基于“脑肠轴”探讨俞募配穴法治疗溃疡性结肠炎(肝郁脾虚型)疗效及作用机制

Exploration on the effect and mechanism of back-shu points and front-mu points combination method in treating liver-stagnation with spleen-deficiency type ulcerative colitis based on the theory of brain-gut axis

目的比较俞募配穴法与美沙拉嗪片治疗肝郁脾虚型溃疡性结肠炎的疗效差异,并初步探讨其对溃疡性结肠炎的治疗作用机制。方法将2015年1月~2019年6月年河南中医学药大学第一附属医院门诊及住院患者符合纳入标准的120例,随机分为俞募配穴组60例(治疗组)、美沙拉嗪组60例(对照组)。两组均采用美沙拉嗪片口服基础治疗,治疗组同时采用俞募配穴法针刺治疗,穴取脾俞(章门)、胃俞(中脘)、肝俞(期门)。各组均治疗30d后,观察临床疗效及治疗后第1、2、3个月的复发率及5羟色胺(5-HT)、组胺(HIS)的数值变化。结果治疗组总有效率为96.67%,对照组为83.30%,差异有统计学意义(P<0.05);治疗组第1、2、3个月复发率分别为3%、6%、13%,对照组第1、2、3个月复发率分别为3%、8.3%、20%,差异有统计学意义(P<0.05);两组治疗后血清5-HT、HIS数值均降低,治疗组治疗后血清5-HT、组胺数值为(169.46±45.34)ng/L、(20.8±3.80)ng/L,对照组治疗后血清5-HT、HIS数值分别为(187.21±47.53)ng/L、(20.80±4.53)ng/L,差异有统计学意义(P<0.05)。结论俞募配穴法明显改善肝郁脾虚型溃疡性结肠炎患者临床疗效,可降低复发率,尤其是对较长期的复发率有更好的效果,俞募配穴法能明显降低血清5-HT、HIS数值,初步探讨俞募配穴法通过调节脑肠轴达到更好疗效的作用机制。

Objective To compare the therapeutic effect of back-shu points and front-mu points combination method and mesalazine tablets in the treatment of ulcerative colitis with liver-stagnation and spleen-deficiency,and to explore the mechanism of action on ulcerative colitis.Methods 120 cases of outpatients and inpatients from the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from January 2015 to June 2019 who met the inclusion criteria were randomly divided into the back-shu points and front-mu points combination group(treatment group,n=60)and mesalazine group(control group,n=60).Both groups were treated with oral mesalazine tablets for basic treatment,while the treatment group was also given acupuncture treatment of back-shu points and front-mu points.Acupuncture points include pishu(zhangmen),weishu(zhongwan)and ganshu(qimen).After 30 days of treatment,the clinical efficacy,changes in 5-hydroxytryptamine(5-HT)and histamine(HIS)values in the first,second,and third months after treatment were observed.Results The total effective rate in the treatment group was 96.67%,and 83.30%in the control group,and the difference was statistically significant(P<0.05);The recurrence rates in the first,second,and third months of the treatment group were 3%,6%,and 13%,respectively,while in the control group were 3%,8.3%,and 20%,respectively,and the differences were statistically significant(P<0.05);The serum 5-HT and HIS values in both groups were reduced after treatment,and the serum 5-HT and HIS values in the treatment group were(169.46±45.34)ng/L,(20.8±3.80)ng/L,and in the control group were(187.21±47.53)ng/L,(20.80±4.53)ng/L,respectively,and the differences were statistically significant(P<0.05).Conclusion The combination method of back-shu points and front-mu points in treating liver-stagnation with spleen-deficiency type ulcerative colitis can improve the clinical effect,reduce the recurrence rate,especially for longer-term recurrence rate.It can also lower 5-HT and HIS values.Thus,the action mechanism of back-shu points and front-mu points combination method is explored based on the theory of brain-gut axis.