粪菌移植联合美沙拉嗪治疗大肠湿热型溃疡性结肠炎临床研究  

Clinical efficacy of fecal bacteria transplantation combined with mesalazine in the treatment of ulcerative colitis with intestinal moist heat syndrome type

作　　者：孙滨滨[1] 王帅 吴京伟 董金华 李健平 李翠 张俊美[1] SUN Bin-bin;WANG Shuai;WU Jing-wei;DONG Jin-hua;LI Jian-ping;LI Cui;ZHANG Jun-mei(Department of Gastroenterology,Beijing Rectum Hospital,Beijing 100120,China)

机构地区：[1]北京市肛肠医院(北京市二龙路医院)脾胃病科,北京100120

出　　处：《中国中西医结合消化杂志》2018年第11期897-902,共6页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：北京中医药科技发展基金项目(No:JJ2016-05)

摘　　要：[目的]观察粪菌移植联合美沙拉嗪治疗大肠湿热型活动期溃疡性结肠炎的临床疗效。[方法]选择中医辨证为大肠湿热型的活动期溃疡性结肠炎患者30例,随机分为粪菌移植联合美沙拉嗪组(观察组)及安慰剂联合美沙拉嗪组(对照组)2组,在治疗前、治疗后2周、治疗后4个月观察2组改良Mayo评分、中医证候评分及C反应蛋白(CRP)、血沉(ESR)的变化情况,以减分值评定疗效,并对观察组和对照组的血常规、肝肾功能等指标进行观察,治疗中的不良反应进行记录。[结果]观察组治疗后2周、治疗后4个月Mayo评分及中医证候积分下降值均优于对照组(Z_2周_(Mayo)=-2.208,Z_4月_(Mayo)=-2.02,Z_2周中医=-2.029,Z_4月中医=-2.15,P<0.05),观察组治疗后2周CRP及ESR下降值均优于对照组(Z_(CRP)=-2.118,Z_(ESR)=-2.118,P<0.05),治疗后4个月观察组CRP下降值优于对照组(Z=-1.986,P<0.05),ESR下降值对比无差异(Z=-1.879,P>0.05)。2组天门冬氨酸氨基转移酶(ALT)、门冬氨酸转移酶(AST)、肌酐(CR)、尿素氮(BUN)、白细胞(WBC)、血红蛋白(HGB)前后比较差异无统计学意义(Z_(HGB)=-1.828,T_(WBC)=1.676,Z_(CR)=-0.442,Z_(BUN)=-0.965,ZALT=-1.416,Z_(AST)=-0.032,P>0.05)。[结论]粪菌移植联合美沙拉嗪可有效治疗大肠湿热型活动期溃疡性结肠炎,其疗效优于单药美沙拉嗪,且无明显不良反应,安全性高。[Objective]To observe the clinical efficacy of fecal microbiota transplantation combined with mesalazine in treatment of active ulcerative colitis with intestinal moist heat syndrome type.[Methods]Thirty active ulcerative colitis patients with TCM syndrome type of intestinal moist heat are randomly divided into feces transplantation combined with mesalazine and placebo combined with mesalazine group.Before treatment,after 2 weeks of treatment and after 4 months of treatment,the changes of modified Mayo scores,TCM syndrome scores,C-reactive protein,and ESR were observed to evaluate the efficacy of score reduction,at the same time,we observe the blood routine,liver and kidney function in observation group and control group.[Results]The Mayo score and the decrease in TCM syndrome scores in the observation group after 2 weeks and 4 months of treatment were all better than those in the control group.The decrease in CRP and ESR in the observation group was better than that in the control group after 2 weeks of treatment(P<0.05).The decrease in CRP in the observation group was better than that in the control group after 4 months of treatment(P<0.05).But there was no difference in the ESR decrease between the two groups(P>0.05).There was no significant difference in liver and kidney function,white blood cells,red blood cells,and electrocardiogram between the two groups(P<0.05).[Conclusion]Fecal microbiota transplantation combined with mesalazine can effectively treat the active intestinal ulcerative colitis with intestinal moist heat syndrome type and reduce the index of inflammatory activity.The curative effect is better than that of the single drug mesalazine,and is relatively safe.

关 键 词：溃疡性结肠炎 粪菌移植 大肠湿热 

分 类 号：R574.62[医药卫生—消化系统]