小柴胡汤联合美沙拉嗪治疗急性期溃疡性结肠炎的临床疗效观察  

Observation on the Clinical Efficacy of Xiaochaihu Decoction Combined with Mesalazine in the Treatment of Acute Ulcerative Colitis

作　　者：李又春[1] 胡秀玲 程珍珍[1] 金曙 杨光义 邓卫平 范荣国[1] LI You-chun;HU Xiu-ling;CHENG Zhen-zhen;JIN Shu;YANG Guang-yi;DENG Wei-ping;FAN Rong-guo(Department of Gastroenterology,Danjiangkou First Hospital,Danjiangkou 442700,China;Department of Gastroenterology,Taihe Hospital,Hubei University of Medicine,Shiyan 442000,China)

机构地区：[1]湖北省十堰市丹江口市第一医院消化内科,湖北丹江口442700 [2]湖北医药学院附属医院十堰市太和医院消化内科,湖北十堰442000

出　　处：《现代中药研究与实践》2021年第6期84-88,共5页Research and Practice on Chinese Medicines

基　　金：十堰市科技局指导项目(2019CFC931);2017年省卫生和计划生育委员会指导项目(WJ2017F079)。

摘　　要：目的观察小柴胡汤联合美沙拉嗪治疗急性期溃疡性结肠炎的临床疗效。方法将入选的86例患者按随机分为对照组、研究组。对照组口服美沙拉嗪,研究组加服小柴胡汤。比较两组临床疗效、炎症因子、肠道屏障功能、中医证候积分、症状改善情况及该治疗方案对患者小肠细菌过度生长的影响。结果治疗后,研究组肿瘤坏死因子-a、白细胞介素-1β、大便白细胞计数、C反应蛋白、粪便钙卫蛋白、细菌内毒素、二胺氧化酶、D-乳酸、乳果糖氢呼气试验阳性率、中医证候积分、镜下严重程度指数和溃疡性结肠炎Seo.m临床活动指数均低于对照组,总有效率、白细胞介素-10和转化生长因子-β1高于对照组(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论小柴胡汤联合美沙拉嗪治疗急性期溃疡性结肠炎较单一使用美沙拉嗪疗效更佳,通过调节肠道菌群、抑制小肠细菌过度生长并调节炎症反应程度进而修复肠黏膜可能是其关键机制。Objective To observe the clinical effect of Xiaochaihu decoction combined with mesalazine in the treatment of acute ulcerative colitis.Methods The selected 86 patients are randomly divided into control group and study group.The control group is given oral mesalazine,and the study group is given Xiaochaihu decoction.The clinical efficacy,inflammatory factors,intestinal barrier function,TCM syndrome points,symptom improvement,and the effect of the treatment plan on the overgrowth of small intestinal bacteria are compared between the two groups.Results After treatment,the study group tumor necrosis factor-α,interleukin-1β,stool white blood cell count,C-reactive protein,fecal calprotectin,bacterial endotoxin,diamine oxidase,D-lactic acid,the positive rate of lactulose hydrogen breath test,TCM syndrome points,severity index under microscope,and Seo.m clinical activity index of ulcerative colitis are all lower than those of the control group,the total effective rate,interleukin-10 and transforming growth factor-β1 are higher than those of the control group(P<0.05).The incidence of adverse reactions in the two groups is not statistically significant(P>0.05).Conclusion Xiao chaihu decoction combined with mesalazine has better curative effect in the treatment of acute ulcerative colitis than single application of mesalazine.Regulating intestinal flora,inhibiting the overgrowth of small intestinal bacteria,regulating the degree of inflammation,and repairing the intestinal mucosa may be its key mechanism.

关 键 词：急性期溃疡性结肠炎 小柴胡汤 炎症因子 肠道屏障功能 小肠细菌过度生长 

分 类 号：R285.6[医药卫生—中药学]