英夫利西单抗联合自拟行气活血汤保留灌肠对中重度小肠克罗恩病患者免疫及凝血功能的影响  

Effect of infliximab combined with self-made Xingqi Huoxue decoction by retention enema on immunity and coagulation function in patients with moderate to severe intestinal Crohn's disease

作　　者：孙俊 王宏志[2] 汪毅 计春燕 屈银宗 薛娟 SUN Jun;WANG Hongzhi;WANG Yi;JI Chunyan;QU Yinzong;XUE Juan(Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine,Wuhan 430015,Hubei,China;Huangshi Central Hospital of Edong Heath Care Group,Huangshi 435000,Hubei,China)

机构地区：[1]湖北省中西医结合医院,湖北武汉430015 [2]鄂东医疗集团黄石市中心医院中心院区,湖北黄石435000

出　　处：《现代中西医结合杂志》2018年第13期1402-1406,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察英夫利西单抗(IFX)联合行气活血汤保留灌肠对中重度小肠克罗恩病(CD)患者免疫及凝血功能的影响。方法将90例中重度小肠CD患者随机分为观察组45例和对照组45例,对照组给予IFX治疗,观察组在对照组基础上给予自拟行气活血汤保留灌肠治疗,2组疗程均为6个月。记录2组治疗前后主要临床症状、生化检查指标、克罗恩病活动指数(CDAI)、克罗恩病简化内镜评分(SES-CD)及免疫炎性、凝血功能指标变化情况。结果 2组治疗后腹痛腹泻、发热、营养不良、食欲不振积分及CDAI、SES-CD评分均显著降低(P均<0.05),且观察组上述评分均显著低于对照组(P均<0.05);2组治疗后C反应蛋白(CRP)、血沉(ESR)、Th1/CD4^+比例、Th1/Th2比值、TNF-α水平及血小板计数(Plt)、D-二聚体、纤维蛋白原(FIB)水平均显著降低(P均<0.05),血红蛋白(Hb)、活化部分凝血酶时间(APTT)、IL-10水平均显著升高(P均<0.05),且观察组上述指标改善情况均优于对照组(P均<0.05)。结论 IFX联合自拟行气活血汤保留灌肠治疗中重度小肠CD能够显著改善患者的临床症状,缓解病情并促进小肠黏膜愈合,可能与二者联合应用调节Th1/Th2淋巴细胞平衡,并抑制高凝状态有关。Objective It is to observe the effect of infliximab(IFX)combined with Xingqi-huoxue decoction by retention enema on immune and coagulation function in patients with moderate to severe Crohn’s disease(CD).Methods 90 cases of moderate to severe CD were randomly divided into observation group(45 cases)and control group(45 cases).The control group was treated with IFX,the observation group was treated with self-made Xingqi Huoxue decoction by retention enema on the basis of therapy in the control group.Both groups were treated for 6 months.The changes of main clinical symptoms,biochemical indicators,Crohn's disease activity index(CDAI),Crohn's disease simplified endoscopy score(SES-CD)and indexes of immune inflammatory,coagulation function before and after treatment in both groups were observed.Results The scores of abdominal pain,diarrhea,fever,malnutrition,loss of appetite,CDAI and SES-CD were significantly decreased in the two groups after treatment(P<0.05),and the above scores in the observation group were lower than those in the control group(P<0.05).After treatment,C-reactive protein(CRP),ESR,Th1/CD4+ratio,Th1/Th2 ratio,TNF-αand activated partial thrombin time(APTT),platelet count(PLT),D-dimerization Body and fibrinogen(FIB)were significantly decreased(P<0.05),hemoglobin(Hb)and IL-10 levels were significantly increased in both groups(P<0.05),and the improvements of above indicators in the observation group were better than those in the control group(P all<0.05).Conclusion IFX combined with self-made Xingqi-huoxue decoction by retention enema can significantly improve the patient's clinical symptoms,alleviate the condition and promote the healing of small intestine mucosa in the treatment of moderate-severe small intestine CD,which may be related with that the combination of the treatment could regulate Th1/Th2 lymphocyte balance and inhibit hypercoagulability status.

关 键 词：英夫利西单抗 行气活血汤 保留灌肠 克罗恩病 免疫功能 凝血功能 

分 类 号：R516.1[医药卫生—内科学]