Escolar Documentos
Profissional Documentos
Cultura Documentos
(2009) 7: 80-83
DOI: 10.1007/s11726-009-0080-1
Clinical Study
UC
TNF- 67 UC35
32
TNF-
TNF-TNF-R1TNF-R2
TNF-R1 UC
TNF-TNF-R1TNF-R2 TNF-R1
-
Abstract Objective: To observe the effects of herbal cake-partitioned moxibustion and
bran-partition moxibustion in improving symptoms of ulcerative colitis (UC) and the TNF-
and its receptor of colon mucosa. Method: 67 UC cases were randomly allocated into herbal
cake-partition moxibustion group of 35 cases and bran-partitioned moxibustion group of 32
cases, to compare the improvement and detect the TNF- and its receptor with immunohistochemical method in both groups. Result: Herbal cake-partitioned moxibustion is prior to
bran-partitioned moxibustion in improving of diarrhea, flatus, lassitude, tenesmus and lumbar
soreness; The expression of TNF-,TNF-R1, and TNF-R2 are significantly decreased after
treatment in herbal cake-partitioned moxibustion group, while in bran-partitioned moxibustion
group only TNF-R1 expression is significant decreased after treatment. Conclusion:
Moxibustion can well improve the syndromes of UC, Herbal cake-partitioned Moxibustion is
prior to bran-partitioned moxibustion in the improvement of diarrhea and flatus; Herbal
cake-partitioned moxibustion could down-regulate the expression of TNF-,TNF-R1, and
TNF-R2, while bran-partitioned moxibustion could only down-regulate the expression of
TNF-R1.
Key WordsColitis, Ulcerative; Indirect Moxibustion; Diarrhea; Acupuncture-moxibustion
Therapy; Tumor Necrosis Factor-alpha
CLC NumberR246.1
Document CodeA
Ulcerative Colitis (UC) is a common disease in
digestive system which mainly manifested with
diarrhea, abdominal pain, mucus bloody purulent
stool. The incidence of UC is high. The disease
possesses a long-term duration and recurrent attacks
nature, which subject to fibrous degeneration
1 Clinical Data
1.1 General data
Sixty-seven UC patients were diagnosed according
to the revised diagnostic criteria in The Inflammatory
Bowel Disease Seminar in 2000 (Chengdu)[4]. They
all came from the OPD of UC department in Shanghai
Research Institute of Acupuncture and Meridian from
February 2003 to February 2006 and classified as
mild and moderate type. Sixty-seven cases were
divided into 35 cases in herbal cake-partitioned
moxibustion group and 32 cases in bran-partitioned
moxibustion group. Among the 35 cases in herbal
cake-partitioned moxibustion group, male cases: 20,
female cases: 15; the oldest: 71 years old and the
youngest: 15 years old, at the average age of 41.83
years old; the disease duration lasts from 1 month to
40 years. Among the 32 cases in bran-partitioned
moxibustion group, male cases: 17, female cases: 15,
the oldest: 73 years old, the youngest: 20 years, at the
average age of 45.2 years old; the disease duration
lasts from 3 month to 30 years. The data between two
groups are comparable after the statistical treatment.
1.2 Score scale of clinical symptoms
Evaluate the score of 12 symptoms (abdominal
pain, diarrhea, mucosal fluid stool, bloody purulent
stool, rugitus, abdominal distention, flatus, chilly,
lassitude, tenesmus, lumbar soreness and poor
appetite) before and after treatment according to the
severity such as: 0 (no symptoms appear), 1
(occasionally appear) and 2 (always and persistent
appear).
1.3 Observation index
1.3.1 Therapeutic effect
The symptoms of 67 patients before and after
treatment were analyzed to evaluate the effect
according to the symptom score.
Improved: The score difference before and after
treatment1.
Ineffective: The score difference before and after
treatment=1.
3 Results
3.1 Improvement of symptoms in the two groups
All syndromes were improved well in both groups.
There is no significant difference between two groups
in the improvement of abdominal pain, mucosal fluid
stool, bloody purulent stool, abdominal distention,
rugitus, chilly and poor appetite; while the herbal
cake-partitioned moxibustion group is superior to
bran-partitioned moxibustion in improving diarrhea,
flatus, lassitude, tenesmus and lumbar soreness (see
table 1).
3.2 Expression of TNF-TNF-R1TNF-R2
of colon mucosa
The unit integrate optical density of TNF-
TNF-R1TNF-R2 are comparable since there is no
statistical difference between two groups before
treatment. The unit integrate optical density of
TNF-TNF-R1TNF-R2 decreased significantly
in herbal cake-partitioned moxibustion group after
treatment; Only TNF-R1 decreased significantly in
bran-partitioned moxibustion group. There is no
significant change of TNF-R1 in two groups after
treatment (table 2).
