摘要
溃疡性结肠炎(UC)是一种肠道炎症疾病,其病变累及部位众多,临床难治且易复发,严重危害患者生命健康,临床以药物治疗为主,但存在不良反应大、药物依赖与抵抗、疗效个体差异大等弊端.根据UC不同中医证型,艾灸可单用或联合其他疗法,作为药物治疗的补充替代疗法,对药物减毒增效和从整体改善肠道炎症具有重要意义.艾灸可通过多途径、多层次保护肠道黏膜、调节免疫炎症反应、调节肠道菌群治疗UC.通过近20年文献研究发现艾灸应用于治疗UC的证型包括大肠湿热证、脾虚湿蕴证、肝郁脾虚证、脾肾阳虚证.高频选穴包括天枢、中脘、神阙、关元、足三里、气海、脾俞、肾俞、大肠俞、上巨虚,灸法以隔姜灸和温和灸占比较高,多采用21～30 min或3～5壮,1次/d.现有研究存在应用证型不全面、设计不严谨、研究不深入等问题,未来可针对UC不同分期、不同证型,进一步探究各灸法的量效关系或与其他疗法的配伍关系,优化临床治疗方案,强化基础研究,深化艾灸治疗UC的生物效应机制研究.
Abstract
Ulcerative colitis(UC)is an inflammatory bowel disease characterized by lesions affecting multiple sites,presenting sig-nificant clinical challenges due to its refractory nature and high recurrence rate,severely endangering patients'health.While phar-macological treatments remain the primary approach,they are often accompanied by issues such as severe side effects,drug depend-ence and resistance,and significant individual variability in efficacy.In traditional Chinese medicine(TCM),moxibustion,either as a standalone treatment or in combination with other therapies,is a valuable adjunct or alternative therapy tailored to different TCM syndromes of UC.It plays a crucial role in enhancing the efficacy of medications,reducing toxicity,and holistically improving intes-tinal inflammation.Moxibustion achieves these benefits through multi-pathway,multi-level actions,such as protecting the intestinal mucosa,modulating immune and inflammatory responses,and regulating gut microbiota.A review of studies over the past 20 years reveals that moxibustion is used to treat UC syndromes including dampness-heat in the large intestine,spleen deficiency with damp-ness accumulation,liver depression with spleen deficiency,and spleen-kidney yang deficiency.Frequently selected acupoints in-clude Tianshu(ST25),Zhongwan(CV12),Shenque(CV8),Guanyuan(CV4),Zusanli(ST36),Qihai(CV6),Pishu(BL20),Shen-shu(BL23),Dachangshu(BL25),and Shangjuxu(ST37).Common techniques involve ginger-separated moxibustion and mild mox-ibustion,with a duration of 21 to 30 min or 3 to 5 moxa cones per session,typically applied once daily.However,existing research faces limitations,such as incomplete syndrome coverage,lack of rigorous study designs,and insufficient depth in investigations.Fu-ture studies should focus on UC's different stages and syndromes to explore the dose-effect relationship of various moxibustion meth-ods and their compatibility with other therapies.Efforts should aim to optimize clinical protocols,strengthen basic research,and deepen understanding of the biological mechanisms underlying therapeutic effects of moxibustion on UC.
维普
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