|Year : 2023 | Volume
| Issue : 1 | Page : 1-7
Expert consensus on diagnosis and treatment of ulcerative colitis with integrated traditional Chinese and Western medicine: A nursing perspective
Bing Xu1, Miao Liu1, Hairong Hu2, Jing Zhang2, Yanping Huang3, Ling Tang2
1 Department of Gastroenterology, Dongfang Hospital of Beijing University of Chinese Medicine, Beijing, China
2 Department of Nursing, Dongfang Hospital of Beijing University of Chinese Medicine, Beijing, China
3 Department of Gastroenterology, Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing, China
|Date of Submission||17-Mar-2022|
|Date of Decision||19-Jan-2023|
|Date of Acceptance||23-Jan-2023|
|Date of Web Publication||23-Mar-2023|
Prof. Ling Tang
Department of Nursing, Dongfang Hospital of Beijing University of Chinese Medicine, Zone 1, Fangzhuang Fangxing Garden, Fengtai District, Beijing 100078
Source of Support: None, Conflict of Interest: None
Ulcerative colitis (UC) is a chronic nonspecific intestinal inflammatory disease of unclear etiology, characterized by continuous and diffuse inflammatory changes of colorectal mucosa. In recent years, the incidence rate of UC in China has increased year by year, but there is no effective cure method in Western medicine. Traditional Chinese medicine treatment based on syndrome differentiation has the unique advantages of simplicity, convenience, effectiveness, and low cost. Therefore, integration of Chinese and Western medicine has become an important strategy for UC diagnosis and treatment, and has made significant progress in UC. On the basis of learning from a number of consensuses at home and abroad, combined with Chinese research results and the actual clinical situation of traditional Chinese and Western medicine, the UC group of the Chinese Association of Integrative Medicine has formulated the expert consensus on the diagnosis and treatment of UC with integrated traditional Chinese and Western medicine. In this consensus, the pathogenesis, etiology and pathogenesis, diagnosis, integrated traditional Chinese and Western medicine treatment, and chronic disease management with integrated traditional Chinese and Western medicine for UC were recommended by experts. This article interprets the consensus from the perspective of nursing in order to provide reference basis for clinical nursing workers.
Keywords: Consensus, continuing care, integrated traditional Chinese and Western medicine nursing, nursing perspective, traditional Chinese medicine, ulcerative colitis
|How to cite this article:|
Xu B, Liu M, Hu H, Zhang J, Huang Y, Tang L. Expert consensus on diagnosis and treatment of ulcerative colitis with integrated traditional Chinese and Western medicine: A nursing perspective. J Integr Nurs 2023;5:1-7
|How to cite this URL:|
Xu B, Liu M, Hu H, Zhang J, Huang Y, Tang L. Expert consensus on diagnosis and treatment of ulcerative colitis with integrated traditional Chinese and Western medicine: A nursing perspective. J Integr Nurs [serial online] 2023 [cited 2023 May 28];5:1-7. Available from: https://www.journalin.org/text.asp?2023/5/1/1/372412
| Introduction|| |
Ulcerative colitis (UC), also known as chronic nonspecific UC or idiopathic UC, is a chronic nonspecific intestinal inflammatory disease characterized by continuous and diffuse inflammatory changes of colorectal mucosa. Its lesions are mainly limited to colorectal mucosa and submucosa. According to the clinical manifestations of mucus purulent bloody stool, repeated attacks, and difficulty to heal, it is categorized as “chronic dysentery,” “rest dysentery,” and “intestinal dysentery” in traditional Chinese medicine (TCM). The prevalence of UC in China is about 11.6/100000, which is increasing year by year, and its diagnostic methods and treatment methods are constantly updated. Many authoritative institutions and professional societies abroad have issued several guidelines and consensuses for diagnosis and treatment of UC, such as guideline issued by the American Gastroenterology Association, evidence-based consensus issued by the European Crohn´s and Colitis Organization, and consensus issued by the British Gastroenterology Society, which provide reference for clinical medical workers.
