消溃汤加减治疗溃疡性结肠炎  

Modified Xiaokui Decoction in Treating Ulcerative Colitis

作　　者：张慧俭[1] 刘世举[1] ZHANG Huijian;LIU Shiju(Henan University of Chinese Medicine,Zhengzhou Henan China 450046)

机构地区：[1]河南中医药大学,河南郑州450046

出　　处：《中医学报》2023年第6期1315-1321,共7页Acta Chinese Medicine

基　　金：河南省科技厅资助项目(202102310500);河南省教育厅高等学校重点科研项目(20A360015);河南省中医药拔尖人才培养项目专项课题项目(2022ZYBJ20)。

摘　　要：目的:观察消溃汤加减方灌肠治疗溃疡性结肠炎的临床疗效。方法:60例溃疡性结肠炎患者按照随机数字表法平均分为对照组和观察组。对照组给予美沙拉嗪,观察组在对照组治疗基础上给予消溃汤加减方灌肠。两组患者均连续治疗4周。治疗后,比较两组患者溃疡治愈效果、结肠黏膜损伤程度、肠黏膜屏障功能及血清炎症因子水平。结果:(1)治疗后,观察组有效率为96.67%,明显优于对照组的73.33%,差异有统计学意义(P<0.05)。(2)治疗后,观察组腹泻、便血、黏膜表现及医师评估病情评分分别为(0.61±0.21)、(0.41±0.11)、(0.50±0.12)、(0.60±0.13)分,均低于对照组的(1.27±0.30)、(1.08±0.16)、(1.18±0.18)、(1.21±0.16)分,差异均有统计学意义(P<0.05)。(3)治疗后,观察组肠黏膜充血、水肿、溃疡、炎性物质渗出程度评分分别为(1.45±0.11)、(1.42±0.12)、(1.38±0.13)、(1.30±0.11)分,均低于对照组的(2.30±0.18)、(2.36±0.20)、(2.21±0.18)、(2.08±0.21)分;腹泻、黏液脓血便、腹痛、里急后重程度评分分别为(0.83±0.24)、(0.78±0.26)、(0.64±0.17)、(0.65±0.15)分,均低于对照组的(2.07±0.39)、(2.11±0.30)、(1.65±0.18)、(1.49±0.22)分,差异均有统计学意义(P<0.05)。(4)治疗后,观察组白细胞介素(interleukin,IL)-17、IL-6水平分别为(231.21±33.68)、(36.82±8.82) ng·L^(-1),低于同期对照组,差异均有统计学意义(P<0.05);IL-10及转化生长因子-β水平分别为(32.36±4.28)、(52.48±5.28) ng·L^(-1),高于同期对照组,差异均有统计学意义(P<0.05)。(5)治疗后,观察组二胺氧化酶、D-乳酸、细菌内毒素水平分别为(12.41±1.36)、(21.20±2.28)、(9.73±1.15) U·L^(-1),均低于同期对照组(P<0.05)。(6)两组患者在治疗期间均未出现明显不良反应。结论:消溃汤加减灌肠治疗溃疡性结肠炎疗效显著,可减轻患者结肠黏膜损伤程度,改善肠道屏障功能,降低血清炎症因子水平。Objective:To observe the clinical curative effect of modified Xiaokui Decoction enema in treating ulcerative colitis(UC).Methods:60 UC patients were equally divided into control group and observation group according to the random number table method.The control group was given mesalamine,and the observation group was given Xiaokui Decoction modified enema based on the treatment of the control group.Both groups were treated continuously for 4 weeks.After treatment,the ulcer healing effect,colonic mucosal injury degree,intestinal mucosal barrier function,and serum inflammatory factor levels were compared between the two groups.Results:(1)After treatment,the effective rate of the observation group was 96.67%,significantly better than that of the control group(73.33%),and the difference was statistically significant(P<0.05).(2)After treatment,the scores of diarrhea,blood stool,mucosal manifestations,and doctor′s assessment of the disease in the observation group were(0.61±0.21),(0.41±0.11),(0.50±0.12),and(0.60±0.13)respectively,all of which were lower than those of the control group(1.27±0.30),(1.08±0.16),(1.18±0.18),(1.21±0.16)points,and the differences were statistically significant(P<0.05).(3)After treatment,the degrees of intestinal mucosal hyperemia,edema,ulcers,and inflammatory substance exudation in the observation group were(1.45±0.11),(1.42±0.12),(1.38±0.13),(1.30±0.11),respectively.Lower than those of the control group(2.30±0.18),(2.36±0.20),(2.21±0.18),(2.08±0.21).The degrees of diarrhea,mucopurulent bloody stool,abdominal pain,and tenesmus were(0.83±0.24),(0.78±0.26),(0.64±0.17),(0.65±0.15)respectively,which were lower than those of the control group(2.07±0.39),(2.11±0.30),(1.65±0.18),(1.49±0.22),and the differences were statistically significant(P<0.05).(4)After treatment,the levels of interleukin(IL)-17 and IL-6 in the observation group were(231.21±33.68)and(36.82±8.82)ng·L-1,respectively,which were lower than those in the control group at the same period.and the differences

关 键 词：溃疡性结肠炎 消溃汤 美沙拉嗪 炎症因子 

分 类 号：R259.741[医药卫生—中西医结合]