Improved
Ineffective
Improved
Ineffective
26
19
73.08
25
20
80.00
1)
Diarrhea
25
24
96.00
26
19
73.08
Mucous stool
21
18
85.71
22
16
72.73
20
15
75.00
23
17
73.91
Abdominal distention
20
19
95.00
22
17
77.27
Rugitus
20
19
95.00
19
15
78.95
Flatus
19
18
94.741)
21
15
71.43
Lassitude
25
19
76.001)
25
17
32.00
Chilly
10
70.00
17
52.94
1)
Tenesmus
15
60.00
17
13
23.53
Lumbar soreness
75.001)
16
14
12.50
Poor appetite
10
70.00
10
50.00
Time
TNF-
TNF-R1
TNF-R2
Before treatment
15
0.1060.0270
0.1880.0779
0.1040.0093
After treatment
15
0.0870.0234 1)
0.1580.0707 1)
0.0630.0014 1)
Before treatment
15
0.1150.0498
0.1770.0099
0.0890.0084
After treatment
15
0.1010.0295
0.1540.00851)
0.0730.0034
4 Discussion
UC belongs to the scope of "diarrhea", "Chang pi"
in traditional Chinese Medicine, the main mechanism
of UC is deficiency of spleen and stomach. It always
induced or aggravated by the heat-damp and liver qi
attacking spleen. Long term duration or frequent
attacks could lead to the yang deficiency of spleen
and kidney and appear a serious of complicated
intestinal syndromes. The main treatment principal is
warm nourishing the spleen and kidney as well as
activating blood and smoothing qi. Thus the points
Tianshu (ST 25), Qihai (CV 6) and Guanyuan (CV 4)
were selected to treat both root and branches of the
disease. Tianshu (ST 25) can remove dampness and
turbid and activate blood, Qihai (CV 6) and
Guanyuan (CV 4) reinforcing the lower Jiao and
strengthen the kidney. Tianshu (ST 25) and Guanyuan
(CV 4) are the Front-Mu points for the large and small
intestines which regulating the complicated excess
and deficiency situation between Zheng qi (the vital
qi) and Xie qi (the evil qi). The research indicated that
herbal cake-partitioned moxibustion and branpartitioned moxibustion could well improve all the
symptoms of UC. The Herbal cake-partitioned
moxibustion group is superior to bran-partitioned
moxibustion in the improvement of diarrhea, flatus,
lassitude, tenesmus and lumbar soreness. While there
is no statistical difference between two groups in the
improvement of abdominal pain, mucosal fluid stool,
bloody purulent stool, abdominal distention etc. The
treatments in two groups are both indirect
moxibustion, the effect comes from the synergism of
moxibustion, points and herb (or paste). This article
found that herbal cake-partitioned moxibustion is
prior to bran-partitioned moxibustion in improvement
of certain UC syndromes, which shows that the effect
is closely related with the pastes. The author
presumed that in the herb paste, Fu Zi (Radix Aconiti
Lateralis) and Rou Gui (Cortex Cinnamomi) could
warming yang Mu Xiang (Radix Aucklandiae), Dan
Shen (Radix Salviae Miltiorrhizae) and Hong Hua
(Flos Carthami) have the function of activating blood
and smoothing qiwhile bran paste have no such
TNF-R2 in the colonic mucosa. While branpartitioned moxibustion could only significant down
regulated TNF-R1 statistically, TNF- and TNF-R2
could be down regulated by bran-partitioned
moxibustion with no statistical change. It shows that
bran-partitioned
moxibustion
improved
the
inflammation by down-regulating the expression of
TNF-R1 and decreased the reaction of colonic
mucosa epithelium and TNF-. This article studied
initially about the effect of herbal cake-partitioned
moxibustion and bran-partitioned moxibustion in
treating UC and regulating the TNF- and its
receptors, which still needs further research.
References
[1] WU Huan-gan, GAO Zhen-wu, ZHANG Lan. Clinical and
Empirical study of chronic non-specificity Colitis in the
Treatment of Herb-partitioned Moxibustion. Chinese
Acupuncture-moxibustion, 1992, 12 (1): 28-31.
[2] WU Huan-gan, TAN Wei-lin, CHEN Han-ping, et al. Effect
on Ulcerative Colitis and Influence on HLA-DR Antigen of
Enterocyte. Acupuncture Research, 1999, 24 (1):12-16.
[3] LIU Hui-rong, TAN Lin-ying, WU Huan-gan, et al. Effect
of Moxibustion on the Synthesis and Secretion of Collagen
by Colonic Fibroblasts in Ulcerative Colitis Fibrosis Rast.
Journal of Acupuncture and Tuina Science, 2008, 6 (1): 4-7.
[4] OUYANG Qin, FAN Guo-zong, WEN Zhong-hui, et al.
Proposition on the Criteria of Diagnosis and Therapeutic
Effects in Inflammatory Bowel Disease. Chinese Journal of
Digestion, 2001, 21(4): 236-239.
Translator: YANG Ling ( )
Received Date: October 10, 2008
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