With the deepening understanding of UC, clinical and basic research in China has become more and more standardized, and evidence-based evidence that can be used to formulate consensus and guidelines is increasing. The digestive system disease professional committee of the Chinese Association of Integrative Medicine formulated the consensus on the diagnosis and treatment of UC with integrated traditional Chinese and Western medicine (draft) in 2010. The spleen and stomach disease branch of the China Association of Chinese Medicine formulated expert consensus on TCM diagnosis and treatment of UC in 2017 and the guidelines for TCM diagnosis and treatment of common diseases of the digestive system – UC (grassroots doctors version) in 2019. However, there is still a lack of expert consensus on the diagnosis and treatment of UC with integrated traditional Chinese and Western medicine, which is based on the integration of the advantages of traditional Chinese and Western medicine, and achieves the best curative effect and minimum toxic and side effects. In view of this, the Digestive System Diseases Professional Committee of the Chinese Society of Integrated Traditional and Western Medicine has formulated the Consensus on the Diagnosis and Treatment of UC with Integrated Traditional and Western Medicine (2017) (hereinafter referred to as the Consensus) on the basis of drawing on a number of consensuses at home and abroad and combining the research results of China and the clinical situation of TCM and Western medicine. The Consensus is formulated for adult patients with UC, supported by the clinical cooperation project of traditional Chinese and Western medicine for major and difficult diseases of UC (chronic dysentery). It highlights the characteristics of diagnosis and treatment of integrated traditional Chinese and Western medicine, and promotes the complementary and coordinated development of the two medical systems. The Consensus is formulated by using the internationally common Delphi procedure. In this article, it is interpreted from the perspective of nursing in order to improve nurses' cognition of UC and improve the nursing level of integrated traditional Chinese and Western medicine in UC.
| Pathogenesis, Etiology, and Pathogenesis of Ulcerative Colitis|| |
The Consensus points out that the etiology of UC is not clear, and the current research tends to believe that it is related to factors such as heredity, infection, environment, psychosis, and immune regulation disorder.
During the active period of UC, the destroyed intestinal barrier function and the bacterial translocation activates the intestinal natural immunity and acquired immunity that are difficult to self-limit and excessively hyperactive, and occur alternately in attack and remission, causes the intestinal lasting and difficult to self-limit immune inflammatory response, and leads to the pathological changes such as intestinal ulcer lasting for a long time and inflammatory hyperplasia. TCM believes that the etiology of UC during this period is improper diet, injury to the spleen and stomach, or stagnation of the liver restricting the spleen due to emotional disorder, or internal injury to the spleen and stomach due to attack of evil Qi (exogenous pathogenic factors). The pathogenesis of UC is that spleen deficiency results in failing to transport water-dampness, retention of water-dampness turns into turbid substance and diffuses into the blood. Dampness-heat and turbid toxin are stagnating in the intestines, which makes intestines swelling, erosion and suppuration, which finally becomes the disease.
In remission stage, the activities of cells and cytokines involved in intestinal immune injury are inhibited, and the immune inflammatory response is dormant at this stage. TCM believes that this period is mostly manifested as intermingled deficiency and excess. The main pathogenesis is deficiency of healthy Qi and lingering evil Qi. Deficiency of healthy Qi is mainly manifested as spleen deficiency and kidney deficiency. Lingering evil Qi is mainly manifested as the retention of damp-heat evil, which affects and causes each other with the syndrome of spleen deficiency.
| Clinical Staging and Syndrome Differentiation of Ulcerative Colitis|| |
Clinical staging from the perspective of Western Medicine
According to the Consensus, UC has active phase and remission phase based on the pathological manifestations of the mucosal biopsy. In the active phase, UC is divided into “mild,” “moderate,” and “severe” according to the modified Truelove and Witts disease severity classification standard recommended by the Consensus on the Diagnosis and Treatment of Inflammatory Bowel Disease in China. Mild UC is manifested as defecation times <4 times; no bloody stool or mild bloody stool symptoms; normal pulse, body temperature, and hemoglobin; and erythrocyte sedimentation rate <20 mm/h. Severe UC is manifested as defecation times ≥6 times, severe hematochezia symptoms, pulse >90 times/min, body temperature >37.8°C, hemoglobin <75% of normal value, and erythrocyte sedimentation rate <20 mm/h. The severity of symptoms of moderate UC is between mild and severe. According to the clinical classification, it can be divided into initial type and chronic recurrent type. According to the location of the disease, Montreal classification is recommended, which is divided into rectal type (E1), left hemicolon type (E2), and extensive colon type (E3). The Consensus describes the clinical classification and staging of UC in detail, which provides an objective, scientific, and practical evaluation scale for clinical nurses to objectively evaluate the patient's condition in their work, observe the patient's condition, and carry out nursing research in the future.
