怡情止泻汤对肝郁脾虚型溃疡性结肠炎肠道菌群结构的影响  

Effect of Yiqing Zhixie Decoction on Intestinal Microflora Structure in Patients with Ulcerative Colitis Due to Liver Depression and Spleen Deficiency

作　　者：赵恩春[1] 王斌[1] 郑勇[1] 付荣华[1] ZHAO Enchun;WANG Bin;ZHENG Yong;FU Ronghua(Department of Anus and Intestines,Huaian Hospital of Traditional Chinese Medicine,Huai'an 223001,Jiangsu,China)

机构地区：[1]淮安市中医院肛肠科,江苏淮安223001

出　　处：《中华中医药学刊》2020年第6期205-209,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：江苏省中医药局科技项目(YB2017069)。

摘　　要：目的探究怡情止泻汤对肝郁脾虚型溃疡性结肠炎患者的肠道菌群结构的影响,旨在提升临床治疗效果。方法研究共计纳入60例肝郁脾虚型溃疡性结肠炎患者,入组患者均由医院2017年5月—2018年12月收治,采取随机数字表法将所有患者分为观察组和对照组,对照组患者(30例)口服美沙拉嗪肠溶片治疗,观察组患者(30例)则采取怡情止泻汤治疗,比较两组患者临床治疗效果、治疗前后患者腹泻、脓血便、腹痛症状积分及结肠镜下黏膜病变积分、患者血清炎性因子水平变化情况、肠道菌群变化情况、汉密尔顿焦虑量表(HAMA)及抑郁量表(HAMD)评分、生活质量评分(IBDQ)、不良反应及患者治疗满意率。结果观察组患者治疗有效率93.33%(28/30)高于对照组患者73.33%(22/30)(P<0.05);治疗前,两组患者腹泻、脓血便、腹痛症状积分及结肠镜下黏膜病变积分、HAMA及HAMD评分、IBDQ评分相当(P>0.05),治疗后观察组及对照组患者腹泻、脓血便、腹痛症状积分及结肠镜下黏膜病变积分、HAMA及HAMD评分、IBDQ评分均改善,观察组患者腹泻、脓血便、腹痛症状积分及结肠镜下黏膜病变积分、HAMA及HAMD评分、IBDQ评分优于对照组(P<0.05);治疗前,两组患者血清炎性因子白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子α(TNF-α)水平相当,治疗后各组患者IL-6、IL-8、TNF-α水平下降,观察组患者指标水平优于对照组(P<0.05);治疗前,两组患者肠道菌群数量相当(P>0.05),治疗后两组患者双歧杆菌及乳酸杆菌数量升高,而粪肠球菌、大肠杆菌数量下降,较对照组患者治疗后,观察组患者双歧杆菌及乳酸杆菌、粪肠球菌、大肠杆菌数量均优于对照组(P<0.05);观察组患者不良反应发生率(3.33%)低于对照组(23.33%)(P<0.05);观察组患者满意率(96.67%)高于对照组(70.00%)(P<0.05)。结论怡情止泻汤可显著提升肝郁脾虚型溃疡性结肠炎患者临床治疗效果,�Objective To explore the effect of Yiqing Zhixie Decoction on the intestinal flora structure of patients with ulcerative colitis due to liver depression and spleen deficiencyin order to improve the clinical therapeutic effect.Methods Sixty cases of patients with ulcerative colitisdue to liver depression and spleen deficiencyin our hospital from May 2017 to December 2018 were divided into observation group and control group by taking a random number table method.The control group(30 cases)were treated with Mesalazin Enteric-coated Tablets orally.The observation group(30 cases)weregiven Yiqing Zhixie Decoction.We compared two groups’clinical treatment effect,integral scores of diarrhea,purulent blood,abdominal pain symptoms and colonoscopy mucosal lesions under microscope before and after treatment,serum levels of inflammatory cytokines,changes of intestinal flora,Hamilton anxiety scale(HAMA)and depression scale(HAMD)scores,the quality of life score(IBDQ),adverse reactionsand patient satisfaction.Results The effective rate of treatment in the observation group 93.33%(28/30)was higher than that in the control group 73.33%(22/30)(P<0.05).Before treatment,two groups’integral scores of abdominal pain,diarrhea,purulent blood symptom and colonoscopy mucosal lesions under microscope,HAMA and HAMD scores and IBDQ score were not significant(P>0.05).After treatment,the observation group and control group’s integral scores of diarrhea,purulent blood,abdominal pain symptoms and colonoscopy mucosal lesions under microscope,HAMA and HAMD scores and IBDQ score were improved.Those of the observation group were better than those of the control group(P<0.05).Before treatment,the levels of serum inflammatory factors interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor(TNF-α)were similar in the two groups.After treatment,the levels of IL-6,IL-8 and TNF-αwere decreased in each group.Beforetreatment,two groups’numbers of intestinal flora were not significant(P>0.05).After treatment,two groups’bifidobacterium and

关 键 词：肝郁脾虚型溃疡性结肠炎 肠道菌群结构 怡情止泻汤 疗效 症状 不良反应 生活质量 

分 类 号：R259.746.2[医药卫生—中西医结合]