清热愈疡汤对大肠湿热型溃疡性结肠炎患者炎性因子、内毒素及肠黏膜屏障的影响  

Effects of Qingre Yuyang Decoction on Inflammator Factors,Endotoxin and Intestinal Mucosal Barrier in Patients with Ulcerative Colitis of Large Intestine Damp-Heat Type

作　　者：周海娟 陈刚 李枝锦[1] ZHOU Hai-Juan;CHEN Gang;LI Zhi-Jin(Haikou Hospital of Traditional Chinese Medicine,Haikou 570216 Hainan,China)

机构地区：[1]海南省海口市中医医院,海南海口570216

出　　处：《广州中医药大学学报》2023年第3期563-569,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：海南省自然科学基金面上项目(编号:817387);海南省自然科学基金项目(编号:813270)。

摘　　要：【目的】探讨清热愈疡汤(由白头翁汤加减化裁而成)对大肠湿热型溃疡性结肠炎患者炎性因子、肠黏膜屏障的影响。【方法】将106例大肠湿热型溃疡性结肠炎患者随机分为观察组和对照组,每组各53例。对照组给予西医常规治疗,观察组在对照组的基础上联合清热愈疡汤治疗,疗程为8周。观察2组患者治疗前后中医证候积分、血清内毒素(LPS)、转化生长因子β1(TGF-β1)、白细胞介素10(IL-10)、肿瘤坏死因子α(TNF-α)、前列腺素E2(PGE2)、D-乳酸、二胺氧化酶(DAO)的变化情况,并评价2组患者的临床疗效和安全性。【结果】(1)治疗8周后,观察组的总有效率为94.34%(50/53),对照组为73.58%(39/53),组间比较,观察组的疗效明显优于对照组(P<0.01)。(2)治疗后,2组患者的主要症状(便下黏液脓血、腹痛、腹泻)积分和次要症状(口干口苦、肛门灼热)积分均较治疗前降低(P<0.05),且观察组治疗后的主要症状积分和次要症状积分均明显低于对照组(P<0.01)。(3)治疗后,2组患者血清LPS、TNF-α、PGE2、DAO、D-乳酸水平均较治疗前降低(P<0.05),血清TGF-β1、IL-10水平均较治疗前升高(P<0.05),且观察组治疗后的血清LPS、TNF-α、PGE2、DAO、D-乳酸水平明显低于对照组,血清TGF-β1、IL-10水平明显高于对照组,差异均有统计学意义(P<0.01)。(4)观察组的不良反应发生率为3.78%(2/53),明显低于对照组的15.09%(8/53),差异有统计学意义(P<0.05)。【结论】对于大肠湿热型溃疡性结肠炎患者,联合清热愈疡汤的治疗效果显著,有助于减轻肠道炎症反应,抑制疼痛介质分泌,保护肠黏膜屏障,提高临床疗效。Objective To investigate the effect of Qingre Yuyang Decoction(derived from the modification of Baitouweng Decoction)on inflammatory factors and intestinal mucosal barrier in patients with ulcerative colitis of large intestine damp-heat type. Methods One hundred and six patients with ulcerative colitis of the large intestine damp-heat type were randomized to the observation group and the control group,with 53 patients in each group.The control group was given conventional western medicine treatment,while the observation group was treated with Qingre Yuyang Decoction on the basis of treatment for the control group. Both groups were treated for a period of8 weeks. The changes in traditional Chinese medicine(TCM)syndrome scores and serum levels of lipopolysaccharide(LPS),transforming growth factor β1(TGF-β1),interleukin 10(IL-10),tumor necrosis factor α(TNF-α),prostaglandin E2(PGE2),D-lactate and diamine oxidase(DAO)in the two groups were observed before and after treatment. Moreover,the clinical efficacy and safety of the two groups were evaluated. Results(1)After 8 weeks of treatment,the overall effective rate of the observation group was 94.34%(50/53)and that of the control group was73.58%(39/53),and the intergroup comparison showed that the efficacy of the observation group was significantly superior to that of the control group(P<0.01).(2)After treatment,the scores of the major symptoms of mucous purulent stool with blood,abdominal pain and diarrhea,and the scores of the secondary symptoms of dry mouth with bitterness in the mouth,burning sensation in the anus in both groups were decreased compared with those before treatment(P<0.05),and the scores of major symptoms and secondary symptoms in the observation group were significantly lower than those in the control group after treatment(P<0.01).(3)After treatment, serum LPS,TNF-α,PGE2,DAO and D-lactate levels in both groups were decreased(P<0.05)and serum TGF-β1and IL-10 levels were increased compared with those before treatment(P<0.05). The intergroup comp

关 键 词：清热愈疡汤 白头翁汤 溃疡性结肠炎 大肠湿热型 转化生长因子Β1 肿瘤坏死因子α 内毒素 肠黏膜屏障 不良反应 

分 类 号：R574.62[医药卫生—消化系统]