Traditional Chinese medicine syndrome differentiation
The Consensus puts forward that deficiency of spleen Qi is the basis of UC onset, and the main inducements are attacks of external evils, improper diet, internal emotion injury, etc., TCM syndrome differentiation includes damp-heat accumulating in intestine syndrome, hot toxin flaming syndrome, turbid-toxin internal accumulation syndrome, spleen deficiency and dampness accumulation syndrome, mixed cold and heat syndrome, spleen and kidney Yang deficiency syndrome, blood stasis blocking intestinal collaterals syndrome, as well as liver depression and spleen deficiency syndrome.
The active stage is mostly manifested as excess syndrome, and the main pathogenesis is damp-heat accumulating in the intestine and the imbalance of Qi and blood. The remission period is mostly manifested as intermingled deficiency and excess syndrome, and the main pathogenesis during this period is spleen deficiency, dampness lingering, and spleen failing to transportation. Mild-to-moderate patients are mainly damp-heat, while severe patients are mainly turbid toxin, blood stasis, and heat.
For those who are recurrent and difficult to heal, the factors of phlegm turbidity, blood stasis, and deficiency of spleen and kidney should be considered. The main pathogenesis of the initial type is damp-heat accumulating in the intestine, while the chronic recurrent type is mainly Qi deficiency of spleen and stomach and Yang deficiency of spleen and kidney.
| Treatment Principle of Integrated Traditional Chinese and Western Medicine|| |
The Consensus advocates that the goal of integrated traditional Chinese and Western medicine in the treatment of UC is to quickly induce remission, maintain clinical remission and mucosal healing for a long time, prevent complications and adverse drug reactions, improve the quality of life of patients, and strengthen the long-term management of patients. In the treatment of UC with integrated traditional Chinese and Western medicine, different treatment schemes should be formulated according to different grades, stages, and segments of the disease.
Mild-to-moderate UC is mainly treated with integrated traditional Chinese and Western medicine, oral Western medicine or TCM preparation, suppository or enema alone, Western medicine combined with acupuncture, acupoint catgut embedding, or oral Western medicine combined with TCM enema. Severe UC is mainly induced by Western medicine for remission, with TCM assisting to improve the nutritional status of patients. For the links where Western medicine cannot take effect, it is necessary to take advantages of TCM. In the active phase, the main goal is to induce the remission of clinical symptoms. The goal of the remission stage is to maintain the remission of clinical symptoms and mucosal healing, improve the quality of life and prevent recurrence. Distal colitis can be treated locally. Patients with extensive colitis or extraintestinal symptoms are mainly treated systematically.
| Integrated Traditional Chinese and Western Medicine Nursing|| |
It is believed that improper diet and daily life lead to diarrhea. The Consensus suggests that patients should keep the environment clean, pay attention to personal hygiene, and avoid unclean food so as to prevent intestinal infection. Feng et al. conducted a retrospective study on the recurrence factors of 90 patients with UC. The results showed that improper diet was the main inducement of recurrence, accounting for 31.1%; overwork accounted for 20.0%; 7.8% were induced by intestinal infection and unknown causes.
The Consensus also points out that eating, sleeping, and taking medicine on time are the basic requirements to ensure the therapeutic effect of UC. A study found that sleep disorder is one of the important risk factors for the recurrence of UC patients; therefore, patients are required to follow work and rest rules to ensure adequate sleep, quit smoking and alcohol, and avoid catching cold. Patients with frequent diarrhea and bloody stool in the acute stage should stay in bed to reduce intestinal peristalsis and spasm, and reduce the symptoms of diarrhea and abdominal pain. After the condition is stable, appropriate activities should be carried out, and self-regulation should be carried out according to the patient's tolerance. Moreover, heavy physical labor is avoided not to aggravate or induce complications.
Some research reports show that regular, timely, and quantitative medication is helpful to consolidate and ensure the rehabilitation treatment of patients, improve the medication compliance of patients, and is of great significance for the treatment of UC. Patients have insufficient understanding of the long-term nature, necessity and importance of drug treatment, and worry about the occurrence of side effects. Poor medication compliance such as unauthorized discontinuation, reduction, or switching to other drugs is one of the main reasons for recurrence of some patients after remission. The Consensus points out that patients in mild-to-moderate active stage and remission stage can take oral TCM preparations. In the application of TCM in the treatment of UC, Mao et al. pointed out that the TCM granules in prescriptions should be mixed up with warm boiled water and taken immediately, one dose a day, taken twice, and 1 h after meals in the morning and evening; during the medication period, the patients shouldn't eat/drink milk, soybean milk, spicy, cold and crude fiber food (such as celery), and shouldn't stay up late and overwork.
