Clinical research progress of acupuncture for the prevention and treatment of ulcerative colitis

  Ulcerative colitis (UC) is a group of intestinal diseases characterized by a non-specific inflammatory response, with abdominal pain, diarrhea, and mucopurulent stools as the main clinical symptoms. The disease is often persistent and recurrent, causing great suffering to patients. According to its clinical manifestations, it can be classified as “intestinal fetish”, “long-standing diarrhea” and “long-standing dysentery” in Chinese medicine. The cause of this disease has not been fully understood yet, but is generally believed to be related to autoimmune, genetic, infectious, neuropsychiatric and other factors. Since the cause of the disease is not known, western medicine treatment is mainly through anti-inflammatory drugs and immunosuppressants, and even surgical treatment. The high recurrence rate and side effects make it difficult for patients to tolerate. In recent years, certain progress has been made in the treatment of ulcerative colitis using acupuncture therapy, which is reviewed from clinical studies as follows.  1, acupuncture therapy Wu Huan-Gan et al. observed the clinical efficacy and the improvement of the main symptoms of UC treated with isolated moxibustion at Zhonggui, Tianshu (double) and Guangyuan points, and compared it with isolated bran moxibustion. The results showed that there was no statistically significant difference between the total effective rate of the isolated medicine moxibustion group and the isolated bran moxibustion group. In terms of improvement of abdominal pain, mucus stool, purulent stool, abdominal distension, intestinal tinnitus, and poor appetite, there was no statistically significant difference between the herbal moxibustion group and the bran moxibustion group; however, in terms of improvement of abdominal pain and posterior urgency, the herbal moxibustion group improved better than the bran moxibustion group, indicating that the efficacy of moxibustion in treating UC was definite. The clinical efficacy and symptom improvement of chronic UC treated with intermittent herbal moxibustion were observed by Hua Xuegui et al. The treatment of chronic UC with moxibustion was effective. The damp-heat accumulation was accompanied by the addition of the dampness and heat of the intestine (double) and water; the liver-depression and spleen-deficiency was accompanied by the addition of the spleen-deficiency (double) and spleen-deficiency (double); the spleen-kidney-yang deficiency was accompanied by the addition of the kidney-deficiency (double) and Guan-yuan. The results showed that the efficiency of the isolated medicine moxibustion group was significantly better than that of the control group, and the improvement effect on the symptoms of posterior urgency was significantly better than the improvement effect on the symptoms of intestinal tinnitus. Some studies used acupuncture to treat UC also had good efficacy, and the selected acupoints were Tianshu, Feosanli, Shangjiuxu and Qihai. Ma Xiangming treated patients with UC with acupuncture and took oral western medicine liuzesulfapyridine tablets as a control. Acupuncture points such as Shang Ju Xu, Tian Shu, Guan Yuan, Shu San Li, Zhong Gui, Da Yin Yu, and Chang Qiang were taken. Except for the Changqiang point, the point of the needle was directed toward the lesion and moderate intensity stimulation was performed so that the needle was felt to the lesion. At the Changqiang point, the needle was inserted upward along the front of the sacrum to produce a strong sensation of heavy distension, and the needle was withdrawn after 30 min. The acupuncture needle was left for 30 min and then discharged. Moxibustion with moxa was then performed on Zhonggui, Tianshu and Guangyuan. The results showed that the efficacy of the acupuncture treatment group was better than that of the western medicine group. Wang Xu et al. treated 38 patients with chronic non-specific UC by taking Zhonggui, Tianshu, Shuansanli, Shangjiu, Daoyu and Shenqu as the main acupuncture points, and the results showed that 18 cases were clinically cured, 15 cases were clinically effective and 5 cases were ineffective. Yang Zhenhui et al. used acupuncture points of the jiaoji with plum blossom acupuncture for the treatment of UC. the jiaoji points were selected from T8-T12, with diarrhea first and then tonic method. The acupuncture points of Sanjiao Yu and Large Intestine Yu were combined with plum blossom acupuncture, and cupping was used for bleeding after heavy tapping. The results showed that the total effective rate was 93. 