研究疾病:
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胃食管反流性咳嗽
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研究疾病代码:
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Target disease:
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Gastroesophageal reflux cough
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Target disease code:
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研究类型:
Study type:
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干预性研究
Interventional study
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研究设计:
Study design:
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随机平行对照
randomized controlled trial(parallel group design)
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研究所处阶段:
Study phase:
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探索性研究/预试验
Pilot clinical trial
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研究目的:
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1.采用通督宣肺降逆法埋线治疗胃食管反流性咳嗽,并与西药雷贝拉唑肠溶胶囊的治疗作用进行比较;比较内容为反流性疾病诊断问卷(RDQ)评分,咳嗽症状积分表,莱塞斯特咳嗽问卷(LCQ),FeNO浓度,血清TRPV1检测,食管下括约肌压力(LESP)等,以明确各自的作用特点及对患者生理、心理、社会的影响;
2.研究通督宣肺降逆法对胃食管反流性性咳嗽气道高反应性及食管下括约肌压力的影响;
3.比较观察通督宣肺降逆法的有效性、安全性、依从性及经济性。
通过上述临床观察和研究,寻找一种可以替代目前通用的西药治疗的简便、安全、有效、易于推广的治疗方法,以提高临床疗效,改善生活质量,并减轻病人负担,减少药物副作用等,形成规范、可操作的临床技术方案并予以推广应用。
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Objectives of Study:
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1.The treatment of gastroesophageal reflux cough was treated by the reverse embedment method of tongdu xuan lung-lowering, and the therapeutic effect was compared with that of western medicine rabeprazole enteric capsule; The contents of the comparison were reflux disease diagnostic questionnaire (RDQ) score, cough symptom score table, Leicester cough questionnaire (LCQ), FeNo concentration, serum TRPV1 test, lower esophageal sphincter pressure (LESP), etc., in order to clarify the characteristics of their effects and their effects on the physiological, psychological and social of patients;
2.To study the effects of tongdu xuan-lung-lowering inverse method on airway hyperresponsiveness and pressure of lower esophageal sphincter in gastroesophageal reflux cough;
3.To compare and observe the effectiveness, safety, compliance and economy of the inverse method of tongdu xunfei lowering.
Through the clinical observation and research, to find an alternative to the general western medicine treatment is simple, safe, effective and easy to promote treatment, in order to improve the clinical curative effect, improve the quality of life, and reduce the financial burden on patients and reduce side effects of drugs, the clinical technical specification and operational scheme and popularization and application.
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药物成份或治疗方案详述:
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1.试验组
取穴:督脉阳性反应点(C7-T9);如果未探测到阳性反应点,则取:神道、灵台、至阳、大椎、风户。
方法:通督宣肺降逆法
具体操作:患者采取俯卧位,后揣穴定穴,穴位用碘伏消毒。医者洗手,消毒,将羊肠线从注射针头的针尖处装入针体,此时注射针头内针芯稍退后,线头与针失内缘齐平,沿督脉向上斜刺,刺入25-30mm,行提插捻转手法,待得气后,边推针芯,边退针管,将医用可吸收聚乙醇酸手术缝合线埋植于穴位皮下组织或肌层内,线头不得外露,消毒针孔,外敷无菌敷料,胶布固定24小时、嘱患老保持施术部位清洁。每2两周治疗1次,共治疗6周,6周为1疗程。
2.对照组
雷贝拉唑肠溶胶囊(江苏济川制药有限公司)20mg,口服,每次1粒,早晚各一次,共治疗6周,6周为1疗程。
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Description for medicine or protocol of treatment in detail:
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1.Test group
Acupoint selection: positive reaction point of Du pulse (C7-T9); If no positive reaction points are detected, then take: Shinto, Lingtai, Zhiyang, Dazhui, and Fenghu.
