壮医药线点灸联合梅花针治疗胆汁淤积性肝病瘙痒临床研究

舒发明 黄英 邱华 覃丽萍 秦祖杰

摘要：目的 觀察壮医药线点灸联合梅花针治疗胆汁淤积性肝病瘙痒的临床疗效。方法 将纳入符合课题研究标准的胆汁淤积性肝病瘙痒患者64例随机分为4组，每组16例。A组：点灸组;B组：梅花针组;C组：点灸加梅花针组;D组为对照组，采用炉甘石治疗。观察时间为2个疗程，共14 d。收集各组患者治疗前后血生化ALP、GGT、TBIL、TBA指标，VAS瘙痒程度评分。结果 经治疗后，4组患者在肝功能指标组内比较：肝功能指标ALP、GGT、TBIL等指标数值均较治疗前下降，差异有统计学意义（P<0.05）。组间比较，肝功能差异无统计学意义（P>0.05）;治疗后在改善VAS瘙痒程度比较：各组评分均较治疗前下降，差异有统计学意义（P<0.05）;C组优于其他3组，差异具有统计学意义（P<0.05）;4组患者临床疗效比较：C组明显优于A组、B组、C组，差异具有统计学意义差异（P<0.05）。结论 （1）壮医药线点灸加梅花针组在改善瘙痒疗效上优于壮医药线点灸组、梅花针组、炉甘石组，提高患者生活质量。（2）4种不同干预措施均可改善肝功能指标，但差异不明显。（3）治疗期间安全，无明显的不良反应，是安全有效的治疗措施。

关键词：壮医药线点灸;梅花针组;胆汁淤积;瘙痒

中图分类号：R246 文献标志码：B 文章编号：1007-2349（2021）06-0051-04

【Abstract】Objective： To observe the clinical effect of Zhuang medicated thread-point moxibustion combined with plum-blossom needle in the treatment of cholestatic liver disease pruritus. Methods： 64 cholestatic liver disease pruritus patients who met the research criteria of the subject were randomly divided into 4 groups， 16 cases per group. Namely， group A was as moxibustion group; group B， plum blossom needle group， group C， moxibustion plus plum-blossom needle group， and group D， the control group， and all were treated with calamine. The observation time was 2 courses of treatment， 14 days altogether. The blood biochemical ALP， GGT， TBIL， TBA indexes and VAS pruritus scores of the patients of each group were collected before and after treatment. Results： After treatment， the comparison of the liver function index of the patients in the four groups showed the liver function indexes ALP， GGT， TBIL and other indexes were all lower than those of the prior treatment， and the difference was statistically significant （P<0.05）. There was no statistically significant difference in liver function among the groups （P>0.05）. The comparison of the improvement of VAS pruritus after treatment showed the scores of each group were lower than those of the prior treatment， and the difference was statistically significant （P<0.05）. Group C was better than the other 3 groups， and the difference was statistically significant （P<0.05）. Among the comparison of the clinical effect of the four groups， group C was significantly better than group A， group B and group C， and the difference was statistically significant （P<0.05）. Conclusion： （1） Zhuang medicated thread-point moxibustion combination group is better than Zhuang medicine thread-point moxibustion group， the plum blossom needle group and calamine group in the improvement of the curative effect of the pruritus， and improves the quality of life of patients. （2） The four different interventions can improve liver function indexes， but the difference is not obvious. （3） The method is safe during the treatment period without obvious adverse reactions， and is a safe and effective treatment.

【Key words】Zhuang Medicated Thread-Point Moxibustion; Plum-Blossom Needle Group; Cholestasis; Pruritus

胆汁淤积是指因肝内或者肝外等诸多原因致使胆汁的生成、分泌或排泄障碍，胆汁不能正常到达十二指肠，反流至血液，进入血液循环，从而引起一系列生理病理改变的临床综合征，主要表现有皮肤瘙痒，黄疸，大便呈灰白陶土样，伴有乏力、食欲减退等症状[1]。近年来，本病的发病率不断上升，瘙痒作为胆汁淤积性肝病一个常见症状，给肝病患者带来极大痛苦，目前西医有关胆汁淤积性肝病继发瘙痒发病机制仍不明确，疗效有限。民族医药在皮肤病的治疗积累了丰富经验，而作为民族医学分支之一的壮医，近年来在皮肤瘙痒的治疗上异军突起，疗效显著。课题组通过观察壮医药线点灸联合梅花针治疗胆汁淤积性肝病瘙痒的临床疗效，疗效满意，现总结报道如下。……