The Consensus points out that reasonable dietary care in the treatment of UC can improve the curative effect and shorten the course of disease. In daily diet management, diet guidance can be given in combination with TCM syndrome differentiation. The specific contents are as follows: (1) patients with damp-heat accumulating in the intestines are mostly in the acute attack period. They need fasting and parenteral nutrition to correct the disorder of water and electrolyte and avoid dehydration. During the attack period, sorghum rice, millet, and purslane can be used for clearing heat, purging fire, and detoxification. After the condition is stable, yam, jujube, and lotus seed meat are used to cook porridge. Avoid eating mutton and spicy food. (2) Patients with spleen deficiency and dampness accumulation have long-term eating disorders due to prolonged illness. For diet of those patients, it is emphasized strengthening the stomach and benefiting the spleen. They should mainly eat light and cooked food. Frequent small meals are recommended. It is recommended to use yam, coix seed, red dates, lentils, and Huangqi (Radix Astragali seu Hedysari) to make porridge or cook dishes and to avoid cold (cold dishes) and spicy irritants. (3) Patients with Yang deficiency of spleen and kidney have a weak constitution, and pay attention to tonifying the kidney and nourishing the spleen in their diet. They can often eat Huangqi (Radix Astragali seu Hedysari), yam, lentils, corn, lotus seeds, wheat, yellow rice, and glutinous rice. They can also add cinnamon and dried ginger when they cook dishes. They should avoid eating cold food (such as cold melons and fruits, cold drinks, cold dishes, and cold rice). (4) Patients with liver depression and spleen deficiency have great psychological pressure. It is recommended to eat food with effects of soothing the liver and strengthening the spleen, such as radish porridge, hawthorn, yam, and coix seed. (5) Patients with blood stasis blocking intestinal collaterals are with a weak constitution, long disease course, and recurrent attacks. It is recommended to eat foods with effects of dredging collaterals and removing blood stasis, such as peach kernel, japonica rice, and brown sugar. They should eat less and more meals in daily diet, mainly liquid food. The research results of Han et al. showed that eating more red meat, milk, margarine, chocolate, and high sucrose increased the risks of occurrence and recurrence of UC, while supplementing fruits and vegetables, deep-sea fish oil, probiotics, and vitamins played a positive role in the prevention and treatment of the disease.
The Consensus points out that at present, there is no single eating plan suitable for all UC patients, and an individualized eating plan should be formulated according to the patient's course of disease, lesion location, disease degree, and other specific conditions. Self-recording daily diet in diet examination and record is helpful to improve patients' initiative in disease treatment and nursing intervention, improve patients' dietary structure, and help them develop good and regular eating habits.
Proper exercise in life can strengthen the body, delight the mind, and thus be beneficial to the rehabilitation of diseases. The American Sports Medical Association put forward the concept of “exercise is medicine,” and believes that regular exercise, as a prescription in patients' daily treatment, is no less effective than simple drug treatment. The Consensus points out that noncompetitive sports such as medical gymnastics, functional exercise, aerobic training, Tai Chi, Tai Chi sword, and Qigong, have a gentle rhythm, which can avoid excessive physical exertion and are a good choice. Several studies show that long-term aerobic exercise can alleviate the symptoms of UC patients, reduce the inflammatory reaction, offset the adverse reactions of drug therapy to a certain extent, and even reduce the drug dosage, reduce complications, and then reduce the economic burden.,, Baduanjin has the function of coordinating the five Zang-organs and six Fu-organs. Among the eight-section movements of Baduanjin, two-section movements “holding up your hands to regulate the triple energizers” and “raising one arm to regulate the spleen and stomach” can have a massage effect on the spleen and stomach in the middle energizer and thus regulate the spleen and stomach and meridians. Zhang and Wang showed that the application of Baduanjin in UC patients can improve the symptoms of anxiety and depression, reduce clinical symptoms, and improve the quality of life of the patients. Tang et al. instructed patients to take Baduanjin exercise in every morning and evening, 15–20 min each time, 5–6 days a week, 3 months as a course of treatment, which significantly improved the fatigue symptoms of patients with mild-to-moderate inflammatory bowel disease.
