OBJECTIVE To investigate the time-effect relationship of ginger-partitioned moxibustion in treating fecal incontinence in patients with mild to moderate active Crohn's disease so as to optimize moxibustion duration and provide a basis for clinical application.

METHODS A total of 128 patients with Crohn's disease complicated by fecal incontinence who met the inclusion criteria were selected as the study subjects. They were divided into a control group and three experimental groups (experimental group Ⅰ, Ⅱ, and Ⅲ) of 32 patients each using a stratified random method (with 1 dropout in experimental group Ⅰ). Patients in the control group received routine anti-tumor necrosis factor-α monoclonal antibody (adalimumab) treatment, while patients in the experimental groups received ginger moxibustion therapy in addition to the treatment provided to the control group. Among them, experimental group Ⅰ received treatment for 20 minutes, experimental group Ⅱ for 40 minutes, and experimental group Ⅲ for 60 minutes. The course of treatment for all four groups was 3 months. Changes in TCM syndrome scores were compared before and after treatment in the four groups to assess clinical efficacy. The cleveland clinic incontinence score (CCIS) was used to assess the severity of fecal incontinence, the Crohn's disease activity index (CDAI) was used to assess the degree of disease activity, and the inflammatory bowel disease questionnaire (IBDQ) was used to evaluate the quality of life. Anal pressure index and peripheral blood CRP and ESR levels were measured, and the relationship between moxibustion time and effect was analyzed.

RESULTS After 3 months of treatment, the total TCM syndrome scores of all four groups improved to varying degrees (P < 0.05, P < 0.01). The total scores of groups Ⅰ, Ⅱ, and Ⅲ were superior to those of the control group (P < 0.05, P < 0.01), while group Ⅱ had the lowest total TCM syndrome score. Group Ⅱ had the highest overall clinical effective rate, significantly better than both the control and group Ⅰ (P < 0.05, P < 0.01). CCIS scores, IBDQ scores and total scores, and peripheral blood ESR levels were significantly reduced in all four groups (P < 0.01), with group Ⅱ having the lowest score, lower than both the control and group Ⅰ (P < 0.05, P < 0.01). CRP levels were significantly reduced in groups Ⅱ and Ⅲ (P < 0.05, P < 0.01), both lower than the control group (P < 0.05, P < 0.01), with group Ⅱ lower than group Ⅰ (P < 0.01). Intestinal symptom scores in the IBDQ of groups Ⅱ and Ⅲ were significantly higher than those in the control group and group Ⅰ (P < 0.05, P < 0.01). The maximum resting pressure of the anal canal, rectal defecation threshold, and maximum tolerance capacity all increased significantly in the four groups (P < 0.05, P < 0.01), but there were no significant differences among the groups (P > 0.05). During the treatment, two cases of mild skin redness occurred in group Ⅲ, which resolved after treatment, with no serious adverse reactions.

CONCLUSION Ginger moxibustion in the treatment of Crohn's disease complicated by fecal incontinence exhibits a time-effect relationship, with 40 minutes as the optimal duration. It can effectively improve symptoms, control inflammation, enhance quality of life, and has good safety.