针刺鬼眼穴联合膈下逐瘀汤治疗活动期湿热型溃疡性结肠炎临床观察

Clinical Observation of Acupuncture at Guiyan Point Combined with Infradiaphragmatic Stasis-expelling Decoction in the Treatment of Damp and Heat Type Ulcerative Colitis in Active Stage

目的:观察针刺联合膈下逐瘀汤治疗活动期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:选取在医院接受治疗的90例活动期溃疡性结肠炎(湿热型)患者为研究对象,通过随机分组的方式将患者分为对照组与研究组各45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,研究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,并进行为期6个月的随访工作,对比两组患者疾病复发率。结果:研究组治疗总有效率为93.33%,明显高于对照组73.33%(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,且研究组均明显低于对照组(P<0.05);治疗后研究组肿瘤坏死因子(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);治疗前,两组患者脑肠肽神经递质水平比较均无明显差异(P>0.05),治疗后研究组P物质(SP)水平明显低于对照组(P<0.05),生长抑素(SS)与血管活性肠肽(VIP)水平均明显高于对照组(P<0.05);治疗后,研究组患者炎症性肠病生活质量问卷(IBDQ)各维度评分均明显高于对照组(P<0.05);研究组6个月内疾病复发率为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显著提高活动期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,提高患者的生活质量。

Objective:To observe the clinical efficacy of acupuncture combined with Infradiaphragmatic Stasis-expelling Decoction in the treatment of active dampness-heat type ulcerative colitis,and analyze its effect on the serum inflammatory factors and neurotransmitter levels of brain-gut peptide.Methods:90 patients with active ulcerative colitis(damp and heat type)were selected as the research objects,and the patients were divided into control group and study group by random grouping,with 45 patients in each group.Patients in both groups received basic treatment.On this basis,patients in the control group were treated with Infradiaphragmatic Stasis-expelling Decoction,while patients in the study group were treated with acupuncture at ghost-eye points combined with Infradiaphragmatic Stasis-expelling Decoction.The two groups of patients were treated continuously for 4 weeks.At the end of the treatment course,the efficacy,colonic mucosal lesions and healing,serum inflammatory factors,levels of brain-gut peptide neurotransmitter,and quality of life of the two groups were analyzed and compared.A 6-month follow-up was conducted to compare the disease recurrence rate between the two groups.Results:The total effective rate was 93.33%of the study group,which was significantly higher than 73.33%of the control group(P<0.05).After treatment,Baron score,Geboes index and lesion activity index of the two groups were decreased,and the study 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 study group were significantly lower than the control group(P<0.05).Before treatment,there was no significant difference in the levels of brain-gut peptide neurotransmitter between the two groups(P>0.05).After treatment,the levels of substance P(SP)in the study group were significantly lower than the control group(P<0.05),and the levels of somatostatin(SS)and vasoactive intestinal peptide(VIP)were significantly higher than the control group(P<0.05).After treatment,IBDQ scores of the study group were significantly higher than those of the control group(P<0.05).The disease recurrence rate of the study group within 6 months was 17.78%,significantly lower than that of the control group 37.78%(P<0.05).Conclusion:Acupuncture combined with Infradiaphragmatic Stasis-expelling Decoction can significantly improve the clinical efficacy of active dampness-heat type ulcerative colitis,regulate the level of serum inflammatory factors and levels of brain-gut peptide neurotransmitter,improve the intestinal mucosal function,and the life quality of the patients.