加味白头翁汤灌肠联合针灸治疗湿热下注型溃疡性结肠炎的临床观察

Clinical Observation of Pulsatilla Decoction Enema Combined with Acupuncture in the Treatment of Damp-Heat Type Ulcerative Colitis

摘要: 目的：本研究通过临床观察探究加味白头翁汤灌肠疗法联合针灸治疗湿热下注型溃疡性结肠炎疗效及相关理论，为治疗湿热下注型溃疡性结肠炎提供一种新的思路和方法，更好地发挥中医优势。方法：选取2021年11月~2022年11月就诊于黑龙江省中医医院肛肠科的符合标准的湿热下注型溃疡性结肠炎患者72例作为研究对象，并通过随机数字表法将研究对象随机分成治疗组(加味白头翁汤灌肠疗法联合针灸治疗，n = 36)、对照组(加味白头翁汤灌肠，n = 36)。两组患者均需要进行为期8周的治疗，对比两组治疗前后的血清炎症因子水平、肠镜检查评分各项指标的变化及中医证候的临床疗效。结果：1. 临床总体疗效评价：治疗组、对照组药物均能改善溃疡性结肠炎的临床症状，治疗组治疗效果优于对照组，对照组差异有统计学意义。2. 两组患者治疗后的血清C反应蛋白(CRP)、白介素(IL)-13含量均较治疗前降低，且治疗组的下降程度相比对照组明显，差异具有统计学意义(P < 0.05)；3. 两组肠镜检查评分均较治疗前降低，且治疗组治疗后的评分比对照组下降程度明显，差异具有统计学意义(P < 0.05)。4. 两组各个症候评分对比情况：两组治疗后腹泻、黏液样脓血便、腹痛、便不尽感、肛门坠胀感和肛门灼热感评分均较前降低(P < 0.05)，说明两组治疗皆能有效改善患者症状。5. 治疗有效率：治疗组、对照组治疗有效率分别为97.2%、80.6%。说明加味白头翁汤灌肠疗法联合针灸治疗湿热下注型溃疡性结肠炎的疗效有差异。结论：可以显著得出加味白头翁汤灌肠疗法联合针灸治疗湿热下注型溃疡性结肠炎的方法有确切的疗效的理论，可明显降低患者血清炎症因子水平、肠镜检查评分各项指标，及明显改善患者的腹泻、黏液样脓血便、腹痛、便不尽感、肛门坠胀感及肛门灼热感等临床症状，起到促进肠黏膜愈合、降低活动度，且能提高患者的生活质量、改善患者焦虑情绪等治疗作用。

Abstract: Objective: Through clinical observation, this study explored the therapeutic effect and related theories of supplemented Baitouong decoction enema therapy combined with acupuncture in the treatment of damp-heat ulcerative colitis, providing a new idea and method for the treatment of damp-heat ulcerative colitis, and better play the advantages of traditional Chinese medicine. Method: Seventy-two patients with damp-heat ulcerative colitis who met the criteria and were admitted to the Anorectal Department of Heilongjiang Provincial Hospital of Traditional Chinese Medicine from November 2021 to November 2022 were selected as the study objects, and the study subjects were randomly divided into treatment group (supplemented Pulsatilla decoction enema therapy combined with acupuncture treatment, n = 36) and control group (supplemented pulsatilla decoction enema, combined with acupuncture treatment, n = 36) by random number table method. The two groups of patients were treated for 8 weeks, and the changes of serum inflammatory factor levels, colonoscopy scores and clinical effects of TCM syndromes before and after treatment were compared between the two groups. Results: 1. Overall clinical efficacy evaluation: both the treatment group and the control group could improve the clinical symptoms of ulcerative colitis, and the therapeutic effect of the treatment group was better than that of the control group, with statistical significance. 2. The contents of serum C-reactive protein (CRP) and interleukin-13 in 2 groups after treatment were lower than those before treatment, and the decrease degree of treatment group was significantly higher than that of control group, with statistical significance (P < 0.05). 3. The colonoscopy scores of both groups were lower than before treatment, and the score of the treatment group after treatment was significantly lower than that of the control group, with statistical significance (P < 0.05). 4. Comparison of the scores of various symptoms between the two groups: After treatment, the scores of diarrhea, mucoid pus and blood stool, abdominal pain, constipation, anal swelling and anal burning in the two groups were all lower than before (P < 0.05), indicating that the treatment in both groups could effectively improve the symptoms of patients. 5. Effective rate of treatment: The effective rate of treatment group and control group was 97.2% and 80.6% respectively. It shows that there are differences in the curative effect of supplemented pulsatilla decoction enema combined with acupuncture in the treatment of damp-heat type ulcerative colitis. Conclusion: It can be concluded that supplemented Baitanwongtang enema therapy combined with acupuncture in the treatment of damp-heat type ulcerative colitis has a definite effect theory, which can significantly reduce the level of serum inflammatory factors and various indexes of colonoscopy score of patients. It also significantly improved the clinical symptoms of diarrhea, mucoid pus and blood stool, abdominal pain, constipation, anal swelling and anal burning, and played a therapeutic role in promoting intestinal mucosal healing, reducing activity, improving patients’ quality of life, and improving patients’ anxiety.