TCM theory puts forward that emotional depression is the main cause of UC. The whole disease process has different degrees of Qi stagnation. The method of soothing the liver and regulating Qi can make Qi and blood flow smooth, and then restore the function of the whole intestine to normal. The Consensus points out that actively adjusting the mentality and stabilizing the mood is very important to improve the condition. Patients can treat life and disease with an optimistic and stable mentality, which can promote the development of the disease in a good direction. Patients should learn to establish their own social support forces, including from family members, patients and doctors, and health websites. They can distract their attention and relieve their worries by watching TV, reading, making friends, etc., Patients with serious mental and psychological symptoms can be treated in combination with Chaihu (Radix Bupleuri), Hehuanpi (Cortex Albiziae), Fuling (Poria), Baihe (Bulbus Lilii), or Ganmai Dazao Decoction to relieve depression and calm the mind, or take antidepressants and sedatives, such as Deanxit, Prozac, diazepam, and Shule diazepam. Some scholars believe that UC is closely related to patients' own emotions. UC is a kind of physical and mental disease. Patients are vulnerable to mood, fatigue, unreasonable diet, and other factors, resulting in acute attack of the disease. A number of studies have shown that five-tone therapy combined with acupoint massage can effectively alleviate the anxiety state of UC patients and improve their satisfaction; patients with liver depression and spleen deficiency syndrome, manifested as sparse stool, poor appetite, and abdominal pain, can be treated with playing Gong tone and Jiao tone in turn; patients with large intestine damp-heat syndrome, manifested as more blood in stool, insomnia, and heart kidney disharmony, are mainly treated by playing Zhi tone and Yu tone.,
Appropriate traditional Chinese medicine techniques
According to the syndrome differentiation of patients, the implementation of appropriate TCM techniques can not only effectively improve the symptoms and signs of UC patients but also improve their intestinal mucosa and overall situation. Acupuncture, acupoint catgut embedding, massage, TCM foot bath, and drug iontophoresis recommended in the Consensus can be used as adjuvant treatment for UC, but there is still a lack of high-level evidence-based medical evidence support. The following focuses on the TCM retention enema and moxibustion recommended in the Consensus.
Traditional Chinese medicine retention enema
The Consensus recommends TCM and Chinese patent medicine for enema according to clinical manifestations and endoscopic mucosal manifestations. TCM retention enema is administered through the rectum, which can make the drugs act directly on the lesion of intestinal mucosa and give full play to the curative effect of the drugs. Secondly, TCM retention enema follows the principle of syndrome differentiation and treatment to flexibly select prescriptions and drugs according to the changes of patients' symptoms and clinical syndrome differentiation. The operation method of the recommended routine enema is as follows: the enema solution should be 100–150 mL and the temperature should be 39°C. Patients take left lying position for 30 min, flat lying position for 30 min, and the right lying position for 30 min, and then take a comfortable position. It is recommended to perform enema before going to bed and after defecation. After enema, try to keep the drug solution in the intestine for more than 1 h. The time of enema, the temperature and speed of drugs, the insertion depth, and the body position of patients with different types are all important factors affecting the effect of enema. In a study conducted by Gao, catheter enema was used, with thermostat to keep the enema liquid constant temperature, and the patients were asked to be in right lying position to make the enema liquid reach the hepatic flexure. The research showed little irritation to the anus and intestinal mucosa during the insertion process, which reduced the patient's pain and bleeding probability, and increased the action time between the drug and intestinal mucosa, thus improving the effect of drug retention enema. Zhou et al. studied the treatment of UC with different insertion depth of TCM retention enema, suggesting that the insertion depth of anal canal is 5–7 cm, and the intestinal mucosa is slightly damaged. Yang et al. observed that TCM enema with constant temperature in the treatment of UC has high cure rate and high patient satisfaction. Lan et al. studied the application of rotary anal tube insertion technique retention enema in the treatment of UC and found that the improved rotary anal tube insertion technique can improve the comfort of patients. Fei et al. used TCM enema in combination with meridian flow in UC, and found that it can improve the deficiency of spleen and kidney radically, warm the kidney Yang, restore the function of transporting water and grain essence of the spleen to normal, and stop diarrhea of patients. Li proposed in his experience that during TCM enema in the treatment of UC, the patient should take the left lying position, which can be inserted to more than 25 cm. After administration, the patient should keep chest-knee position for half an hour, then take the right lying position, and keep the hip high with pad for more than 2 h, which makes the effect better.
