参芪五味子汤加味结合五运六气理论对溃疡性结肠炎患者肠道免疫屏障的影响  

Effect of modified Shenqi Wuweizi decoction combined with the theory of five movements and six climates on intestinal immune barrier in patients with ulcerative colitis

作　　者：赵洪霄[1] 张金颖[1] ZHAO Hongxiao;ZHANG Jinying(People’s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,Xinjiang,China)

机构地区：[1]新疆维吾尔自治区人民医院,新疆乌鲁木齐830001

出　　处：《现代中西医结合杂志》2022年第19期2675-2679,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：吴阶平医学基金会临床科研专项资助基金(320.6750.2021-01-04)。

摘　　要：目的 探讨五运六气理论指导下应用参芪五味子汤治疗溃疡性结肠炎(UC)的临床效果及对肠黏膜屏障功能的影响。方法 选择2021年2—11月新疆维吾尔自治区人民医院收治的UC患者80例,随机分为对照组和观察组各40例。对照组采用美沙拉嗪肠溶片治疗,观察组采用参芪五味子汤结合五运六气理论治疗,2组均连续治疗4周。比较2组临床疗效,观察2组治疗前后中医症状评分、血沉(ESR)、血清降钙素原(PCT)、肠黏膜免疫屏障功能指标[血清免疫球蛋白A(IgA)、免疫球蛋白G(IgG)水平和粪便中分泌型免疫球蛋白A(sIgA)含量]、肠黏膜病变(采用肠镜下Baron评分及Mayo评分评估)、生活质量(采用SF-36评分量表评估)变化。结果 治疗4周后,观察组临床总有效率为87.5%(35/40),显著高于对照组的70.0%(28/40),差异有统计学意义(P<0.05)。2组治疗后中医症状评分、ESR及血清PCT、IgA、IgG水平和Baron评分、Mayo评分均较治疗前明显降低(P均<0.05),且观察组各指标均明显低于对照组(P均<0.05);2组治疗后粪便中sIgA含量及生活质量评分均较治疗前明显升高(P均<0.05),且观察组各指标均明显高于对照组(P均<0.05)。结论 参芪五味子汤结合运气理论治疗UC患者临床疗效肯定,效果优于美沙拉嗪治疗,其机制可能与调节肠黏膜屏障功能,提高局部免疫能力相关。Objective It is to investigate the clinical effect of Shenqi Wuweizi decoction under the guidance of the theory of five movements and six climates on ulcerative colitis(UC)and its influence on intestinal mucosal barrier function.Methods Eighty UC patients admitted to People’s Hospital of Xinjiang Uygur Autonomous Region from February to November 2021 were randomly divided into control group and observation group with 40 patients in each group.The control group was treated with mesalazine enteric coated tablets,and the observation group was treated with Shenqi Wuweizi decoction under the guidance of the theory of five movements and six climates.Both groups were treated continuously for 4 weeks.The clinical efficacy of the two groups was compared,the changes in TCM symptom score,erythrocyte sedimentation rate(ESR),serum procalcitonin(PCT),intestinal mucosal immune barrier function indicators[levels of serum immunoglobulin A(IgA),immunoglobulin G(IgG)and content of excretory immunoglobulin A(sIgA)in stool],intestinal mucosal lesions(Baron score and Mayo score under colonoscopy),and quality of life(SF-36 scale)before and after treatment were observed in the two groups.Results After 4 weeks of treatment,the total clinical effective rate in the observation group was 87.5%(35/40),which was significantly higher than that 70.0%(28/40)in the control group(P<0.05).After treatment,the scores of TCM symptoms,ESR,levels of serum PCT,IgA,IgG,Baron score and Mayo score in both groups were significantly lower than those before treatment(all P<0.05),and the indexes in the observation group were significantly lower than those in the control group(all P<0.05).The content of sIgA in feces and the score of quality of life in both groups after treatment were significantly higher than those before treatment(all P<0.05),and the indexes in the observation group were significantly higher than those in the control group(all P<0.05).Conclusion Shenqi Wuweizi decoction under the guidance of the theory of five movements and six climates has

关 键 词：溃疡性结肠炎 参芪五味子汤 五运六气 免疫屏障 

分 类 号：R574.62[医药卫生—消化系统]