涤肠方对直肠黏膜炎症的治疗作用及对血清中炎性因子含量的影响  

Effect of Dichang Formula on Inflammation of Rectal Mucosa and The Influence of Inflammatory Factors

作　　者：李岩[1] 高福洋[1] 张化玉[2] LI Yan1 ,GAO Fuyang1,ZHANG Huayu2(1. Department of Anorectal Surgery, Chengde Central Hospital, Chengde 067000, Hebei, China ; 2. Department of General Surgery, Chengde Central Hospital, Chengde 067000, Hebei, Chin)

机构地区：[1]承德市中心医院肛肠科,河北承德067000 [2]承德市中心医院普外科,河北承德067000

出　　处：《中华中医药学刊》2018年第5期1234-1237,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：河北省科学技术厅基金项目(20151510)

摘　　要：目的：观察涤肠方治疗直肠黏膜炎的临床治疗效果及其具体的作用机制研究。方法：选取2014年9月—2016年12月来医院就诊的慢性直肠黏膜炎患者91例,随机分为对照组及观察组,对照组44例,观察组47例。两组患者均给予消炎、止血、解痉、合理饮食以及营养支持等治疗,对照组采用柳氮磺吡啶栓纳肛,早晚排空大便后,各1次,每次1 g,15 d为1个疗程,隔2 d再进行下一疗程,第2疗程每日1次,第3、4疗程每周3次。观察组患者采用涤肠方治疗,在睡前排空大便后保留灌肠1次,每天1剂,15 d为1疗程,连续服用4疗程。观察比较治疗前后两组患者的血清中的白介素2（IL-2）、白介素4（IL-4）、白介素10（IL-10）及干扰素-γ（IFN-γ）的含量;比较两组患者治疗4个疗程后的临床疗效;观察两组患者血常规（白细胞数目WBC、红细胞数目RBC）,肝功能（谷丙转氨酶ALT、谷草转氨酶AST）,肾功能检查（血肌酐BUN、血尿素氮Scr）,以及腹痛、坠胀、肛周不适反应。随访：结束后每3个月复查1次。结果：治疗4个疗程后两组患者血清中炎性因子IL-2、IL-4、IL-10及IFN-γ水平明显较治疗前改善（P〈0.05）,并且观察组较对照组患者改善的更加明显（P〈0.05）。对照组患者肝功能指标升高明显（P〈0.05）,观察组患者肝功能指标变化不明显,观察组患者肾功能指标BUN、Scr、TC及TG均下降（P〈0.05）,并且观察组较对照组下降幅度更为明显（P〈0.05）。观察组治疗总有效率91.5%高于对照组的79.5%（P〈0.05）,差异显著。观察组患者复发情况及不良反应均较对照组少（P〈0.05）,观察组患者临床各项评分均较对照组低（P〈0.05）。结论：涤肠方治疗直肠黏膜炎的临床疗效确切,因此涤肠方保留灌肠是临床上治疗直肠黏膜炎的有效治疗方剂,值得在临床上推广。Objective： To observe the clinical therapeutic effect of Dichang Formula on rectal adhesion and its specific function mechanism. Methods： Ninety-one patients with chronic rectal mucolitis were selected from September 2014 to December 2016,and randomly divided into control group and observation group,44 cases in control group and 47 in observation group. Two groups were given antiphlogistic drugs,hemostatic drugs,spasmolysis,reasonable diet and nutrition support treatment. The control group adopted the： Sulfasalazine Suppositories,in the morning and evening after emptying the intestine,each time 1 g,15 d for a period of treatment. After interval of 2 d the patients would carry out the next treatment course. In the second course,the medicaiton was used once a day and in the third and fourth course,three times a week. In the observation group,the patients were treated with self-made Dichang Decoction for enema before bedtime after defecating,1 dose per day,15 d for 1 treatment course and continuously for 4 courses. We observed the contents of interleukinin 2（IL-2）,interleukin-4（IL-4）,interleukin-10（IL-10） and interferon-gamma（IFN-gamma）in serum of two groups before and after treatment. The clinical efficacy after 4 courses,blood routine（number of white blood cells the WBC and RBC RBC）,liver function（ALT ALT,aspertate aminotransferase AST）,renal function examination serum creatinine,BUN,blood urea nitrogen（Scr）,and abdominal pain were compared. The patients were followed up every three months after treatment. Results： After four courses,two groups＇ inflammatory cytokines in serum IL-2,IL-4,IL-10 and IFN-gamma levels obviously improved（P〈0. 05）,and the observation group＇s improved more significantly than the control group＇s（P〈0. 05）. Control group＇s liver function index increased obviously（P〈0. 05） and the observation group＇s liver function index change was not obvious. The observation group＇s renal function indexes BUN,Scr,TC and TG decreased（P〈0.

关 键 词：涤肠方 柳氮磺吡啶栓 IL-2 IL-4 

分 类 号：R285.5[医药卫生—中药学]