With the help of its own medicinal properties and the warm effect of wormwood leaves when burning, moxibustion can warm and dredge the meridians, sthrengthen healthy Qi and dispel evil, and tonify the spleen and stomach. The main acupoints recommended in the Consensus are Zhongwan, Qihai and Zusanli, Dachangshu, Tianshu, and Shangjuxu. The latter three can be used alternately. Pishu acupiont is added for patients with spleen and stomach weakness; Shuifen acupiont is added for patients with damp-heat accumulating in the intestines; Ganshu acupoint and Pishu acupoint are added for patients with liver depression and spleen deficiency; Guanyuan acupoint is added for patients with spleen and kidney Yang deficiency type; Yinbai acupoint is added for bloody purulent stool. Many studies have shown that moxibustion can improve intestinal inflammatory response by regulating patients' immune balance, regulating intestinal flora, improving intestinal mucosal barrier function, and regulating cell apoptosis., Modern biology and time medicine research show that the rise and fall of human meridians are closely related to the changes of 12 h. At different times, the human body responds differently to the same intensity of stimulation. Hu et al. applied meridian flow theory to select acupoints at appropriate time for moxibustion in the treatment of hospitalized UC patients, e.g., moxibustion on Zusanli, Shangjuxu, and bilateral Tianshu acupoints at 7–9 o'clock and moxibustion on Weishu and Dachangshu acupoints for 15–17 o'clock.
TCM nursing is an important part of China's nursing field and a unique nursing model in China. TCM nursing clinic is an effective form of continuous nursing, which can provide convenient and professional nursing services for discharged patients, implement whole-process management of health, and provide continuous services such as rehabilitation guidance, health education, and follow-up medical advice for discharged patients. Continuous TCM nursing can improve the disease-related symptoms of UC patients, improve the disease-related knowledge level of patients, and improve the quality of life of patients. Nurses need to continuously improve their clinical scientific research ability, optimize the evaluation tools and standard system of evidence-based methodology in the field of TCM, use evidence-based thinking to find high-quality and best evidence, and formulate evidence-based nursing practice plan, so as to further give full play to the characteristics of TCM nursing. Hu et al. applied TCM continuous nursing from the evidence-based perspective to patients with mild-to-moderate active UC, and found that after 3 months of intervention, the disease severity, quality of life, disease knowledge level, and self-efficacy of the two groups were better than those before treatment. Xu et al. explore the effect of health education on quality of life and self-efficacy of patients with UC and found that after the intervention, the IBD self-efficacy score, the total score of IBD-Q scale, intestinal symptoms, systemic symptoms, emotional function, and social function scores were significantly higher than those before the intervention (P < 0.05).
However, there are some problems, such as the lack of existing professional talents in TCM nursing, the lack of overall dialectical nursing ability of TCM nursing team, and the lack of innovative development of TCM nursing technology. To improve the clinical service ability of TCM nursing, nursing staff should improve the operation level of TCM nursing, widely apply the characteristic technology, innovate the TCM nursing service mode, and improve the clinical curative effect of TCM.
| Conclusion|| |
Combined with the actual situation in China and the latest literature at home and abroad, the Consensus introduces the diagnosis and treatment of UC with traditional Chinese and Western medicine in detail, which provides a scientific basis and practical guidance for the diagnosis and treatment of UC patients in China. In the Consensus opinion, the clinical research evidence from China is still very limited. Due to the lack of high-level evidence such as randomized controlled trial related to the treatment of UC with integrated traditional Chinese and Western medicine, there is a lack of research evidence on personalized continuous nursing and TCM continuous nursing. There are many studies on the application of TCM operation technology alone or combined in UC, including acupoint selection, syndrome differentiation, implementation methods, curative effect evaluation, and so on. TCM characteristic nursing intervention can effectively improve clinical symptoms and the quality of life of UC patients. TCM nursing clinic focuses on rehabilitation, health preservation, and health care, which meets the development requirements of aging society and facilitates the development of chronic disease management. It is a beneficial supplement to medical treatment and is worthy of further research and promotion.
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Conflicts of interest
There are no conflicts of interest.
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