Clinical Observation of Treating Ulcerative Colitis with Acupuncture at Front Mu Points Combined with Oral Mesalazine
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摘要:
目的 观察针刺募穴治疗溃疡性结肠炎的临床疗效。 方法 收集昆明市中医医院2022年8月至 2023年6月收治的溃疡性结肠炎患者60例。随机数字表法，分为对照组、联合组各30例，治疗方法为连续8周予对照组口服美沙拉嗪，联合组美沙拉嗪口服结合针刺募穴。从治疗前后临床疗效、肠镜结果评分 （the baron score，Baron）、结肠粘膜愈合评分（colonic mucosal healingscore，Geboes）3个方面进行比较，并随访3月，计算联合组、对照组疾病复发率。 结果 临床疗效联合组高于对照组（P < 0.05），总有效率分别为 93.33%、67.67%，治疗后，疾病活动指数、Baron 评分、Geboes 评分较治疗前下降（P < 0.05），联合组治疗后疾病活动指数、Baron 评分、Geboes 评分比对照组低（P < 0.05）。 比较治疗后3月的疾病复发率，发现联合组低于对照组。 结论 针刺募穴明显改善溃疡性结肠炎临床症状，相较于对照组患者，降低了复发机率，安全可靠，未见严重不良反应。 Abstract:Objective To observe the clinical efficacy of acupuncture at Front Mu point in the treatment of ulcerative colitis. Methods Sixty patients with ulcerative colitis treated at the Traditional Chinese Medicine Hospital in Kunming from August 2022 to June 2023 were collected. Using a random number table method, 30 cases were assigned to each of the control group and the combined group. The treatment method involved administering oral mesalazine to the control group for a continuous period of 8 weeks, while the combined group received both oral mesalazine and acupuncture at front Mu points. The clinical efficacy, colonoscopy results score （Baron score）, and colonic mucosal healing score （Geboes） before and after treatment were compared. Follow-up was conducted at 3 months to calculate the recurrence rate in the combination and control groups. Results The total effective rate in the combination group was higher than that in the control group （P < 0.05）, with rates of 93.33% and 67.67%, respectively. After treatment, the disease activity index, Baron score, and Geboes score decreased compared to before treatment （P < 0.05）, and the combination group had a lower disease activity index, Baron score, and Geboes score than the control group after treatment （P < 0.05）. Comparing the recurrence rates at 3 months post-treatment, the combination group was lower than the control group. Conclusion Acupuncture at Front Mu Point can significantly improve the clinical symptoms of ulcerative colitis, reduce the recurrence rate compared to patients in the control group, and is safe and reliable without serious adverse reactions. -
Key words:
- Ulcerative colitis /
- Mesalazine /
- Front Mu point /
- Clinical efficacy /
- Recurrence rate
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图 2 治疗后联合组黏膜病变情况肠镜图像
Figure 2. Endoscopic images of mucosal lesions in the combined group after treatment
图 3 治疗前对照组黏膜病变情况肠镜图像
Figure 3. Endoscopic images of mucosal lesions in the control group before treatment
图 1 治疗前联合组黏膜病变情况肠镜图像
Figure 1. Endoscopic images of mucosal lesions in the combined therapy group before treatment.
图 4 治疗后对照组黏膜病变情况肠镜图像
Figure 4. Endoscopic images of mucosal lesions in the control group after treatment
表 1 溃疡性结肠炎症状评分标准
Table 1. Ulcerative colitis symptom scoring criteria
临床表现 0分 1分 2分 3分 腹泻 无 腹泻 < 4次/d 腹泻4～6次/d 腹泻 > 4次/d 腹痛 无 轻微疼痛，偶尔发作 腹部疼痛，每天发作数次 腹部疼痛或绞痛 脓血便 无 少量脓血便 脓血便为主 全部为脓血便或纯血 
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表 2 2组患者性别及疾病严重程度比较[n（%）]
Table 2. Comparison of gender and disease severity between two groups of patients [n（%）]
特征 联合组 对照组 χ2 P 性别 3.267 0.071 男 17（56.7） 20（66.7） 女 13（43.3） 10（33.3） 严重程度 0.267 0.606 轻度 15（50.0） 13（43.3） 中度 15（50.0） 17（56.7）
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表 3 2组患者年龄及病程比较（$ \bar x \pm s $）
Table 3. Comparison of age and disease duration between two groups of patients （$ \bar x \pm s $）
特征 联合组 对照组 t P 年龄（岁） 34.27 ± 8.33 32.07 ± 8.92 0.987 0.328 病程（a） 2.42 ± 1.19 3.01 ± 1.13 −1.810 0.075
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表 4 2组患者治疗前后临床疗效比较[n（%）]
Table 4. Comparison of clinical efficacy before and after treatment between two groups of patients [n（%）]
组别 n 疗效 总有效率（%） Z P 治愈 显效 有效 无效 联合组 30 4 6 18 2 93.33 −22.233 0.026* 对照组 30 2 4 14 10 67.67 *P < 0.05。
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表 5 不同组别治疗前后各种评分差异比较[M（P25，P75）]
Table 5. Comparison of differences in various scores before and after treatment between different groups [M（P25，P75）]
评分项 疾病活动指数 Baron评分 Geboes指数 联合组 治疗前 6.5（6，8） 6（3，9） 3（2，5） 治疗后 4（1，4） 3（0，3） 1（1，2） Z −4.740 −4.582 −4.579 P < 0.001* < 0.001* < 0.001* 对照组 治疗前 7（5，8） 6（3，9） 3（2，5） 治疗后 4.5（3，6） 3（3，6） 2（1，3） Z −4.15 −3.394 −3.869 P < 0.001* < 0.001* < 0.001* Za −0.203 −0.174 −0.559 P 0.839 0.862 0.576 Zb −2.418 −2.897 −2.304 P 0.016* 0.004* 0.021* *P < 0.05；a：联合组与对照组治疗前比较；b：联合组与对照组治疗后比较。
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