提插泻法针刺外治联合痛泻汤内服治疗湿热内蕴证溃疡性结肠炎患者的效果分析  

Analysis of the effect of external treatment of acupuncture with lifting-thrusting-reducing method combined with oral administration of Tongxie Decoction in the treatment of ulcerative colitis patients with damp-heat accumulation syndrome

作　　者：叶道冰 杨会举[2] 高宗跃 YE Daobing;YANG Huiju;GAO Zongyue(Nanyang Second Hospital,Henan Nanyang 473001,China;Third Affiliated Hospital of Henan University of Traditional Chinese Medicine,Henan Zhengzhou 450003,China;Henan Provincial Hospital of Traditional Chinese Medicine,the Second Affiliated Hospital of Henan University of Traditional Chinese Medicine,Henan Zhengzhou 450000,China)

机构地区：[1]河南省南阳市第二人民医院,河南南阳473001 [2]河南中医药大学第三附属医院,河南郑州450003 [3]河南省中医院,河南中医药大学第二附属医院,河南郑州450000

出　　处：《中医药临床杂志》2025年第1期176-180,共5页Clinical Journal of Traditional Chinese Medicine

基　　金：2023年度河南省中医药科学研究专项课题(2023ZY2116)。

摘　　要：目的:探讨提插泻法针刺外治联合痛泻汤内服应用于湿热内蕴证溃疡性结肠炎(UC)患者的临床价值。方法:2022年6月—2024年6月,南阳市第二人民医院收治的81例UC患者,按照随机数字表法分为对照组40例,采用美沙拉嗪口服治疗,观察组41例,在对照组治疗的基础上加痛泻汤、提插泻法针刺治疗。两组均治疗4周。比较两组治疗4周后的临床疗效,治疗前、治疗4周后的视觉模拟评分法(VAS)、炎症性肠病简明健康量表(SHS)评分、溃疡性结肠炎Mayo评分(Mayo)、肠黏膜屏障功能指标,炎症因子及治疗期间的不良反应。结果:观察组治疗4周后总有效率高于对照组;与治疗前比,治疗4周后对照组、观察组的VAS评分、SHS评分、Mayo评分及血清二胺氧化酶(DAO)、脂多糖(LPS)、D-乳酸(D-LA)、白细胞介素(IL)-23、IL-17水平均降低,且观察组更低;血清IL-4水平均上升,且观察组更高(P<0.05)。治疗期间,两组不良反应发生率比较无差异(P>0.05)。结论:提插泻法针刺外治联合痛泻汤内服应用于湿热内蕴证UC的疗效显著,可降低痛感,提高肠黏膜屏障功能,同时降低炎症反应,安全性良好,整体具有较高的临床应用价值。Objective:To explore the clinical value of external treatment of acupuncture with lifting-thrustingreducing method combined with oral administration of Tongxie Decoction in the treatment of ulcerative colitis(UC)with damp-heat syndrome.Methods The study was conducted in a sample size of 81 cases,prospectively included from June 2022 to June 2024,to ensure that UC patients were admitted to Nanyang Second People‘s Hospital,and divided into the control group(40 cases,mesalazine)and the observation group(41 cases,On the basis of the control group+Tongxie Decoction,lifting-thrusting-reducing acupuncture)according to the random numer table method.Both groups were treated for 4 weeks.The clinical efficacy after 4 weeks of treatment,visual analogue scale(VAS),simplified health survey(SHS)score,ulcerative colitis Mayo score(Mayo),intestinal mucosal barrier function index and inflammatory factors before and after 4 weeks of treatment,the incidence of adverse reactions during treatment of the both groups were compared.Results The total effective rate of the observation group was higher than that of the control group after 4 weeks of treatment.Compared with before treatment,after 4 weeks of treatment,the VAS score,SHS score,Mayo score,serum diamine oxidase,lipopolysaccharide,D-lactic acid,interleukin(IL)-23 and IL-17 levels of the control group and the observation group decreased,and the observation group was lower;serum IL-4 levels increased,and the observation group was higher(P<0.05).During treatment,there was no difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The external treatment of acupuncture with lifting-thrusting-reducing method combined with oral administration of Tongxie Decoction is effective in the treatment of UC with damp-heat syndrome.It can reduce pain,improve intestinal mucosal barrier function,and reduce inflammatory reaction.It has good safety and high clinical application value.

关 键 词：痛泻汤 提插泻法 针刺 湿热内蕴证 溃疡性结肠炎 炎症反应 

分 类 号：R574.62[医药卫生—消化系统]