以“肺-肠轴”理论分析参苓白术散加减与针刺联合对溃疡性结肠炎患者的影响

doi:10.3969/j.issn.1006-5725.2025.21.023

Abstract

Abstract:

Objective Using the theory of the “lung?intestinal axis” to analyze the therapeutic efficacy of acupuncture combined with modified Ginseng?Ling?Bai?Zhu?San in patients with ulcerative colitis and its effects on intestinal flora balance. Methods One hundred and fifty patients with ulcerative colitis who received treatment at our hospital between October 2022 and December 2024 were enrolled in this study. These patients were randomly assigned to either the combination group or the control group， with 75 patients in each group. The control group was treated with modified Shenling Baizhu San， while the combination group received acupuncture in addition to the same herbal formula. After four treatment cycles， changes in TCM symptom scores， intestinal mucosal barrier function， immune microenvironment， gut microbiota balance， and overall clinical efficacy were evaluated and compared between the two groups. Results Compared with the control group， the combination group showed significant improvements after treatment： TCM syndrome scores， IBDQ， DAI， Baron score， DAO， PCT， ET， IL?23， IL?6， IL?1β， CD8⁺， Enterobacteriaceae， Escherichia coli， Bifidobacterium bifidum， Th17/Treg ratio， and incidence of adverse reactions were significantly reduced； meanwhile， levels of Hb， ALB， PAB， TGF?β1， CD4⁺， CD4⁺/CD8⁺ ratio， and Lactobacillus， as well as clinical efficacy， were markedly increased. All differences were statistically significant （P < 0.05）. Conclusion Effective and safe treatment of ulcerative colitis can be achieved through the combination of acupuncture and a modified formula of Ginseng?Ling?Bai?Juju?San， which may improve intestinal mucosal lesions， reduce inflammation， and stabilize the balance of intestinal flora by modulating the endocrine network of the “lung?intestinal axis”.

Key words: ginseng ling baizhu san plus reduction, based on the theory of “lung?intestinal axis”, acupuncture, ulcerative colitis, intestinal flora balance

CLC Number:

R466.6

Xin ZHOU,Bin YUE,Yuedong. LIU. Analyzing the effects of the combination of ginseng⁃lingbaijusan plus reduction and acupuncture on patients with ulcerative colitis by the theory of “lung⁃intestinal axis”[J]. The Journal of Practical Medicine, 2025, 41(21): 3455-3461.

Figures/Tables 10

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References 24

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组别	例数	年龄（x ± s）/岁	病程（x ± s）/月	病变部位
组别	例数	年龄（x ± s）/岁	病程（x ± s）/月	直乙状结肠	左半结肠	直肠
对照组	75	43.22 ± 10.01	6.22 ± 1.80	29（38.67）	22（29.33）	24（32.00）
联合组	75	43.13 ± 10.04	6.15 ± 1.73	31（41.33）	24（32.00）	20（26.67）
t/χ²值		0.055	0.243	0.517
P值		0.956	0.809	0.772

组别	例数	食欲不振/分		黏液脓血便/分		腹泻便溏/分		食少乏力/分
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	75	2.22 ± 0.52	1.37 ± 0.51^?	3.47 ± 0.71	2.60 ± 0.72^?	4.47 ± 1.01	2.44 ± 0.42^?	2.17 ± 0.60	1.70 ± 0.80^?
联合组	75	2.21 ± 0.52	1.11 ± 0.20^?	3.30 ± 0.62	1.82 ± 0.53^?	4.44 ± 1.07	2.30 ± 0.35^?	2.14 ± 0.52	1.13 ± 0.71^?
t值		0.118	3.153	1.562	7.556	0.177	2.218	0.327	4.615
P值		0.906	0.002	0.120	< 0.001	0.860	0.028	0.744	< 0.001

组别	例数	PCT/（μg/L）		ET/（EU/mL）		DAO/（U/mL）
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	75	5.20 ± 0.70	3.66 ± 0.61^*	0.30 ± 0.11	0.20 ± 0.05^*	7.32 ± 1.01	6.40 ± 0.71^*
联合组	75	5.17 ± 0.66	2.25 ± 0.55^*	0.28 ± 0.09	0.15 ± 0.04^*	7.36 ± 0.95	5.22 ± 0.60^*
t值		0.270	14.867	1.219	6.763	0.250	10.993
P值		0.788	< 0.001	0.225	< 0.001	0.803	< 0.001

