保留灌肠配合针灸治疗溃疡性结肠炎的疗效及对细胞因子的影响

Efficacy of Retention Enema with Acupuncture Treatment of Ulcerative Colitis and Its Effect on the Cytokine

目的探讨中药保留灌肠配合针灸治疗溃疡性结肠炎(UC)的疗效及对细胞因子的影响。方法选取自2013年1月至2014年1月阜新矿业集团总医院收治的UC患者100例,按随机数字表法分为对照组和观察组,各50例。对照组患者口服西药(柳氮磺胺吡啶片,每次1 g,每日3次)配合穴位针灸治疗,观察组患者给予中药(白头翁苦参汤)保留灌肠配合针灸治疗。治疗2个疗程后评估两组患者的疗效,观察临床症状的改善情况,检测治疗前后肠黏膜中细胞因子的表达水平,并进行比较。结果 2个疗程后,观察组总有效率为88.0%(44/50),显著高于对照组64.0%(32/50)(P<0.05);两组患者治疗后的症状体征及肠镜黏膜病变评分均较治疗前明显下降,且观察组下降幅度更大,观察组治疗后的腹痛、腹泻、脓血便及肠镜下表现评分均较对照组低(P<0.05);与治疗前相比,两组患者治疗后的γ干扰素(INF-γ)水平均显著下降,而白细胞介素(IL)-4、IL-10水平均显著升高,差异有统计意义(P<0.01);且观察组INF-γ显著低于对照组[(7.8±1.6)ng/L比(9.4±1.8)ng/L],IL-4、IL-10显著高于对照组[(9.3±1.9)ng/L比(7.4±1.7)ng/L,(30.3±5.3)ng/L比(22.8±4.9)ng/L,P<0.01]。结论白头翁苦参汤保留灌肠配合针灸对溃疡性结肠炎的治疗效果显著,明显优于西药治疗,能明显改善患者的临床症状,减轻肠黏膜炎症、降低INF-γ,升高IL-4、IL-10,有助于肠黏膜免疫功能的改善,值得在临床上推广应用。

Objective - To investigate the efficacy of traditional Chinese medicine retention enema with acupuncture treatment of ulcerative colitis and its influence on the cytokine. Methods From Jan. 2013 to Jan. 2014 in Fuxin Mining Group General Hospital 100 cases of ulcerative colitis were included in the study, according to a random number table they were divided into a control group and an observation group,50 eases in each group. The control group was given sulfasalazine tablets（ 1 g per time and 3 times a day） and acu- puncture treatment, while the observation group was treated with traditional Chinese medicine （Pulsatilla Sophora soup） retention enema with acupuncture treatment. After two courses of treatment the efficacy of the two groups was assessed, the clinical symptoms improvement was observed, the intestinal mucosal cytokine expression levels were tested and compared. Results After two courses of treatment, the total efficacy of the observation group was significantly higher than the control group [ 88.0% （44/50） vs 64. 0% （32/50） （ P 〈 0. 05 ） ; symptoms and signs of the two groups after treatment and colonoscopy mucosal lesions signifi- cantly decreased compared with before treatment, and the observation group decreased more obviously, the abdominal pain,diarrhea,blood and pus and colonoscopy performance scores of the observation group after treatment were lower than the control group （P 〈 0. 05 ） ; compared with before treatment,interferon 3＇ （ INF- 3＇） level of the two groups were significantly decreased, while interleukin （IL）-4, IL-10 levels were signifi- cantly increased, the differences were statistically significant （ P 〈 O. 01 ） ; after treatment, the level of INF-5, in the observation group was significantly lower than the control group [ （ 7. 8 ± 1.6） ng/L vs （ 9. 4 ± 1.8） ng/L] ,while IL-4, IL-10 were significantly higher than the control group [ （ 9.3 ± 1.9 ） ng/L vs （7.4±1.7） ng/L,（30.3 ±5.3） ng/Lvs （22.8±4.9） ng/L,P〈O. O1].Conclusion Pulsatilla sophora soup retention enema with acupuncture treatment for ulcerative colitis has significant effect compared withwestern medicine, which not only can significantly improve the clinical symptoms, reduce inflammation of the intestinal mucosa and INF-Y, but also can effectively improve IL-4 and IL-10, helping to improve the intestinal mucosal immune function, thus is woahv of the clinical aoolication.