从肺论治以荆芥连翘方结合针刺鬼眼穴治疗溃疡性结肠炎的临床观察

Treatment of ulcerative colitis with Jingjie Lianqiao Decoction in combination with acupuncture at Guiyan(LU 11 and SP 1) from the viewpoint of "treating lung primarily"

目的 观察从肺论治以荆芥连翘方结合针刺鬼眼穴治疗溃疡性结肠炎的临床效果。方法 将泸州市中医医院于2020年2月至2021年5月收治的101例溃疡性结肠炎患者,以随机数字表法分为对照组(51例)与观察组(50例),对照组给予美沙拉嗪灌肠治疗,观察组在对照组基础上给予荆芥连翘方结合针刺鬼眼穴治疗,两组均连续治疗1个月。比较两组治疗后的临床疗效、不良反应,治疗前后的中医证候积分、结肠镜检查结果评分(the baron score, Baron)、结肠黏膜愈合情况评分(colonic mucosal healing score, Geboes)及血清中肠道黏膜屏障功能指标D-乳酸(D-lactic acid, D-LA)、二胺氧化酶(diamine oxidase, DAO)的变化,随访1年观察两组疾病复发情况。结果 观察组总有效率为96.00%,对照组总有效率为84.31%,观察组总有效率高于对照组(P<0.05)。治疗后,两组患者中医证候总积分、Baron评分、Geboes评分、D-LA及DAO水平均较治疗前下降(P<0.05),且观察组患者治疗后中医证候总积分、Baron评分、Geboes评分、D-LA及DAO水平均低于对照组(P<0.05)。两组均未见严重不良反应;观察组治疗后1年疾病复发率低于对照组(P<0.05)。结论 从肺论治以荆芥连翘方结合针刺鬼眼穴治疗溃疡性结肠炎临床效果显著,患者疾病好转,恢复较好,且无严重不良反应,1年复发率低,安全可靠。

Objective To observe the clinical efficacy of Jingjie Lianqiao Decoction in combination with acupuncture at Guiyan(LU 11 and SP 1) in the treatment of ulcerative colitis from the viewpoint of "treating lung primarily". Methods A total of101 patients with ulcerative colitis admitted to Luzhou Hospital of Chinese Medicine from February 2020 to May 2021 were randomly divided into control group(51 cases) and observation group(50 cases). The control group was treated with mesalazine enema,and the observation group was treated with Jingjie Lianqiao Decoction combined with acupuncture at Guiyan(LU 11 and SP 1)additionally. Both groups were treated continuously for one month. The clinical efficacy and adverse reactions of the two groups after treatment were compared. Before and after treatment, the TCM pattern score, Baron score, the colonic mucosal healing score(Geboes), and the serous levels of D-lactic acid(D-LA) and diamine oxidase(DAO) which were the indices of the intestinal mucosal barrier function were assessed respectively. The disease recurrence was observed in the two groups after 1 year of follow-up.Results The total effective rate in the observation group which was 96.00%, was higher than that in control group which was84.31%(P<0.05). After treatment, the total score of TCM pattern, Baron score, Geboes score, D-LA and DAO levels of the patients in the two groups decreased compared with those before treatment(P<0.05), and these indices in observation group after treatment were lower than those in control group(P<0.05). No serious adverse reactions were observed in both groups. The recurrence rate of the disease in observation group was lower than that in control group one year after treatment(P<0.05). Conclusion Application of Jingjie Lianqiao Decoction combined with acupuncture at Guiyan(LU 11 and SP 1) in the treatment of ulcerative colitis from the viewpoint of "treating lung primarily" is safe and reliable, which can effectively improve the clinical symptoms and promote the recovery, with no serious adverse reactions and low one-year recurrence rate.