组别	例数	IL-23/（ng/L）		IL-1β/（ng/L）		TGF-β1/（ng/mL）		IL-6/（pg/mL）
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	75	22.28 ± 4.70	18.30 ± 4.07^*	63.33 ± 7.05	36.42 ± 6.10^*	12.20 ± 2.34	5.10 ± 0.68	27.80 ± 4.22	12.39 ± 2.20
联合组	75	22.20 ± 4.56	14.11 ± 4.33^*	63.21 ± 6.95	34.37 ± 5.28^*	12.50 ± 2.10	6.70 ± 1.12	27.46 ± 4.13	15.70 ± 2.82
t值		0.106	6.106	0.101	2.201	0.675	8.635	0.407	6.544
P值		0.916	< 0.001	0.920	0.029	0.502	< 0.001	0.685	< 0.001

组别	例数	ALB/（g/L）			Hb（g/L）		PAB（mg/L）
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	75	38.10 ± 5.23	37.60 ± 6.01^*	97.21 ± 22.10	100.30 ± 23.82^*	175.90 ± 11.77	181.33 ± 16.42^*
联合组	75	38.03 ± 5.20	39.70 ± 4.80^*	97.58 ± 22.05	111.04 ± 28.50^*	176.13 ± 11.70	186.75 ± 9.80^*
t值		0.082	2.365	0.103	2.504	0.120	2.456
P值		0.935	0.019	0.918	0.013	0.905	0.015

Analyzing the effects of the combination of ginseng⁃lingbaijusan plus reduction and acupuncture on patients with ulcerative colitis by the theory of “lung⁃intestinal axis”

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组别	例数	治愈	显效	有效	无效	合计
对照组	75	17（22.67）	27（36.00）	21（28.00）	12（16.00）	63（84.00）
联合组	75	23（30.67）	35（46.67）	14（18.67）	4（5.33）	71（94.67）
χ²值						4.478
P值						0.034

组别	例数	腹胀	头晕头痛	肝功能异常	恶心呕吐	合计
对照组	75	2（2.67）	3（4.00）	1（1.33）	2（2.67）	8（10.67）
联合组	75	1（1.33）	1（1.33）	0（0）	1（1.33）	3（4.00）
χ²值						2.453
P值						0.117

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组别	例数	IBDQ评分/分		DAI评分/分		Baron评分/分
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	75	130.28 ± 10.50	44.56 ± 14.90^*	3.25 ± 0.69	1.06 ± 0.27^*	6.39 ± 1.05	4.40 ± 0.82^*
联合组	75	129.96 ± 10.41	30.23 ± 13.53^*	3.36 ± 0.71	0.70 ± 0.22^*	6.45 ± 1.03	3.16 ± 0.70^*
t值		0.187	6.166	0.962	8.952	0.353	9.960
P值		0.852	< 0.001	0.338	< 0.001	0.724	< 0.001

组别	例数	CD8⁺/%		CD4⁺/%		CD4⁺/CD8⁺/%		Th17/Treg/%
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	75	33.88 ± 6.10	25.70 ± 5.05^*	34.96 ± 6.03	39.11 ± 7.05^*	1.03 ± 0.98	1.20 ± 0.96^*	0.74 ± 0.20	0.49 ± 0.18^*
联合组	75	34.03 ± 6.04	21.63 ± 4.75^*	34.80 ± 5.88	42.22 ± 7.08^*	1.02 ± 0.97	1.52 ± 0.97^*	0.70 ± 0.22	0.29 ± 0.15^*
t值		0.151	5.084	0.165	2.696	0.063	2.031	1.165	7.392
P值		0.880	< 0.001	0.870	0.008	0.950	0.044	0.246	< 0.001

组别	例数	肠杆菌		大肠杆菌		双歧杆菌		肠球菌		乳酸杆菌
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	75	10.55 ± 1.50	9.22 ± 1.02^?	7.75 ± 0.41	7.21 ± 0.36^?	2.20 ± 0.42	3.90 ± 0.47^?	7.21 ± 0.53	5.75 ± 0.44^?	3.09 ± 0.52	3.82 ± 0.50^?
联合组	75	10.37 ± 1.43	8.11 ± 0.51^?	7.77 ± 0.43	7.09 ± 0.35^?	2.17 ± 0.45	4.10 ± 0.46^?	7.25 ± 0.51	5.17 ± 0.42^?	3.05 ± 0.50	4.45 ± 0.47^?
t值		0.752	8.429	0.292	2.070	0.422	2.634	0.471	8.258	0.471	7.951
P值		0.453	< 0.001	0.771	0.040	0.674	0.009	0.638	< 0.001	0.638	< 0.001