针刺联合中药治疗溃疡性结肠炎疗效及对相关指标的影响
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摘要
目的观察针刺联合中药治疗溃疡性结肠炎(UC)近期疗效及对其血红蛋白(Hb)、红细胞比容(Hct水平及肠道菌群和炎症因子的影响。方法选取130例UC患者,按照随机数字表法分为观察组和对照组,每组65例,两组均给予维持水电解质平衡、改善营养等对症治疗,在此基础上对照组给予中药益阳愈溃汤治疗,观察组在对照组基础上联合针刺治疗。观察两组治疗前后中医症候积分、症状消失时间、临床疗效,检测Hb和Hct水平、肠道菌群、肿瘤坏死因子-α(TNF-α)、白介素-33(IL-33)、白介素-10(IL-10)水平。结果治疗后两组中医症候积分显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05);观察组发热、腹痛、黏液脓血便、腹泻消失时间显著低于对照组(P<0.05);观察组总有效率为92.3%,显著高于对照组的78.5%(P<0.05);治疗后两组Hb、Hct水平显著高于治疗前(P<0.05),且观察组显著高于对照组(P<0.05);治疗后两组双歧杆菌、乳酸杆菌显著高于治疗前(P<0.05),且观察组显著高于对照组(P<0.05),两组肠球菌与治疗前比较差异无统计学意义(P>0.05);治疗后两组TNF-α、IL-33水平显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05),两组IL-10水平显著高于治疗前(P<0.05),且观察组显著高于对照组(P<0.05)。结论针刺联合中药可有效提高UC患者Hb、Hct水平,改善肠道菌群和炎症因子,提高临床疗效。
Objective To observe the short-term efficacy of acupuncture plus Chinese medication in treating ulcerative colitis(UC) and its effect on hemoglobin(Hb), hematocrit(Hct), intestinal flora and inflammatory factors.Method A total of 130 UC patients were recruited and divided by the random number table into an observation group and a control group, with 65 cases in each group. The two groups were both given treatments for maintaining water and electrolyte balance and improving nutrition, based on which, the control group was given Chinese medication Yi Yang Yu Kui decoction and the observation group was given the same decoction plus acupuncture. The change in traditional Chinese medicine(TCM) symptom and sign score, symptom releasing time, clinical efficacy, levels of Hb and Hct,intestinal flora, and levels of tumor necrosis factor(TNF)-α, interleukin(IL)-33 and IL-10 in the two groups were observed. Result The TCM symptom and sign score declined significantly after the intervention in both groups(P<0.05), and the score was markedly lower in the observation group than in the control group(P<0.05); it took significantly less time in the observation group to release fever, abdominal pain, mucous bloody stool and diarrhea compared with the control group(P<0.05); the total effective rate was 92.3% in the observation group, significantly higher than 78.5% in the control group(P<0.05); the Hb and Hct levels increased significantly after the treatment in both groups(P<0.05), and the observation group was markedly higher than the control group(P<0.05); the levels of bacillus bifidus and bacillus acidi lactici rose significantly after the intervention in both groups(P<0.05), and the observation group was markedly higher than the control group(P<0.05); there was no significant change in the level of enterococci after the treatment in the two groups(P>0.05); the levels of TNF-α and IL-33 declined markedly after the intervention in both groups(P<0.05), and the observation group was significantly lower than the control group(P<0.05); the level of IL-10 increased significantly after the treatment in both groups(P<0.05), and the observation group was markedly higher than the control group(P<0.05). Conclusion Acupuncture plus Chinese medication can effectively boost the Hb and Hct levels in UC patients, and it can improve the intestinal flora and inflammatory factors and enhance the clinical efficacy.
Objective To observe the short-term efficacy of acupuncture plus Chinese medication in treating ulcerative colitis(UC) and its effect on hemoglobin(Hb), hematocrit(Hct), intestinal flora and inflammatory factors.Method A total of 130 UC patients were recruited and divided by the random number table into an observation group and a control group, with 65 cases in each group. The two groups were both given treatments for maintaining water and electrolyte balance and improving nutrition, based on which, the control group was given Chinese medication Yi Yang Yu Kui decoction and the observation group was given the same decoction plus acupuncture. The change in traditional Chinese medicine(TCM) symptom and sign score, symptom releasing time, clinical efficacy, levels of Hb and Hct,intestinal flora, and levels of tumor necrosis factor(TNF)-α, interleukin(IL)-33 and IL-10 in the two groups were observed. Result The TCM symptom and sign score declined significantly after the intervention in both groups(P<0.05), and the score was markedly lower in the observation group than in the control group(P<0.05); it took significantly less time in the observation group to release fever, abdominal pain, mucous bloody stool and diarrhea compared with the control group(P<0.05); the total effective rate was 92.3% in the observation group, significantly higher than 78.5% in the control group(P<0.05); the Hb and Hct levels increased significantly after the treatment in both groups(P<0.05), and the observation group was markedly higher than the control group(P<0.05); the levels of bacillus bifidus and bacillus acidi lactici rose significantly after the intervention in both groups(P<0.05), and the observation group was markedly higher than the control group(P<0.05); there was no significant change in the level of enterococci after the treatment in the two groups(P>0.05); the levels of TNF-α and IL-33 declined markedly after the intervention in both groups(P<0.05), and the observation group was significantly lower than the control group(P<0.05); the level of IL-10 increased significantly after the treatment in both groups(P<0.05), and the observation group was markedly higher than the control group(P<0.05). Conclusion Acupuncture plus Chinese medication can effectively boost the Hb and Hct levels in UC patients, and it can improve the intestinal flora and inflammatory factors and enhance the clinical efficacy.