1%. Some researchers used a combination of acupuncture and moxibustion for the treatment of UC. sun Gonghai et al. used acupuncture and moxibustion with ginger intervals for the treatment of chronic UC, taking the middle epigastric, qihai, foot sanli (double), tianshu (double), upper juxu (double), and hegu (double). After acupuncture, moxibustion with ginger was used. In the control group, oral administration of compound Huangliansu, haloperidol and gentamicin was given at 80,000 u. After three courses of treatment, the efficacy was found to be statistically significant, and the difference in total effective rate between the two groups was found to be statistically significant.  Shan Chijun et al. treated 87 cases of chronic UC patients with warm acupuncture based on Zhonggui, Tianshu, Feet Sanli, Shangjiu, Spleen Yu, Large Intestine Yu and Guan Yuan, once a day for 10 sessions. After 2-5 courses of treatment, the total effective rate was 97.7%. It was found that the efficacy of acupuncture with herbal enema for UC was better than that of the pure herbal control group. Guo Xiaoyuan et al. used acupuncture and moxibustion therapy with herbal enemas to treat UC, and acupuncture was applied to Hegu, Tianshu, Shangjiu, Spleen Yu and Zhangmen as the main points. The results showed that there were significant differences in clinical symptoms and colonoscopic findings, and the treatment group was more effective than the control group. Cao Shiqiang used this method to treat 40 patients with chronic UC. The acupoints of Foot San Li, Zhen Men and Guan Yuan were selected and moxibustion was administered along with acupuncture retention. The enema was retained every night before bedtime. The total effective rate was 95%. He Jian combined acupuncture and drug enema to treat 36 cases of UC patients, the results were cured in 16 cases, improved in 18 cases, invalid in 2 cases, with a total efficiency of 94. 44%.  2, other therapies Feng Guoxiang, etc. used homemade pain and diarrhea Ning acupuncture point application to treat 30 cases of UC patients. The acupuncture points were Foot San Li and Spleen Yu; Tian Shu and Large Intestine Yu. The two groups alternated with painful diarrhea Ning acupuncture point patching. The results showed statistically significant differences in symptom scores between the two groups before and after treatment, and the efficacy was significantly better than that of the Western medicine control group. Zhang Guangqi et al. applied the Chinese medicine Jianshuanyi intestinal san for internal use, together with the solid capital preservation abdominal bag for umbilical application to treat 115 patients with UC. The clinical efficiency of the combination of the two therapies was found to be significantly superior compared with that of the single therapy. Liu Yanshou used electroacupuncture plus qigong to treat 53 cases of UC patients. The acupuncture points of Spleen Yu (double), Sanjiao Yu (double) and Stomach Yu (double) and Kidney Yu (double) were taken, and the two groups of points were treated alternately; the qigong therapy followed Liu Guizhen’s internal health gong method. Among the 53 cases, 41 cases were cured and 12 cases were improved, which were significantly better than those treated with electroacupuncture or qigong alone. Jia Xiaoqiang et al. divided the patients with chronic UC into 45 cases in the treatment group, and applied integrated therapy such as oral lutetrapyridine tablets, intestinal ulcer nimbus paste applied to the Shenqui point, and Erhuang Sanbai soup preserved enema, and used single therapy as a control respectively. The total effective rate of the treatment group was 97.78%, which was significantly different from that of the control group. This indicates that the synergy of the three methods can significantly improve the clinical efficacy. FANG Gong et al. used acupoint injections to treat 44 cases of UC patients and compared them with western medicine treatment. The acupuncture points were taken from Spleen Yu, Foot San Li, and Shang Ju Xu. Astragalus injection and angelica injection were selected, and 2 mL was injected into each acupuncture point after obtaining qi. Both acupuncture points were used alternately. It was found that the difference in recent efficacy between the acupoint injection group and the western medicine treatment group was not statistically significant, and the difference in their recurrence rate was statistically significant. Wang Huizhen [used acupuncture and moxibustion combined therapy to treat 64 patients with UC. Acupuncture and water acupuncture points were taken from Spleen Yu, Kidney Yu, Zhonggui, Tianshu, Guan Yuan, and Foot San Li. The acupuncture and water acupuncture points were taken from Zhongyu, Tianshu, Guan Yuan, Spleen Yu and Kidney Yu. The results showed that 50 of 64 cases were cured and 14 were effective, with an overall efficiency of 100%.