四君子汤加味治疗克罗恩病的临床疗效和对炎症因子的调节作用  

Clinical Efficacy of Modified Si Junzitang in Treatment of Crohn’s Disease and Regulation Effect on Inflammatory Factors

作　　者：张海洋[1] 宋展[1] 钱国武[1] 吕柯[1] 王新伟[1] 丁珊珊[2] 吴照科[3] ZHANG Hai-yang;SONG Zhan;QIAN Guo-wu;LYU Ke;WANG Xin-wei;DING Shan-shan;WU Zhao-ke(Nanyang Hospital Affiliated to Zhengzhou University,Nanyang 473000;Fujian University of Traditional Chinese Medicine,Fuzhou 350122,China;The Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州大学附属南阳医院,河南南阳473000 [2]福建中医药大学,福州350122 [3]郑州大学第二附属医院,郑州450014

出　　处：《中国实验方剂学杂志》2018年第17期172-176,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(81503498);河南省高等学校重点专科项目(17A320009)

摘　　要：目的：观察四君子汤加味治疗克罗恩病的临床疗效，探讨其对炎症指标的调节作用。方法：将88例克罗恩病患者随机分为观察组和对照组，每组各44例，对照组给予西药常规治疗，观察组在西药常规治疗的基础上予以四君子汤加昧治疗，在观察周期8周结束后比较两组临床缓解率和有效率、中医证候疗效、疾病活动评分、炎症程度指标和炎症细胞因子情况并评价安全性。结果：治疗后，观察组临床缓解数和缓解率较对照组显著升高（P〈0．01）；在中医证候疗效方面，观察组总有效人数和有效率较对照组显著升高（P〈0．01）；观察组临床缓解数和缓解率较对照组明显升高（P〈0．05）；观察组无效数和无效率较对照组显著降低（P〈0．01）。与本组治疗前相比，两组患者简化克罗恩病疾病活动指数（CDAI）评分项目，红细胞沉降率（ESR），C反应蛋白（CRP）均较本组治疗前显著降低（P〈0．01）；治疗后，观察组以上3个指标均较对照组降低（P〈0．05）。与本组治疗前相比，两组患者白细胞介素（IL）-6，肿瘤坏死因子（TNF）-α和单核细胞趋化蛋白-1（MCP-1）均较本组治疗前降低（P〈0．01）；治疗后，观察组3个指标均较对照组低（P〈0．05）。两组患者不良反应发生较少且轻微，两组患者不良反应发生率相比差异不明显。结论：中药四君子汤加味联合西药常规药物治疗不仅可以更好地改善疾病症状，也可以明显改善疾病炎症状态，且安全性良好，临床使用可以取得更好的疗效。Objective： To observe the clinical efficacy of modified Si Junzitang in treatment of Crohn＇s disease and investigate its regulation effect on inflammatory markers. Method： The 88 patients with Crohn＇s disease were randomly divided into experimental group and control group, 44 eases in each group. Patients in the control group were treated with routine western medicine treatment while patients in experimental group were treatedwith modified Si Junzitang combined with routine treatment. After 8 weeks, clinical remission rates and effective rates, efficacy of traditional Chinese medicine （TCM） syndrome, disease activity score, inflammation degree index and inflammatory cytokines were compared between two groups and safety was evaluated. Result： After treatment, the number of clinical remission and remission rate in experimental group were significantly higher than those in control group （P 〈 0.01 ）. The total number of effective cases and and effective rate of the TCM syndrome in experimental group were significantly higher than those of the control group （P 〈 0.01 ）. The number of clinical remission cases and remission rate in experimental group were significantly higher than those in control group （P 〈 0.05）. The number of ineffectiveness and inefficiency in experimental group were lower than those in the control group （P 〈 0. 01 ）. As compared with the conditions before treatment, the simplified Crohn＇s disease activity index （CDAI） score, erythrocyte sedimentation rate （ESR） and C-reactive protein （CRP） were significantly lower after treatment in both groups （P 〈 0. 01 ） ; after treatment, the three indexes above in experimental group were lower than those in control group （P 〈 0.05）. The levels of interleukin （IL） -6, tumor necrosis factors （TNF） -ct and monocyte chemotactic protein （MCP） -1 after treatment were lower than those before treatment in both groups （P 〈 0.01 ） ; these three indexes （P 〈 0.05 ） in experimental gro

关 键 词：克罗恩病 四君子汤加味 炎症因子 中医证候 

分 类 号：R22[医药卫生—中医基础理论] R242[医药卫生—中医学]