引文
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[10]陈伟丽,李春耕,王铁钢,等.健脾平溃汤治疗溃疡性结肠炎急性期的临床观察及对炎症因子的影响[J].中国中医急症,2017,26(5):857-859.
[11]王云龙,赵晓峰,郭海.扶正平溃汤对溃疡性结肠炎患者肠道菌群与致炎细胞因子的影响[J].陕西中医,2017,38(8):1016-1017,1036.
[12]黄建强,林清,文小敏,等.针灸治疗溃疡性结肠炎作用机制探讨[J].中国医药导报,2014,11(5):166-168.
[13]张宏,彭婷婷,徐瑾,等.八珍汤灌肠配温针灸治疗溃疡性结肠炎50例疗效观察[J].国医论坛,2013,28(6):33-34.
[14]赵文韬,吴金萍,王业皇.健脾清热活血方治疗溃疡性结肠炎对肠黏膜屏障修复的随机对照研究[J].世界中医药,2017,12(3):591-594.
[15]勾春宏.扶正平溃汤对溃疡性结肠炎患者细胞因子与肠道菌群的影响[J].西部中医药,2016,29(8):8-10.
[16]王茹.加味四逆散治疗肝郁型溃疡性结肠炎116例[J].河南中医,2015,35(9):2029-2030.
[17]殷网虎,袁武军,曹美琳,等.土茯苓配方颗粒对临床常见致病菌的抗菌研究[J].中国中医急症,2011,20(12):1957-1958.
[18]黄绪银,陈秀清,张奇志.中医针灸治疗慢性溃疡性结肠炎疗效观察[J].中国现代药物应用,2015,9(13):255-256.
[19]张润莲,倪广林,郝雪青,等.中药保留灌肠联合针灸治疗溃疡性结肠炎疗效观察[J].吉林中医药,2012,32(3):270-271.
[20]魏超博.温针灸治疗溃疡性结肠炎59例[J].光明中医,2011,26(11):2272-2273.
[2]李峰.美沙拉嗪联合益阳愈溃汤治疗溃疡性结肠炎疗效观察[J].现代中西医结合杂志,2016,25(8):882-883,912.
[3]胡楚胜,阮丽仙.美沙拉嗪联合益阳愈溃汤治疗溃疡性结肠炎的效果分析[J].现代诊断与治疗,2016,27(2):217-218.
[4]刘芳芳.温针灸治疗脾肾阳虚型溃疡性结肠炎的临床观察[D].北京:北京中医药大学,2016:9.
[5]中华医学会消化病学分会炎症性肠病协作组.中国炎症性肠病诊断治疗规范的共识意见[J].中华内科杂志,2008,47(1):73-79.
[6]张声生.溃疡性结肠炎中医诊疗共识意见[J].中华中医药杂志,2010,25(6):891-895.
[7]江学良,权启镇,王志奎.溃疡性结肠炎的诊断、分型及疗效标准[J].世界华人消化杂志,2000,8(3):332-334.
[8]杜修坤,黄如川,符智深,等.美沙拉嗪联合益阳愈溃汤治疗溃疡性结肠炎疗效分析[J].辽宁中医药大学学报,2015,17(7):213-214.
[9]姚惠,郑培奋,李希诗,等.益气愈溃汤对溃疡性结肠炎IL-33、IL-10及肠道菌群紊乱的纠正作用[J].中华中医药学刊,2013,31(6):1449-1451.
[10]陈伟丽,李春耕,王铁钢,等.健脾平溃汤治疗溃疡性结肠炎急性期的临床观察及对炎症因子的影响[J].中国中医急症,2017,26(5):857-859.
[11]王云龙,赵晓峰,郭海.扶正平溃汤对溃疡性结肠炎患者肠道菌群与致炎细胞因子的影响[J].陕西中医,2017,38(8):1016-1017,1036.
[12]黄建强,林清,文小敏,等.针灸治疗溃疡性结肠炎作用机制探讨[J].中国医药导报,2014,11(5):166-168.
[13]张宏,彭婷婷,徐瑾,等.八珍汤灌肠配温针灸治疗溃疡性结肠炎50例疗效观察[J].国医论坛,2013,28(6):33-34.
[14]赵文韬,吴金萍,王业皇.健脾清热活血方治疗溃疡性结肠炎对肠黏膜屏障修复的随机对照研究[J].世界中医药,2017,12(3):591-594.
[15]勾春宏.扶正平溃汤对溃疡性结肠炎患者细胞因子与肠道菌群的影响[J].西部中医药,2016,29(8):8-10.
[16]王茹.加味四逆散治疗肝郁型溃疡性结肠炎116例[J].河南中医,2015,35(9):2029-2030.
[17]殷网虎,袁武军,曹美琳,等.土茯苓配方颗粒对临床常见致病菌的抗菌研究[J].中国中医急症,2011,20(12):1957-1958.
[18]黄绪银,陈秀清,张奇志.中医针灸治疗慢性溃疡性结肠炎疗效观察[J].中国现代药物应用,2015,9(13):255-256.
[19]张润莲,倪广林,郝雪青,等.中药保留灌肠联合针灸治疗溃疡性结肠炎疗效观察[J].吉林中医药,2012,32(3):270-271.
[20]魏超博.温针灸治疗溃疡性结肠炎59例[J].光明中医,2011,26(11):2272-2273.