溃结宁膏穴位贴敷治疗脾肾阳虚型溃疡性结肠炎:随机对照研究  

Treatment of ulcerative colitis with spleen and kidney yang deficiency by kuijiening plaster:a randomized controlled study

作　　者：黄磊 蔡植 朱莹[2] 万虎 

机构地区：[1]长沙市中医医院(长沙市第八医院)消化内科,湖南长沙410100 [2]湖南中医药大学第二附属医院,长沙410005

出　　处：《中国针灸》2013年第7期577-581,共5页Chinese Acupuncture & Moxibustion

基　　金：湖南中医药管理局重点资助项目:2009005;长沙市科技计划项目:K 0902133-31

摘　　要：目的:探讨溃结宁膏穴位贴敷治疗脾肾阳虚型溃疡性结肠炎(UC)与口服柳氮磺胺吡啶(SASP)的临床疗效差异,观察其对血清干扰素-γ(IFN-γ)和白细胞介素4(IL-4)含量的影响。方法:将60例脾肾阳虚型UC患者随机分为溃结宁膏组、SASP组、联合组,每组20例。溃结宁膏组给予溃结宁膏穴位贴敷及SASP模拟剂口服,贴敷穴位以上巨虚、天枢、足三里、命门、关元为主;SASP组给予溃结宁膏模拟剂穴位贴敷及SASP口服;联合组给予溃结宁膏穴位贴敷及SASP口服,疗程均为60天,并于治疗后2个月随访。比较3组综合疗效、中医证候疗效以及治疗前后血清IFN-γ和IL-4的变化。结果:溃结宁膏组和SASP组综合疗效相当[85.0%(17/20)vs 75.0%(15/20),P>0.05],溃结宁膏组中医证候疗效优于SASP组[80.0%(16/20)vs 60.0%(12/20),P<0.05],联合组综合疗效总有效率为95.0%(19/20)、中医证候疗效总有效率为90.0%(18/20),均优于其他两组(均P<0.05);3组治疗前后血清IFN-γ和IL-4含量比较,差异有统计学意义(均P<0.05),均能降低血清IFN-γ的含量,增加血清IL-4的含量,而溃结宁膏组优于SASP组(P<0.05),联合组优于其他两组(均P<0.05)。结论:溃结宁膏穴位贴敷治疗脾肾阳虚型UC疗效不低于SASP,改善中医证候及提高机体免疫力优于后者,与SASP联合治疗效果更佳。Objective To explore the clinical efficacy of ulcerative colitis with spleen and kidney yang deficiency by kuijiening plaster and the impacts on IFN-γ and IL-4 contents, as well as make the comparison with oral medication of sulfasalzine （SASP）. Methods Sixty patients of ulcerative colitis with spleen and kidney yang defi- ciency were randomized into a Kuijiening plaster group, a SASP group arid a combined therapy group, 20 cases in each one. In the Kuijiening plaster group, Kuijiening plaster and oral administration of placebo SASP were applied. The plaster was used at Shangjuxu （ST 37）, Tianshu （ST 25）, Zusanli （ST 36）, Mingmen （GV 4） and Guanyuan （CV 4）. In the SASP group, was applied Kuijiening plaster placebo at the points and SASP oral administration was adopted. In the combined therapy group, Kuijiening plaster and SASP oral administration were given. The duration of treatment was 60 days. The follow-up visit was 2 months after treatment. The com- prehensive efficacy, the efficacy on TCM syndrome and the changes in serum IFN-γ and IL-4 before and after treatment were compared among the three groups. Results The efficacy on TCM syndrome in the Kuijiening plaster was similar to the SASP group [85.0%（17/20） vs 75.0%（15/20） ,P〉0.05]. The efficacy on TCM syn- drome in the Kuijiening plaster group was superior to the western medicine group [80. 0% （16/20） vs 60. 0%（12/20）,P〈0. 05]. The total effective rate of the comprehensive efficacy in the combined therapy group was 95.0% （19/20） and that of TCM syndrome efficacy was 90.0% （18/20）, which were all superior to the other two groups （all P〈0.05）. The differences in serum IFN-γ and IL-4 were statistically significant before and after treatment in all of the three groups （all P〈0.05）. The treatments in the three groups reduced serum IFN-γ, contentand increased serum IL-4 content. The results in the Kuijiening plaster group were superior to the SASP group （P〈0.05） and the results in the combin

关 键 词：溃疡性结肠炎 脾肾阳虚 穴位贴敷 血清干扰素-Γ 白细胞介素4 随机对照试验 

分 类 号：R246.2[医药卫生—针灸推拿学]