补阳止泻汤加减治疗脾肾阳虚型溃疡性结肠炎的临床研究  

Clinical Study on the Treatment of Ulcerative Colitis of Spleen and Kidney Yang Deficiency Syndrome with Modified Buyang Zhixie Decoction(补阳止泻汤加减)

作　　者：席岚岚 宋太平[1] 史孟华 刘全林 宋光瑞 XI Lan-lan;SONG Tai-ping;SHI Meng-hua;LIU Quan-lin;SONG Guang-rui(He'nan University of Traditional Chinese Medicine,Zhengzhou He'nan 450000,China;The Large Intestine&Anus Disease Hospital of Zhengzhou City,Zhengzhou He'nan 450004,China)

机构地区：[1]河南中医药大学,河南郑州450000 [2]郑州市大肠肛门病医院,河南郑州450004

出　　处：《中医药导报》2021年第7期86-89,92,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：河南省中医药科学研究专项课题(2019ZY3010)。

摘　　要：目的:观察补阳止泻汤加减治疗脾肾阳虚型溃疡性结肠炎的临床疗效,并分析其对患者促炎性细胞因子及免疫功能的影响。方法:纳入70例脾肾阳虚型溃疡性结肠炎患者,按照随机数字表法分为对照组和治疗组各35例。对照组患者予美沙拉嗪缓释颗粒口服,1.0 g/次,3次/d;治疗组患者在对照组的基础上给予补阳止泻汤加减内服,连续治疗4周。观察两组患者治疗前后中医症状评分、Mayo评分,评价两组患者中医证候疗效,检测两组患者治疗前后血清白细胞介素-6(IL-6)、IL-8和肿瘤坏死因子-α(TNF-α)的水平,以及免疫功能指标(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)),观察治疗期间不良反应。结果:治疗组总有效率为94.29%(33/35),对照组总有效率为82.86%(29/35),治疗组患者疗效优于对照组(P<0.05)。与治疗前比较,两组患者治疗后中医证候积分、Mayo评分均明显下降(P<0.01);治疗后,治疗组患者中医证候积分、Mayo评分均低于对照组(P<0.01)。与治疗前比较,两组患者治疗后血清IL-6、IL-8、TNF-α水平均明显下降(P<0.01);治疗后,治疗组患者血清IL-6、IL-8、TNF-α水平均低于对照组(P<0.01)。与治疗前比较,两组患者治疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均升高(P<0.01);治疗后,治疗组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均高于对照组(P<0.01)。两组不良反应少且轻微,两组比较,差异无统计学意义(P>0.05)。结论:在西医常规治疗的基础上,补阳止泻汤加减治疗脾肾阳虚型溃疡性结肠炎疗效确切且安全,可改善症状,控制疾病的活动度,并能够调节机体的过度炎症反应及免疫功能,降低促炎性细胞因子水平,临床疗效优于单纯的西医治疗方案。Objective:To observe the clinical efficacy of Modified Buyang Zhixie Decoction in the treatment of ulcerative colitis with spleen and kidney Yang deficiency syndrome and analyze its effect on inflammatory factors and immune function in patients.Methods:Totally 70 patients with ulcerative colitis of spleen and kidney yang deficiency syndrome were divided into control and treatment groups with 35 cases each group,according to random number table.Patients in the control group were given mesalazine sustained-release granules,1.0 g/time,three times a day.Patients in the treatment group were given Modified Buyang Zhixie Decoction orally on the basis of the control group.The course of treatment was continuous for four weeks.The TCM symptom scores and Mayo scores were observed in the two groups before and after treatment,and the TCM syndrome efficacy was evaluated.The levels of serum interleukin-6(IL-6),IL-8 and TNF-α,as well as immune function indicators(CD3^(+),CD4^(+),CD4^(+)/CD8^(+))were detected in the two groups before and after treatment.And the adverse reactions were observed during treatment.Results:The total effective rate was 94.29%(33/35)in treatment group and 82.86%(29/35)in control group.The treatment group showed better efficacy than control group(P<0.05).Compared with before treatment,the TCM syndrome score and Mayo score decreased in the two groups after treatment(P<0.01),and the treatment group showed lower TCM syndrome score and Mayo score than control group after treatment(P<0.01).Compared with before treatment,the levels of serum IL-6,IL-8 and TNF-αdecreased in the two groups after treatment(P<0.01),and the treatment group showed lower levels of serum IL-6,IL-8 and TNF-αthan control group after treatment(P<0.01).Compared with before treatment,the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)decreased in the two groups after treatment(P<0.01),and the treatment group showed lower levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)than control group after treatment(P<0.01).The adverse reactions of the two group

关 键 词：溃疡性结肠炎 脾肾阳虚 补阳止泻汤 美沙拉嗪 促炎性细胞因子 免疫功能 

分 类 号：R254.6[医药卫生—中医内科学]