隔药饼灸治疗脾虚湿蕴证轻中度溃疡性结肠炎临床研究

Clinical Study on Medicinal-cake-separated Moxibustion Treatment for Mild-to-moderate Ulcerative Colitis of Spleen Deficiency and Dampness Type

目的探讨隔药饼灸治疗脾虚湿蕴证轻中度溃疡性结肠炎(UC)的临床疗效及作用机制。方法采用随机数字表法将60例患者分为观察组和对照组各30例。对照组予美沙拉嗪栓剂,每次1栓,每日1次,置入直肠;观察组在上述基础上加用隔药饼灸。将药饼(制附子、党参、黄连、丹参、延胡索、木香3︰3︰2︰2︰2︰1配制)置于穴位(第1组为脾俞、中脘、足三里,第2组为大肠俞、天枢、上巨虚,每次取1组,2组交替使用),将艾炷置于药饼上,每壮灸5 min,每次灸3壮,每日1次。疗程均为8周。观察治疗前后主要症状(腹泻、腹痛、脓血便)评分及总分、肠镜Baron评分和血清CC亚族趋化因子配体20(CCL20)蛋白表达水平,评价临床疗效,观察不良反应。结果观察组和对照组的总有效率分别为93.33%(28/30)、76.67%(23/30),观察组优于对照组(P<0.05);2组治疗后主要症状评分及总分、肠镜Baron评分及血清CCL20蛋白表达水平较治疗前下降(P<0.05),与对照组比较,观察组治疗后各指标改善更明显(P<0.05);观察组、对照组分别出现1、2例不良反应,差异无统计学意义(P>0.05)。结论隔药饼灸治疗脾虚湿蕴证轻中度UC安全有效,其作用可能与调节CCL20蛋白表达水平有关。

Objective To explore clinical efficacy and mechanisms of medicinal-cake-separated moxibustiontreatment for mild-to-moderate ulcerative colitis(UC)of spleen deficiency and dampness type.Methods Totally60cases were randomly divided into observation group and control group according to a random digits table,with30cases in each group.The control group was inserted into the anus with mesalamine suppository1g once a day,whilethe observation group was given medicinal-cake-separated moxibustion treatment once a day based on the treatmentfor the control group.Medicinal cake(Aconiti Lateralis Radix Praeparata:Codonopsis Radix:Coptidix Rhizoma:Salviae Miltiorrhizae Radix et Rhizoma:Corydalis Rhizoma:Aucklandiae Radix=3:3:2:2:2:1)was put on theacupoints(Pishu,Zhongwan and Zusanli for the first group,Dachangshu,Tianshu and Shangjuxu for the secondgroup,one group for each time,and2groups were used interchangeably).One wormwood cylinder was put onmedicinal cake,5min each time,3doses each time,once a day.The treatment course for all was8weeks.The mainsymptom scores(diarrhea,bellyache,pus and blood stool)and total scores,colonoscopy Baron score and serum CCchemokine ligand20(CCL20)expression level were compared between before and after treatment in the two groups.The clinical efficacy was evaluated and the adverse reactions were observed.Results The total effective rate inobservation group was93.33%(28/30)and significantly higher than that of the control group of76.67%(23/30).After the treatment,the main symptom scores and total scores,colonoscopy Baron score and serum CCL20expression levelwere significantly lower than those of pre-treatment in the same one group(P<0.05),which of the observation groupwere remakably lower than those of the control group(P<0.05);there was one case occured adverse reaction in theobservation group and two cases in the control group,with no statistical significance between the two groups(P>0.05).Conclusion Medicinal-cake-separated moxibustion treatment is effective and safe in patients withmild-to-moderate UC of spleen deficiency and dampness type,which effects might be involved in regulating theexpression of serum CCL20.