Methods: The inverse method of promoting lung and lowering lung was used
Specific operation: patients take prone position, after Chuai acupoint fixed acupoint, acupoint with iodine V disinfection. Healer hand washing, disinfection, the gut from the needle into the needle injection needles, needle core slightly back within the needles, thread and needle loss of flush, the du meridian oblique upward, Pierce, 25 to 30 mm line inserted twisting technique, after waiting for qi, side push pin core, edge back needle, the medical absorbable sutures polyglycolic acid preparetions in acupoints of subcutaneous tissue or muscle layer, The thread should not be exposed, the pinhole should be disinfected, the sterile dressing should be applied externally, and the tape should be fixed for 24 hours. The patient should be asked to keep the operation site clean. The patients were treated once every 2 weeks for a total of 6 weeks, and 6 weeks was a course of treatment.
2.Control group
Rabeprazole enteric-dissolved capsule (Jiangsu Jichuan Pharmaceutical Co., Ltd.)20mg, orally, 1 tablet each time, once in the morning and once in the evening, for a total of 6 weeks, 6 weeks as a course of treatment.
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纳入标准:
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1.诊断标准 :
本研究参照《咳嗽的诊断与治疗指南(2015)》[23]和《胃食管反流病诊断和处理指南》[24]中相关诊断标准如下:
(1)慢性咳嗽,以白天咳嗽为主,进食后加重,持续时间超过8周,胸部CT无明显病变;
(2)咳嗽与进食有关,如餐后咳嗽或进食咳嗽;
(3)伴随反酸、嗳气、胸骨后烧灼感等症状;
(4)胃镜可见反流性食管炎性改变;
(5)排除咳嗽变异型哮喘、嗜酸粒细胞性支气管炎、鼻后滴流综合征等疾病。必备上述条件中的(1)、(5)项,再加上其他任何一项即可临床诊断为GERC。
2.纳入标准:
(1)符合上述诊断标准;
(2)年龄为 18~70岁,性别不限;
(3)无14天内新型冠状病毒肺炎接触史;
(4)无消化系统手术史;
(5)近期未接受相关治疗;
(6)签署知情同意书。
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Inclusion criteria
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1.Diagnostic criteria:
In this study, the relevant diagnostic criteria in the Guidelines for the Diagnosis and Treatment of Caughing (2015) and the Guidelines for the Diagnosis and Management of gastroesophageal reflux disease were as follows:
(1)Chronic cough, mainly in the daytime, worsened after eating, lasting for more than 8 weeks, and no obvious lesions on chest CT;
(2)Coughing is related to eating, such as coughing after meals or eating;
(3)Accompanied by acid reflux, belching, burning sensation behind the sternum and other symptoms;
(4)The changes of reflux inflammation of esophagus were observed by endoscopy;
(5)Cut-variant asthma, eosinophilic bronchitis, postnasal drip syndrome and other diseases were excluded. Items (1) and (5) above, together with any of the other items, are required to be clinically diagnosed as GERC.
2.Inclusion criteria:
(1)It meets the above diagnostic criteria;
(2)Aged 18 to 70 years, gender is not limited;
(3)No exposure history of COVID-19 within 14 days;
(4)No history of digestive system surgery;
(5)No recent treatment;
(6)Signed the informed consent.
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排除标准:
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1.合并肠易激综合征等其他消化系统疾病;
2.合并肿瘤、精神疾病、血液疾病、严重感染等;
3.合并心、肝、肾等严重内科疾病;
4.不愿意接受针刺治疗或有晕针史;
5.药物过敏史者;
6.重度焦虑、抑郁,自杀倾向明显;
7.妊娠或哺乳期妇女。
有以上任意一项者,应予以排除。
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Exclusion criteria:
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1.Complicated with irritable bowel syndrome and other diseases of the digestive system;
2.Complicated tumor, mental disease, blood disease, serious infection, etc.;
3.Complicated with heart, liver, kidney and other serious medical diseases;
4.Unwilling to accept acupuncture treatment or have a history of needle sickness;
5.People with a history of drug allergy;
6.Severe anxiety, depression and obvious suicidal tendency;
7.Pregnant or lactating women.
Any of the above items should be excluded.
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研究实施时间:
Study execute time:
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从From
2021-05-16
至To
2024-05-16
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征募观察对象时间:
Recruiting time:
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从From
2021-05-28
至To
2024-05-16
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