清化通络法联合治疗对溃疡性结肠炎患者肠黏膜屏障及炎性因子的改善作用  

Role of Combined Treatment with Qinghua Tongluo Method in the Improvement of Intestinal Mucosa Barrier and Inflammatory Factors in Patients with Ulcerative Colitis

作　　者：魏永辉[1] 郝立艾 贾慧玲 佟雅君 李绵 郑雪 WEI Yong-hui;HAO Li-ai;JIA Hui-ling;TONG Ya-jun;LI Mian;ZHENG Xue(Department of Anorectal Diseases,Tangshan Hospital of Traditional Chinese Medicine,Tangshan,Hebei 063000,China;Department of Surgery,Yutian County Hospital of Traditional Chinese Medicine,Yutian,Hebei 064100,China;Department of Anorectal Diseases,Laoting County Hospital,Laoting,Hebei 063600,China;Department of Traditional Chinese Medicine Surgery,Laoting County Hospital of Traditional Chinese Medicine,Laoting,Hebei 063600,China;Department of Traditional Chinese Medicine Surgery,College of Traditional Chinese Medicine,North China University of Science and Technology,Tangshan,Hebei 063500,China)

机构地区：[1]唐山市中医医院肛肠科,河北唐山063000 [2]玉田县中医医院外科,河北玉田064100 [3]乐亭县医院肛肠科,河北乐亭063600 [4]乐亭县中医院中医外科,河北乐亭063600 [5]华北理工大学中医学院中医外科,河北唐山063500

出　　处：《解放军医药杂志》2022年第10期94-98,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省中医药管理局科研项目(2019218)。

摘　　要：目的探讨清化通络法联合治疗对溃疡性结肠炎(UC)患者肠黏膜屏障及炎性因子的改善作用。方法选取2020年2月—2022年4月收治的108例UC,按照治疗方法不同分为联合组和西医组各54例。西医组予美沙拉嗪肠溶片治疗,联合组在其基础上予清化通络法治疗,2组均治疗3个月。比较2组中医疗效,治疗前后肠黏膜损伤修复指标、肠黏膜屏障指标、炎性因子和生活质量情况,以及治疗期间不良反应发生情况。结果2组治疗后Mayo指数评分、黏膜组织学评分、结肠镜评分均低于治疗前,炎症性肠病生存质量问卷(IBDQ)评分高于治疗前(P<0.05);治疗后联合组Mayo指数评分、黏膜组织学评分、结肠镜评分低于西医组,IBDQ评分高于西医组(P<0.01)。联合组总有效率为94.44%高于西医组的77.78%(P<0.05)。治疗后D-乳酸、二胺氧化酶、内毒素、白细胞介素-1β、白细胞介素-17、白细胞介素-6、肿瘤坏死因子-α2组均较治疗前降低,且联合组低于西医组(P<0.05,P<0.01)。治疗期间,2组不良反应发生率比较差异无统计学意义(P>0.05)。结论清化通络法联合治疗可保护UC患者肠黏膜屏障,抑制炎症反应,促进黏膜组织愈合,改善结肠镜下表现,有效缓解病情,增强疗效,提高生活质量,且安全可靠。Objective To investigate the role of Qinghua Tongluo method in the improvement of intestinal mucosal barrier(IMB)and inflammatory factors in patients with ulcerative colitis(UC).Methods A total of 108 patients with UC from February 2020 to April 2022 were selected and divided into the combination group(n=54)and the western medicine group(n=54)according to different treatment methods.The western medicine group was treated with Mesalazine Enteric Coated Tablets,and the combination group was treated with Qinghua Tongluo method on this basis.Both groups were treated for 3 months.The curative effect of traditional Chinese medicine,indicators associated with repair of intestinal mucosal damage,IMB indicators,inflammatory factors,quality of life before and after treatment and adverse reactions during treatment were compared between the two groups.Results After treatment,the Mayo index score,mucosal histology score and colonoscopy score in both groups were lower than those before treatment,while the inflammatory bowel disease quality of life questionnaire(IBDQ)score was higher than that before treatment(P<0.05).After treatment,the Mayo index score,mucosal histology score and colonoscopy score of the combination group were lower than those of the western medicine group,while the IBDQ score was higher than that of the western medicine group(P<0.01).The total effective rate of the combination group was 94.44%,higher than that of the western medicine group(77.78%,P<0.05).After treatment,D-lactic acid,diamine oxidase,endotoxin,interleukin-1β,interleukin-17,interleukin-6,and tumor necrosis factor-αwere lower in both groups than those before treatment,and lower in the combination group than in the western medicine group(P<0.05,P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Qinghua Tongluo combination therapy can protect IMB of UC patients,inhibit inflammatory reaction,promote the healing of mucosal tissue,improve colonoscopy performance,effectively a

关 键 词：结肠炎 溃疡性 清化通络法 Mayo指数评分 D-乳酸 胺氧化酶(含铜) 肿瘤坏死因子-α 

分 类 号：R574.62[医药卫生—消化系统]