Objective To analyze the clinical efficacy of spleen-fortifying and governor vessel-tonifying decoction combined with moxibustion on aconite cake in the treatment of ulcerative colitis. Methods A total of 96 patients with ulcerative colitis were selected and randomly divided into a control group or a study group, with 48 cases in each group. The control group was treated with moxibustion on aconite cake alone, based on which the study group was additionally treated with spleen-fortifying and governor vessel-tonifying decoction. The Traditional Chinese Medicine (TCM) syndrome scores, levels of inflammatory mediators, indicators of intestinal mucosal barrier function, and clinical scores (Geboes index, endoscopic mucosal performance score) before and after treatment, as well as therapeutic efficacy, were compared between the two groups. Results Before treatment, there was no statistically significant difference in the TCM syndrome scores of diarrhea, mucous purulent bloody stool, tenesmus, anal burning, or short red urine between the two groups (all P>0.05); after 12 weeks of treatment, the above TCM syndrome scores in both groups decreased, and the above TCM syndrome scores in the study group were lower than those in the control group (all P<0.05). Before treatment, there was no statistically significant difference in the serum levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, or IL-10 between the two groups (all P>0.05). After 12 weeks of treatment, the serum levels of TNF-α and IL-6 in both groups decreased, while the serum level of IL-10 increased (all P<0.05); the serum levels of TNF-α and IL-6 in the study group were lower than those in the control group, and the serum level of IL-10 in the study group was higher than that in the control group (all P<0.05). Before treatment, there was no statistically significant difference in the serum levels of diamine oxidase (DAO) or D-lactic acid (D-LA) between the two groups (all P>0.05); after 12 weeks of treatment, the serum levels of DAO and D-LA in both groups decreased, and the serum levels of DAO and D-LA in the study group were lower than those in the control group (all P<0.05). Before treatment, there was no statistically significant difference in the Geboes index or endoscopic mucosal performance score between the two groups (all P>0.05); after 12 weeks of treatment, the Geboes indexes and endoscopic mucosal performance scores in both groups decreased, and the Geboes index and endoscopic mucosal performance score in the study group were lower than those in the control group (all P<0.05). The total clinical effective rate of the study group (95.83%) was higher than that of the control group (81.25%) (P<0.05). Conclusion The combined therapy of spleen-fortifying and governor vessel-tonifying decoction and moxibustion on aconite cake demonstrates significant clinical efficacy in ulcerative colitis, markedly improving TCM syndrome manifestations. The therapeutic mechanism may involve modulation of the intestinal immunologic niche, rebalancing pro- and anti-inflammatory cytokine networks, and restoration of intestinal mucosal barrier integrity.

无