manufactured by Jichuan Pharmaceutical Group Co.,Ltd.).The method of administration was twice a day,one capsule(20 mg)each time.week.In the acupuncture group,the acupuncture points and non-acupuncture points on the dorsal segment T3-T12 of the dorsal vein of the Dumai were selected for acupuncture treatment.The patients were treated three times a week and were treated on Tuesday,Thursday,and Saturday respectively.The treatment cycle was eight weeks.Reflux Disease Diagnostic Questionnaire(RDQ)was scored before and after treatment in both groups of patients.A questionnaire survey was conducted on the symptoms of gastroesophageal reflux chest pain.Results1.Comparison of total RDQ scores before and after treatment between patients in acupuncture group and Western medicine group:There was no significant difference in RDQ scores between the two groups before treatment(P>0.05),which can be compared.After treatment,the two groups were compared within the group and compared between the groups.After treatment,the RDQ scores of the two groups were lower than before treatment(P<0.05).The acupuncture group was compared with the Western medicine group after treatment.The RDQ score of the acupuncture group was compared with the Western medicine group.Significantly reduced,the difference was statistically significant(P<0.05).2.Comparison of the RDQ symptom scores(acid reflux,heartburn,chest pain,and food loss)between the acupuncture group and the Western medicine group before and after treatment:There was no statistically significant difference in the symptom scores between the two groups before treatment(P>0.05).For comparison,after the treatment,the symptom scores in the group were lower than before the treatment.After treatment,there was no statistically significant difference between the two groups in the scores of acid reflux and gastrointestinal symptoms(p>0.05).Compared with the scores of chest pain and heartburn symptoms,the scores of the acupuncture group were significantly lower than those of the western medicine group,and the differences were statistically significant.Academic significance(p<0.01)3.Comparison between the acupuncture group and the Western medicine group before and after the treatment of RDQ scale score:of the two groups of patients with gastroesophageal reflux chest pain,6 patients in the acupuncture group recovered,17 cases were markedly effective,5 cases were effective,2 cases were invalid,no deterioration Case.In the western medicine group,7 patients were cured,2 were markedly effective,12 were effective,9 were ineffective,and there were no worsening cases.The recovery rate was calculated based on the number of patients cured and the number of effective patients.The recovery rate of the patients in the acupuncture group was 76.67%,and the recovery rate of the patients in the western medicine group was 30%.The curative effect was significantly better than that of the western medicine group,and the difference was statistically significant(p<0.01).4.Comparing the total score of minor symptoms in patients with gastroesophageal reflux chest pain between acupuncture group and western medicine group:the difference in total score of minor symptoms before treatment between the two groups was not statistically significant(P>0.05),which can be compared.After treatment,the comparison between the groups was compared with the comparison between the groups.Within the two groups,the symptom score after treatment was significantly lower than the pre-treatment score(p<0.05).The difference was statistically significant.After treatment,the total score of minor symptoms in the acupuncture group was significantly lower than that in the Western medicine group(p<0.05).The difference was statistically significant5.Comparison of various system scores of minor symptoms in patients with gastroesophageal chest pain in acupuncture group and western medicine group:There was no statistically significant difference in system scores between the two groups before treatment(P>0.05).After treatment,the two groups were compared within the group and between the groups.In the group comparison,the acupuncture group’s digestive system symptoms,respiratory system symptoms,facial features dental symptoms,and circulatory system symptoms scores were lower than before treatment(P<0.05),the difference was Statistical significance;there was no statistical difference between the digestive system symptoms and circulatory system symptoms scores in the Western medicine group after treatment(P>0.05),and the respiratory system symptoms and facial features dental symptoms scores were lower than before treatment(P<0.05).Statistical significance.Compared between the two groups,the scores of digestive system symptoms,respiratory system symptoms,and facial features dental symptoms in the acupuncture group after treatment were lower than those in the Western medicine group(P<0.05).6.Comparison of the scores of the secondary symptom scores of patients with gastroesophageal chest pain after acupuncture group and western medicine group The effective rate of secondary symptoms was 46.67%.The acupuncture group was significantly better than the Western medicine group(p<0.05),the difference was statistically