“以火逐龙火”法配合合募配穴针刺治疗急性溃疡性结肠炎的临床研究

Clinical Efficacy Research on Acute Ulcerative Colitis and the Impact of the Change of Inflammatory Factor Levels with Wen Qian Methods Combined with He-Mu Combination Acupuncture

目的观察"以火逐龙火"法配合"合募配穴针刺"治疗急性溃疡性结肠炎的临床疗效及对炎症因子水平变化的影响。方法将110例患者按随机数字表法分为研究组和对照组各55例。研究组予"以火逐龙火"法配合"合募配穴针刺";对照组予枯草杆菌二联活菌肠溶胶囊配合美沙拉嗪肠溶片,均1个月为1个疗程。观察治疗前后肠黏膜Toll样受体4(TLR4)、核转录因子-κB(NF-κB)和Occludin的表达,血清肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)含量变化,结肠镜下病变活动,黏膜病变疗效,综合疗效。结果两组治疗前结肠黏膜中可见大量NF-κB、TLR4细胞,治疗后明显减少,组内治疗前后、组间治疗后比较差异均有统计学意义(P<0.05);两组治疗后Occludin表达逐渐增加、连续,组内治疗前后、组间治疗后比较差异均有统计学意义(P<0.05);两组患者治疗后血清中IL-8、TNF-α含量均较治疗前降低(P<0.01),但研究组在IL-8、TNF-α含量变化方面均低于对照组(P<0.05);治疗后研究组结肠镜下病变活动水平显著低于对照组(P<0.05);黏膜病变疗效方面研究组总有效率为96.37%,对照组总有效率为85.46%,两组总有效率经Wilcoxon秩和检验(P<0.05);综合疗效方研究组总有效率为94.55%,对照组总有效率为76.36%,经Wilcoxon秩和检验(P<0.05)。结论 "以火逐龙火"法配合"合募配穴针刺"能够明显减轻急性溃疡性结肠炎患者临床症状,提高临床疗效,可能的作用机制主要在于降低血清IL-8、TNF-α含量,调节肠黏膜TLR4、NF-κB和Oc-cludin的表达及增强黏膜屏障有关。

Objectives： To observe the clinical efficacy on acute ulcerative colitis and the impact of the change of inflammatory factor levels with Wen Qian Methods combined with He-Mu Combination Acupuncture. Meth- ods： 110 patients were randomly divided into the research group and the control group ,55 cases patients in each group, the research group used Wen Qian Methods combined with He-Mu Combination Acupuncture;the control group was given Live Combined Bacillus Subtilis and Enterocoecus Faeeium Enteric-coated Capsules and mesalazine slow release tablets,one month as a course. The following data was observed before and after treat- ment： the expression of TLR4,NF-KB and Oc-cludin,changes of serum TNF-α and IL-8 content,pathological activity under colonoscopy, curative effeei of mucosal lesion, and comprehensive curative effect. Results： Before treatment,a large number of NF-KB and TLR4 cells were found in the colonic mucosa of the two groups,which decreased significantly after treatment;there was significant difference before and after treatment in the group, and there was significant difference between the groups after treatment （P 〈 0.05 ）. After treatment, the expression of Oc-cludin in the two groups increased gradually and continuously ;there was significant difference before and after treatment in the group,and there was significant difference between the groups after treatment （PP 〈 0.05 ）. The serum levels of IL-8 and TNF-α in the two groups were lower than those before treatment（P〈O.01 ） ,but the con- tent of IL-8 and TNF-α in the research group was lower than that of the control group（P〈0.05）. After treatment,the level of pathological changes under colonoscopy in the research group was significantly lower than that of the control group （P 〈 0.05）. Curative effect of mucosal lesion： the total effective rate of the research group was 96.37% ,while that of the control sroup was 85.46% ,with Wilcox-on rank and inspection （P〈O.05）. Comprehen- sive curative effect： the total effective rate of the research group was 94.55% ,while that of the control group was 76.36% ,with Wilcox-on rank and inspection（P〈 0.05 ）. Conclusions： Wen Qian Methods combined with He-Mu Combination Acupuncture can significantly reduce the clinical symptoms in patients with active ulcerative colitis, raise clinical curative effect. The possible mechanisms of action are to reduce the content of serum IL-8 and TNF-c~,regulate the expression of TLR4,NF-KB and Oc-cludin in intestinal mucosa and enhance the mucosal barrier.