针刺联合穴位埋线序贯治疗轻中度溃疡性结肠炎

Acupuncture combined with acupoint catgut embedding sequential therapy for mild and moderate ulcerative colitis

目的:验证针刺联合穴位埋线序贯与单纯西药治疗轻中度溃疡性结肠炎的疗效。方法:将120例患者随机分为针穴序贯组和美沙拉秦组,每组60例,最终针穴序贯组57例、美沙拉秦组55例纳入统计。针穴序贯组采用活动期针刺治疗,穴取天枢、上巨虚、曲池,缓解期采用穴位埋线,穴取脾俞、足三里、关元;美沙拉秦组采用美沙拉秦口服,均治疗12周。比较两组治疗前后中医症状积分、结肠镜评分、黏膜愈合率。观察两组临床疗效、期间的不良反应及治疗后随访1年的复发率。结果:两组治疗后的中医症状评分均较治疗前降低(均P<0.05),且针穴序贯组低于美沙拉秦组(P<0.05);针穴序贯组总有效率明显高于美沙拉秦组[87.7%(50/57)vs 70.9%(39/55),P<0.05]。治疗后两组结肠镜评分均较治疗前降低(均P<0.05),治疗后结肠镜评分及黏膜愈合率[50.9%(29/57)vs 34.5%(19/55)]组间比较差异均无统计学意义(均P>0.05),针穴序贯组复发率明显低于美沙拉秦组[8.5%(4/47)vs 32.4%(11/34),P<0.05]。两组治疗期间均未发生严重不良反应。结论:针刺联合穴位埋线序贯治疗可以有效治疗轻中度溃疡性结肠炎,复发率低。

Objective To observe the efficacy of acupuncture combined with acupoint catgut embedding sequential therapy and medication for mild and moderate ulcerative colitis. Methods One hundred and twenty patients were randomized into an acupuncture and acupoint catgut embedding sequential therapy group（a combination group） and a mesalazine group, 60 cases in each one. Fifty-seven cases in the combination group and 55 cases in the mesalazine group were included into analysis. In the combination group, acupuncture was applied at Tianshu（ST 25）, Shangjuxu（ST 37）, Quchi（LI 11） during the activity period, and acupoint catgut embedding was applied at Pishu（BL 20）, Zusanli（ST 36）, Guanyuan（CV 4） during the alleviate period. The patients in the mesalazine group were treated with mesalazine orally. The treatment was given for 12 weeks. The scores of TCM symptoms, colonoscopy, mucosa healing rate were compared before and after treatment in the two groups. The effects, adverse reactions and the recurrent rates during 1-year follow-up were observed. Results After treatment, the scores of TCM symptoms decreased in the two groups（both P〈0.05）, and the result in the combination group was better than that in the mesalazine group（P〈0.05）. The total effective rate in the combination group was 87.7%（50/57）, which was better than 70.9%（39/55） in the mesalazine group（P〉0.05）. The colonoscopy scores decreased after treatment in the two groups（both P〈0.05）. There was no significant difference between the two groups on colonoscopy score and mucosal healing rate [50.9%（29/57） vs 34.5%（19/55）, both P〈0.05]. The recurrent rate in the combination group was 8.5%（4/47）,which was lower than 32.4%（11/34） in the mesalazine group（P〉0.05）. No severe adverse reaction was found during the treatment in the two groups. Conclusion Acupuncture combined with acupoint catgut embedding sequential therapy can improve mild and moderate ulcerative colitis and reduce the recurrent rate.