针刺联合膈下逐瘀汤治疗湿热型溃疡性结肠炎临床疗效观察

Observation on the Clinical Effect of Acupuncture Combined with Gexia Zhuyu Decoction in the Treatment of Patients with Damp-heat Ulcerative Colitis

目的:观察针刺联合膈下逐瘀汤治疗湿热型溃疡性结肠炎的临床疗效,分析其对患者血清炎性因子与脑肠肽神经递质水平的影响。方法:选取80例活动期溃疡性结肠炎(湿热型)患者作为研究对象,随机将患者分为对照组与治疗组各40例。两组患者均接受基础治疗,对照组在此基础上采用膈下逐瘀汤治疗,治疗组接受针刺鬼眼穴联合膈下逐瘀汤治疗。两组患者均连续治疗4周,疗程结束后对两组患者疗效情况、结肠黏膜病变及愈合情况、血清炎性因子、脑肠肽神经递质水平、生活质量进行分析比较,并进行随访。结果:治疗组治疗总有效率为92.5%,明显高于对照组的70.0%(P<0.05);治疗后,两组患者Baron评分、Geboes指数及病变活动指数较治疗前均有所下降,且治疗组均明显低于对照组(P<0.05);治疗后治疗组肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平均明显低于对照组(P<0.05);治疗后,治疗组患者炎症性肠病质量问卷(IBDQ)各维度评分均明显高于对照组(P<0.05);治疗组6个月内复发率为17.78%,明显低于对照组的37.78%(P<0.05)。结论:针刺联合膈下逐瘀汤治疗可以显著提高湿热型溃疡性结肠炎的临床疗效,调节患者血清炎性因子与脑肠肽神经递质水平,改善患者肠道黏膜功能,提高患者生活质量。

Objective:To observe the clinical efficacy of acupuncture combined with Gexia Zhuyu Decoction in the treatment of damp-heat ulcerative colitis,and to analyze its effect on the levels of serum inflammatory factors and brain-gut peptide neurotransmitters.Methods:80 patients with active ulcerative colitis(damp-heat type)were selected as the research objects,and the patients were divided into control group and treatment group by random grouping,with 40 cases in each group.Patients in the two groups received basic treatment,the control group was treated with Gexia Zhuyu Decoction on this basis,and the treatment group received acupuncture at the Guiyan acupoint combined with Gexia Zhuyu Decoction.Patients in both groups were treated for 4 consecutive weeks.After the course of treatment,the curative effect,colonic mucosal lesions and healing,serum inflammatory factors,brain gut peptide neurotransmitter levels,and quality of life were analyzed and compared between the two groups of patients,and they were followed up.Results:After treatment,the total effective rate of treatment in the treatment group was 92.5%,which was significantly higher than 70.0%in the control group(P<0.05).After treatment,the Baron score,Geboes index and disease activity index of the two groups of patients decreased compared with before treatment,and the treatment group was significantly lower than the control group(P<0.05).After treatment,the levels of tumor necrosis factor(TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)in the treatment group were significantly lower than those in the control group(P<0.05).After treatment,the scores of all dimensions of the Inflammatory Bowel Disease Quality Questionnaire(IBDQ)in the treatment group were significantly higher than those in the control group(P<0.05).The disease recurrence rate in the treatment group within 6 months was 17.78%,which was significantly lower than 37.78%in the control group(P<0.05).Conclusion:Acupuncture combined with Gexia Zhuyu Decoction can significantly improve the clinical efficacy of damp-heat ulcerative colitis and regulate the levels of serum inflammatory factors and brain-gut peptide neurotransmitters,improve the function of the intestinal mucosa,and improve the quality of life of the patients.