针灸治疗活动期克罗恩病:随机对照研究

Active Crohn's disease treated with acupuncture and moxibustion:a randomized controlled trial

目的：观察针灸治疗活动期轻、中度克罗恩病患者临床常见主症的疗效及安全性。方法：将102例患者随机分成观察组和对照组,各51例。观察组采用隔药灸结合针刺治疗,隔药灸药饼配方以黄连、炮附子、肉桂、木香、红花、丹参、当归等为主要成分,穴取天枢、气海和中脘;针刺穴取足三里、上巨虚、三阴交、太溪、公孙和太冲。对照组采用隔麦麸灸结合浅针刺治疗,隔麦麸灸将麦麸制成饼,取穴同观察组,浅针刺选取观察组穴位旁开1~2cm的非经非穴区。两组均每周治疗3次,治疗12周（共36次）。采用中医症状积分观察患者腹痛（程度、频度、时间）、腹泻（次数、性状、频度）、神疲乏力、食少纳差、肠鸣矢气、畏寒肢冷、腰膝酸软和里急后重症状的临床疗效。结果：经过12周的治疗,两组患者腹痛（程度、频度、时间）、腹泻（次数、性状、频度）、神疲乏力、食少纳差、肠鸣矢气、畏寒肢冷、腰膝酸软和里急后重八组中医症状积分较治疗前均显著降低（均P〈0.05）;观察组腹痛（程度、频度、时间）、腹泻（性状、频度）、神疲乏力及食少纳差症状积分较对照组降低更明显（均P〈0.01）;两组患者其他症状积分组间比较差异均无统计学意义（均P〉0.05）。结论：隔药灸结合针刺是治疗轻、中度克罗恩病的一种安全、有效的治疗方法,能有效改善克罗恩病患者临床常见主症,且对腹痛（程度、频度、时间）、腹泻（性状、频度）、神疲乏力和食少纳差的改善效果显著优于隔麦麸灸结合穴旁浅刺者。

Objective To observe the effects and safety of clinical common symptoms of active Crohn＇s disease at the mild and moderate stages treated with acupuncture and moxibustion.Methods One hundred and two patients were randomly divided into an observation group and a control group,51 cases in each one.Herb-partition moxibustion and acupuncture were used in the observation group.Herbal cakes with Huanglian（coptis chinensis）,Fuzi（radix aconiti carmichaeli）,Rougui（cinnamomum cassia）,Muxiang（radices saussureae）,Honghua（carthamus tinctorious）,Danshen（the root of red-rooted salvia）and Danggui（angelica sinensis）as the main ingredients were used on Tianshu（ST 25）,Qihai（CV 6）and Zhongwan（CV 12）;acupuncture was used at Zusanli（ST 36）,Shangjuxu（ST 37）,Sanyinjiao（SP 6）,Taixi（KI 3）,Gongsun（SP 4）and Taichong（LR 3）.Branpartition moxibustion and shallow acupuncture were applied in the control group.Wheat bran-partition moxibustion in the shape of cake was implemented on the same acupoints as the observation group;shallow acupuncture was used 1~2cm next to the acupoints.Treatment was given three times a week for 12 weeks,36times totally.Clinical effects of eight symptoms were evaluated by TCM symptom score,and the symptoms included abdominal pain（degree,frequency,time）,diarrhoea（number,shape and frequency）,fatigue,anorexia,borborygmus and flatus,fear of cold,soreness and weakness of waist and knees,tenesmus.Results After 12-week treatment,the eight symptoms were improved apparently（all P〈0.05）,with the scores of abdominal pain（degree,frequency,time）,diarrhoea（shape and frequency）,fatigue and anorexia in the observation group decreasing more obviously（all P〈0.01）.There was no statistical significance about the other symptom scores between the two groups（all P〈0.05）.Conclusion Herb-partition moxibustion combined with acupuncture achieve safety and efficacy for mild and moderate Crohn＇s disease,and can improve the clinical common symptoms.Furthermore,their effects on abdominal pain（degree,frequency,time）,diarrhoea（shape and frequency）,fatigue and anorexia are better than those of bran-partition moxibustion and shallow acupuncture.