四神丸合参苓白术散联合美沙拉嗪治疗溃疡性结肠炎临床疗效及对肠道菌群、肠黏膜屏障功能的影响  

Clinical Effect of Sishen Pills and Shenling Baizhu Powder Combined with Mesalazine for Ulcerative Colitis and Its Effect on Intestinal Flora and Intestinal Barrier Function

作　　者：沈灵娜 刘军[1] 钱赟达 熊烈 SHEN Lingna;LIU Jun;QIAN Yunda;XIONG Lie(Jiaxing Hospital of traditional Chinese medicine,Jiaxing 314000,Zhejiang)

机构地区：[1]嘉兴市中医医院,浙江嘉兴314000

出　　处：《新中医》2021年第16期34-38,共5页New Chinese Medicine

基　　金：浙江省嘉兴市科技计划项目(2018AD32123)。

摘　　要：目的:观察四神丸合参苓白术散联合美沙拉嗪治疗溃疡性结肠炎患者的临床疗效及对肠道菌群、肠黏膜屏障功能的影响。方法:将60例脾肾阳虚型溃疡性结肠炎患者随机分为对照组及中药组各30例。对照组口服美沙拉嗪肠溶片治疗,中药组在对照组基础上加用四神丸合参苓白术散口服。观察2组治疗后的中医证候疗效及治疗前后的中医证候积分、改良Mayo活动指数、肠道菌群及肠黏膜屏障功能。结果:治疗后,中药组总有效率为93.3%,高于对照组的70.0%(P<0.05)。与同组治疗前比较,2组治疗后各项中医证候积分、改良Mayo活动指数、大肠杆菌数量及血清内皮素(ET)、D-乳酸、二胺氧化酶(DAO)水平均降低(P<0.05),双歧杆菌、乳杆菌数量均增多(P<0.05);与对照组治疗后比较,中药组治疗后各项中医证候积分、改良Mayo活动指数、大肠杆菌数量及血清ET、D-乳酸、DAO水平均较低(P<0.05),双歧杆菌、乳杆菌数量均增多(P<0.05)。结论:四神丸合参苓白术散联合美沙拉嗪可有效改善脾肾阳虚型溃疡性结肠炎患者的临床症状,其可通过增加肠道有益菌、调节肠道菌群结构、促进肠道黏膜屏障修复,达到治疗效果。Objective:To observe the clinical effect of Sishen pills and Shenling Baizhu powder combined with mesalazine for ulcerative colitis and its effect on intestinal flora and intestinal barrier function. Methods:A total of 60 cases of patients with ulcerative colitis of kidney yang deficiency type were randomly divided into the control group and the Chinese medicine group,30 cases in each group. The control group was given oral administration of mesalazine enteric-coated tablets,and the Chinese medicine group was additionally given Sishen pills and Shenling Baizhu powder based on the treatment of the control group. The Chinese medicine syndrome scores, modified Mayo endoscopic scores, intestinal flora and intestinal barrier function before and after treatment and the curative effect of Chinese medicine syndrome after treatment in the two groups were observed. Results:After treatment,the total effective rate was 93.3% in the Chinese medicine group,higher than that of 70.0% in the control group(P<0.05). After treatment, Chinese medicine syndrome scores, modified Mayo endoscopic scores,the number of escherichia coli and the levels of endothelin(ET),D-lactate and diamine oxidase(DAO) in serum in the two groups were decreased when compared with those before treatment(P<0.05), and the numbers of bifidobacterium and lactobacillus were increased(P<0.05). Chinese medicine syndrome scores,modified Mayo endoscopic scores,the number of escherichia coli and the levels of ET,D-lactate and DAO in serum in the Chinese medicine group were lower than those in the control group(P<0.05),and the numbers of bifidobacterium and lactobacillus were higher(P<0.05). Conclusion: Sishen pills and Shenling Baizhu powder combined with mesalazine can effectively improve the clinical symptoms of patients with ulcerative colitis of kidney yang deficiency type, and can achieve curative effect by increasing intestinal available bacteria,regulating intestinal flora structure and promoting repair of intestinal mucosal barrier.

关 键 词：溃疡性结肠炎 四神丸 参苓白术散 肠道菌群 肠黏膜屏障功能 

分 类 号：R574.62[医药卫生—消化系统]