中药超声导入对溃疡性结肠炎患者的临床疗效及其细胞因子的影响  

Effect of treatment with Chinese medicine delivered by sonophoresis on serum levels of cytokines in patients with ulcerative colitis

作　　者：杨旭[1] 王元钊[1] 叶妮[1] 王轶[1] 张苏闽[2] 方健[2] 周惠芬[2] 

机构地区：[1]南京市中西医结合医院,江苏省南京市210014 [2]南京中医药大学第三附属医院 全国肛肠病医疗中心,江苏省南京市210001

出　　处：《世界华人消化杂志》2013年第31期3450-3455,共6页World Chinese Journal of Digestology

基　　金：江苏省中医药局科技基金资助项目;No.LZ09088;南京市医学科技发展基金重点资助项目;No.ZKX09038~~

摘　　要：目的:观察中药超声导入辅助治疗轻中度溃疡性结肠炎(ulcerative colitis,UC)的临床疗效,并初步探讨其对UC患者细胞因子的影响.方法:采用随机对照试验研究,将符合纳入标准的轻中度UC患者67例随机分为两组(对照组34例,试验组33例),均予以美沙拉嗪肠溶片1.0 g,口服,tid;其中试验组加中药(参苓白术散加减)超声导入治疗,qd;疗程均为3 mo,分别记录两组患者治疗前后的临床症状积分,Southerland疾病活动指数(disease active index,DAI),肠镜检查Baron's积分及患者血清中细胞因子白介素-10(interleukin-10,IL-10)及IL-18的变化等.结果:治疗3 mo后,2组均未见不良反应发生,试验组患者总有效率84.85%显著高于对照组为70.59%(P<0.05),治疗后两组患者腹痛、腹泻及黏液脓血便症状积分均有明显降低,且试验组优于对照组(P<0.05);两组患者治疗后DAI及Baron's积分均有显著改善(P<0.05),但组间差异无统计学意义(P>0.05);两组患者治疗后血清中IL-18含量均降低,且试验组降低程度明显优于对照组(P<0.05),而血清IL-10均升高,且与对照组间差异有统计学意义(P<0.05).结论:中药超声导入辅助治疗轻中度UC疗效确切,值得临床推广应用,其作用机制可能与调节血清细胞因子表达水平有关.AIM： To observe the effect of treatment with Chinese medicine delivered by sonophoresis in patients with mild to moderate ulcerative colitis （UC）, and to detect the changes in serum levels of cytokines. METHODS： This was a randomized controlled trial involving 67 patients with mild to moderate UC. These patients were randomly divided into either a treatment group （n = 33） or a control group （n = 34）. All patients were given oral me- salazine enteric-coated tablets, 1.0 g, rid, while the treatment group was additionally given Chinese medicine （Shenlingbaizhu Powder） by sonophoresis, qd. The course of treatment was 3 months in both groups. Clinical symptoms were scored before treatment and 28, 56 and 84 d af- ter treatment. Inflammation degree was scored using the Baron＇s classification. Southerland disease active index （DAI） was calculated, and serum levels of interleukin-10 （IL-10） and IL-18 were measured before and after treatment. RESULTS： The total response rate was signifi- cantly higher in the treatment group than in the control group （84.85% vs 70.59%, P 〈 0.05）. The scores of abdominal pain, diarrhea and puru- lent stools were significantly decreased in both groups after treatment （all P 〈 0.05）. The differ- ences in Baron＇s scores and Southerland DAI before and after treatment were significant in both groups （both P 〈 0.05）. Three months after treatment, the average serum level of IL-18 was significantly decreased and that of IL-10 was in- creased, which was more significant in the treat- ment group （P 〈 0.05）. No adverse reaction was found in both groups. CONCLUSION： Chinese medicine delivered by sonophoresis shows an appreciated therapeutic effect in patients with mild to moderate UC, which may be related with the regulation of cy- tokine levels.

关 键 词：溃疡性结肠炎 中药 超声导入 细胞因子 

分 类 号：R259[医药卫生—中西医结合]