针刺、脐灸联合美沙拉嗪治疗肝郁脾虚型结肠炎临床研究

Clinical Study on Acupuncture and Umbilical Moxibustion Combined with Mesalazine for Colitis of Liver Constraint and Spleen Deficiency Type

目的:观察针刺、脐灸联合美沙拉嗪治疗肝郁脾虚型结肠炎的临床疗效。方法:选取120例肝郁脾虚型结肠炎患者,按随机数字表法分对照1组、对照2组、治疗组,每组40例。对照1组给予美沙拉嗪治疗,对照2组在对照1组基础上加用脐灸治疗,治疗组在对照1组基础上给予脐灸联合针刺治疗。3组均治疗4周,随访6个月。比较3组临床疗效、症状积分、炎症因子[白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)]、汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分、炎症性肠病患者生活质量量表(IBDQ)评分、复发率及不良反应发生率。结果:治疗4周后,治疗组总有效率95.00%,均高于对照1组70.00%、对照2组77.50%(P<0.05)。对照1组与对照2组总有效率比较,差异无统计学意义(P>0.05)。治疗4周后,3组脓血便、腹痛、腹泻积分均较治疗前降低(P<0.05),治疗组脓血便、腹痛、腹泻积分均低于对照1组、对照2组(P<0.05),对照2组脓血便、腹痛、腹泻积分均低于对照1组(P<0.05)。治疗4周后,3组血清IL-6、TNF-α水平均较治疗前降低(P<0.05),血清IL-10水平均较治疗前升高(P<0.05);治疗组血清IL-6、TNF-α水平均低于对照1组、对照2组(P<0.05),血清IL-10水平均高于对照1组、对照2组(P<0.05);对照2组血清IL-6、TNF-α水平均低于对照1组(P<0.05),血清IL-10水平高于对照1组(P<0.05)。治疗4周后,3组HAMA、HAMD评分均较治疗前降低(P<0.05),IBDQ评分均较治疗前升高(P<0.05);治疗组HAMA、HAMD评分均低于对照1组、对照2组(P<0.05),IBDQ评分均高于对照1组、对照2组(P<0.05);对照2组HAMA、HAMD评分均低于对照1组(P<0.05),IBDQ评分高于对照1组(P<0.05)。治疗组复发率5.26%、不良反应发生率2.50%,均低于对照1组53.57%、25.00%,以及对照2组32.26%、20.00%(P<0.05)。对照1组、对照2组复发率及不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:针刺、脐灸联合美沙拉嗪治疗肝郁脾虚型结肠炎,可有效改善症状、负性情绪及生活质量,调节炎症因子水平,降低复发率,安全性好。

Objective:To observe the clinical effect of acupuncture and umbilical moxibustion combined with Mesalazine on colitis of liver constraint and spleen deficiency type.Methods:A total of 120 cases of patients with colitis of liver constraint and spleen deficiency type were selected and divided into the control group 1,the control group 2,and the treatment group according to the random number table method,with 40 cases in each group.The control group 1 was treated with Mesalazine,the control group 2 was additionally treated with umbilical moxibustion based on the treatment of the control group 1,and the treatment group was additionally treated with acupuncture and umbilical moxibustion on the basis of the control group 1.The three groups were treated for four weeks and followed up for six months.Clinical effects,symptom scores,inflammatory factors[interleukin-6(IL-6),interleukin-10(IL-10),and tumor necrosis factor-α(TNF-α)],the scores of the Hamilton Anxiety Scale(HAMA),Hamilton Depression Rating Scale(HAMD)and Inflammatory Bowel Disease Queationaire(IBDQ),recurrence rates,and incidence of adverse reactions were compared among the three groups.Results:After four-week treatment,the total effective rate was 95.00%in the treatment group,which was higher than that of 70.00%in the control group 1 and that of 77.50%in the control group 2(P<0.05).There was no significant difference in the comparison of the total effective rate between the control group 1 and the control group 2(P>0.05).After four-week treatment,the scores of stool containing pus and blood,abdominal pain,and diarrhea in the three groups were declined when compared with those before treatment(P<0.05);the scores of stool containing pus and blood,abdominal pain,and diarrhea in the treatment group were lower than those in the other two groups(P<0.05);the scores of stool containing pus and blood,abdominal pain,and diarrhea in the control group 2 were lower than those in the control group 1(P<0.05).After fourweek treatment,the levels of IL-6 and TNF-αin serum in the three groups were dropped when compared with those before treatment(P<0.05),and the serum IL-10 levels were increased when compared with those before treatment(P<0.05);the levels of IL-6 and TNF-αin serum in the treatment group were lower than those in the control group 1 and the control group 2(P<0.05),and the serum IL-10 level in the treatment group were lower than those in the other two groups(P<0.05);the levels of IL-6 and TNF-αin serum in the control group 2 were lower than those in the control group 1(P<0.05),and the serum IL-10 level in the control group 2 was lower than that in the control group 1(P<0.05).After four-week treatment,the scores of HAMA and HAMD in the three groups were decreased when compared with those before treatment(P<0.05),and the IBDQ scores were increased when compared with those before treatment(P<0.05);the scores of HAMA and HAMD in the treatment group were lower than those in the control group 1 and the control group 2(P<0.05),and IBDQ scores in the treatment group were higher than those in the other two groups(P<0.05);the scores of HAMA and HAMD in the control group 2 were lower than those in the control group 1(P<0.05),and the IBDQ scores in the control group 2 were higher than those in the control group 1(P<0.05).The recurrence rate and incidence of adverse reactions in the treatment group were 5.26%and 2.50%,respectively,which were lower than those in the control group 1(53.57%and 25.00%,respectively)and the control group 2(32.26%and 20.00%,respectively)(P<0.05).There were no significant differences in the comparison of recurrence rate and incidence of adverse reactions between the control group 1 and the control group 2(P>0.05).Conclusion:Acupuncture and umbilical moxibustion combined with Mesalazine for colitis of liver constraint and spleen deficiency type can effectively improve symptoms,and negative emotions and quality of life,regulate the levels of inflammatory factors,and reduce recurrence rate,with good safety.