significant.7.Comparison of tenderness thresholds of patients with gastroesophageal reflux chest pain between acupuncture group and western medicine group before and after treatment:There was no significant difference in tenderness thresholds between the two groups before treatment(P>0.05).After treatment,the two groups were compared within the group and compared between the groups.After the Western medicine group,the tenderness threshold under the spinous processes of T3,T4,T5,T7,T8,T9,T10,and T12 was lower than before treatment(p<0.05).Acupuncture After treatment,the tenderness threshold under the spinous process T3～T12 was significantly higher than before treatment(p<0.05).After treatment,the acupuncture group was compared with the Western medicine group.The acupuncture group had T6,T7,T8,T9 acupoints under the spinous process The tenderness threshold is more obvious than that of the western medicine group(p<0.05).8.The nature and proportion of pain in the questionnaire survey of symptom characteristics of patients with gastroesophageal reflux chest pain:specifically including eight types of pain,hidden pain,tingling,severe colic,suffocating pain,burning pain,bloating pain,squeezing And near-death pain and dull pain,among which,hidden pain and tingling accounted for the highest proportion,with 21 cases of hidden pain accounting for 35%,and 20 cases of tingling pain,accounting for 33.33%.9.Statistics of the occurrence time of chest pain in patients with gastroesophageal reflux chest pain:specifically including five time points,1-2h after a meal,when sleeping at night,when the mood is unstable,there is no obvious pattern after waking up in the morning,and chest pain occurs There were 22 cases in the first 1-2 hours after the meal,accounting for the highest proportion,36.67%,and 20 cases during nighttime sleep,accounting for 33.33%.10.Statistics of the duration of chest pain in patients with gastroesophageal reflux chest pain:specifically including five time segments,within 15min,15-30min,30-60min,more than 1h,a day of uninterrupted pain,of which the duration of chest pain is within 15min The proportion in the time segment is the highest,18 cases,accounting for 30%.11.In the questionnaire survey on symptoms of patients with gastroesophageal reflux chest pain:35 patients had end-seated breathing symptoms accounted for 58.33%,of which,33 patients had chest pain symptoms relieved after end-seated breathing,accounting for 94.29%.12.In the questionnaire survey of the symptoms and characteristics of patients with gastroesophageal reflux chest pain:37 patients did not take nitroglycerin,fast-acting Jiuxin pills,compound Danshen dripping pills and other drugs for the treatment of cardiogenic chest pain,23 patients had taken it,accounting for 38.33%,And 65.22%of the symptoms have not been relieved after taking.13.The causes of chest pain in patients with gastroesophageal reflux chest pain:specifically include six types,after meals,after eating irritating foods,without obvious incentives,when lying in the supine position or when the abdominal pressure is increased,they are nervous,take aspirin and Steroid anti-inflammatory drugs,etc.Among them,21 patients with no obvious inducement when chest pain occurred,accounting for the highest proportion,35%,15 patients with chest pain after consuming stimulant food,accounting for 25%,13 patients with chest pain after meals,accounting for 21.67%.14.In the questionnaire survey of symptoms of patients with gastroesophageal reflux chest pain:12 patients had a history of misdiagnosis,accounting for 20%.Among them,11 patients were misdiagnosed as cardiogenic chest pain and 1 was misdiagnosed as gastrointestinal stomach pain.15.The frequency of chest pain in patients with gastroesophageal reflux chest pain in the past year:38 patients with chest pain occur once a day,accounting for 63.33%,patients with chest pain once a week and patients with chest pain at least once a month There were 10 cases and 9 cases,accounting for 16.67%and 15%,respectively.The patients with chest pain less than once a month were the least,only 3 cases,accounting for 5%.Conclusion1.The therapeutic effect of acupuncture on T3-T12 acupuncture points and non-acupuncture points of the dorsal segment of the Du vein of gastroesophageal chest pain is better than that of taking rabeprazole enteric-coated capsules in the western medicine group.The therapeutic effect of the dorsal segment of Dumai is better than that of oral rabeprazole enteric-coated capsules.2.The gastroesophageal reflux chest pain patients in the acupuncture group and the western medicine group after treatment had higher thresholds for acupuncture points and non-acupuncture points in the dorsal segment of the dorsal vein of the veins before treatment,and the threshold values in the acupuncture group were more obvious.3.The symptoms of chest pain in patients with gastroesophageal reflux chest pain are similar to the symptoms of cardiogenic chest pain.They are easy to be misdiagnosed and mistreated in clinical practice.Cardiogenic chest pain and gastroesophageal reflux chest pain provide a basis to reduce the waste of medical resources and economic losses. |
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