Evaluation of the effect of LEI's Yinzhan ginger moxibustion combined with Buhuo Shengtu therapy on ulcerative colitis in the remission stage
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摘要:
目的 评价雷氏银盏隔姜灸联合补火生土法治疗缓解期溃疡性结肠炎(ulcerativecolitis, UC)的效果及可能的作用机制。 方法 选择2017年1月—2020年6月衢州市中医医院消化科、肛肠科门诊及住院的73例UC患者,按照随机数字表法分为观察组(36例)和对照组(37例)。观察组采用雷氏银盏隔姜灸联合补火生土法治疗,对照组采用美沙拉嗪治疗,疗程为4周,评价2组干预效果及作用机制。 结果 治疗后观察组疗效优于对照组(Z=2.352,P=0.019)。治疗后观察组主要中医症状积分低于对照组[(26.04±5.37)分vs. (32.23±6.45)分,P<0.05]。治疗后观察组改良梅奥评分低于对照组[(5.32±1.07)分vs. (6.75±1.56)分,P<0.05]。治疗后观察组血清CRP、TNF-α、IL-17水平低于对照组(均P<0.05)。治疗后观察组NK、CD4+与CD4+/CD8+水平高于对照组,CD8+水平低于对照组(均P<0.05)。治疗后观察组IgG、IgM水平明显低于对照组(均P<0.05)。 结论 雷氏银盏隔姜灸联合补火生土法干预治疗缓解期UC的效果明确,其作用机制可能与调节肠道炎症、免疫功能有关。 Abstract:Objective To evaluate the effect and possible mechanism of LEI's Yinzhan ginger-padded moxibustion combined with Buhuo Shengtu therapy in the treatment of ulcerative colitis (UC) in the remission stage. Methods From January 2017 to June 2020, 73 UC patients in the Department of Gastroenterology, Department of Anus and Intestine of Quzhou Hospital of Traditional Chinese Medicine were randomly divided into two groups according to random number table method. The observation group(n=36) was treated with LEI's Yinzhan ginger-padded moxibustion combined with Buhuo Shengtu therapy, whereas the control group(n=37) was treated with mesalazine. The course of treatment was 4 weeks. The intervention effect and mechanism of the two groups were evaluated. Results After treatment, the efficacy of the observation group was better than that of the control group (Z=2.352, P=0.019). The symptom score of the observation group was lower than that of the control group [(26.04±5.37) scores vs. (32.23±6.45) scores, P < 0.05]. The Mayo score in the observation group was lower than that in the control group [(5.32±1.07) scores vs. (6.75±1.56) scores, P < 0.05]. The levels of serum inflammatory factors (CRP, TNF-α and IL-17) were lower in the observation group than in the control group (all P < 0.05). The levels of NK, CD4+ and CD4+/CD8+ were higher in the observation group than in the control group (all P < 0.05). The IgG and IgM values were significantly lower in the observation group than those in the control group (all P < 0.05). Conclusion LEI's Yinzhan ginger-padded moxibustion combined with Buhuo Shengtu therapy has a definite effect on the treatment of UC in the remission stage, and its mechanism may be related to the regulation of intestinal inflammation and immune function. -
表 1 2组溃疡性结肠炎患者临床疗效比较[例(%)]
Table 1. Comparison of clinical efficacy between two groups of ulcerative colitis patients [cases (%)]
组别 例数 完全缓解 有效 无效 总有效 观察组 36 23(63.89) 10(27.78) 3(8.33) 33(91.67) 对照组 37 15(40.54) 11(29.73) 11(29.73) 26(70.27) 注:2组疗效比较,Z=2.352,P=0.019。 表 2 2组溃疡性结肠炎患者中医主要症状积分比较(x±s,分)
Table 2. Comparison of TCM main symptom scores between two groups of ulcerative colitis patients (x±s, scores)
组别 例数 治疗前 治疗后 t值 P值 观察组 36 36.48±4.75 26.04±5.37 -8.737 < 0.001 对照组 37 38.62±5.13 32.23±6.45 -4.691 < 0.001 t值 -1.848 -4.461 P值 0.069 < 0.001 表 3 2组溃疡性结肠炎患者Mayo评分比较(x±s,分)
Table 3. Comparison of Mayo score between two groups of ulcerative colitis patients(x±s, scores)
组别 例数 治疗前 治疗后 t值 P值 观察组 36 8.51±1.69 5.32±1.07 -9.569 < 0.001 对照组 37 8.64±1.52 6.75±1.56 -5.278 < 0.001 t值 -0.346 -4.555 P值 0.730 < 0.001 表 4 2组溃疡性结肠炎患者血清炎症因子水平比较(x±s)
Table 4. Comparison of serum inflammatory factors between two groups of patients with ulcerative colitis(x±s)
组别 例数 CRP(mg/L) TNF-α(ng/mL) IL-17(μg/mL) 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 观察组 36 20.49±5.13 2.15±0.42a 44.01±6.21 26.42±4.65a 33.36±7.05 14.97±2.85a 对照组 37 19.67±4.83 6.48±0.51a 43.78±5.98 34.98±5.42a 33.29±6.84 21.37±3.34a t值 0.703 -39.539 0.161 -7.233 0.043 8.796 P值 0.484 < 0.001 0.872 < 0.001 0.966 < 0.001 注:与同组治疗前比较,aP<0.05。 表 5 2组溃疡性结肠炎患者外周血T淋巴细胞亚群变化比较(x±s)
Table 5. Comparison of T lymphocyte subsets in peripheral blood between two groups of patients with ulcerative colitis(x±s)
组别 例数 NK(%) CD4+(%) CD8+(%) CD4+/CD8+ 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 观察组 36 10.35±2.21 18.36±2.37a 35.65±5.36 48.22±5.26a 39.64±3.08 27.21±2.75a 1.23±0.31 1.65±0.25a 对照组 37 10.38±2.19 14.76±2.09a 35.83±5.43 39.89±5.19a 39.78±3.16 35.41±2.38a 1.25±0.37 1.42±0.29a t值 -0.058 6.888 -0.142 6.810 -0.191 -13.634 -0.250 3.625 P值 0.954 < 0.001 0.887 < 0.001 0.848 < 0.001 0.803 0.001 注:与同组治疗前比较,aP<0.05。 表 6 2组溃疡性结肠炎患者免疫球蛋白变化比较(x±s,g/L)
Table 6. Comparison of immunoglobulin changes between two groups of ulcerative colitis patients (x±s, g/L)
组别 例数 IgG IgM IgA 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 观察组 36 13.01±2.64 7.13±1.24a 1.61±0.54 0.93±0.34a 2.30±1.25 2.25±1.14 对照组 37 12.64±2.31 8.87±1.32a 1.59±0.42 1.21±0.43a 2.29±1.18 2.26±1.07 t值 0.638 -5.801 0.175 -3.081 0.035 -0.039 P值 0.526 < 0.001 0.861 0.003 0.972 0.969 注:与同组治疗前比较,aP<0.05。 -
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