健脾清肠方保留灌肠联合美沙拉嗪治疗轻中度溃疡性结肠炎患者的疗效及对其炎症反应的影响  

Effect of Jianpi Qingchang Decoction Retention Enema Combined with Mesalazine in the Treatment of Mild to Moderate Ulcerative Colitis and Its Influence on Inflam-matory Reaction of Patients

作　　者：李亚 卢军仪 张全乐[1] 秦燕鸿[1] LI Ya;LU Jun-yi;ZHANG Quan-le;QIN Yan-hong(Hebei Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou Hebei 061000)

机构地区：[1]河北省沧州中西医结合医院,河北沧州061000

出　　处：《世界中西医结合杂志》2023年第5期939-943,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：河北省中医药管理局项目(2019278)。

摘　　要：目的 探究健脾清肠方保留灌肠联合美沙拉嗪治疗轻中度溃疡性结肠炎患者(Ulcerative colitis, UC)的临床效果。方法 选取2020年4月—2021年4月期间河北省沧州中西医结合医院收治的104例轻中度UC患者作为研究对象,采用随机数字表法分为对照组和治疗组,每组各52例。对照组给予美沙拉嗪治疗,治疗组给予美沙拉嗪加健脾清肠方保留灌肠治疗。治疗8周后,观察比较两组患者临床综合疗效、中医证候疗效、安全性以及治疗前后疾病活动指数、血清炎症反应指标[肿瘤坏死因子-α(Tumor necrosis factor-alpha, TNF-α)、白细胞介素-1β(Interleukin-1β,IL-1β)]水平变化。结果 (1)临床综合疗效:治疗后治疗组临床综合疗效总有效率94.12%(48/51)高于对照组80.0%(40/50),差异有统计学意义(P<0.05)。(2)中医证候疗效:治疗后治疗组中医证候疗效总有效率92.16%(47/51)高于对照组76.0%(38/50)(P<0.05)。(3)疾病活动指数:治疗后两组患者排便次数、便血、内镜发现、医师总体评价各维度评分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组低于对照组,差异有统计学意义(P<0.05)。(4)炎症反应指标:治疗后两组患者血清TNF-α、IL-1β水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组低于对照组,差异有统计学意义(P<0.05)。(5)安全性:治疗组不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。结论 健脾清肠方保留灌肠联合美沙拉嗪治疗轻中度UC效果显著,安全性高,有利于降低疾病活动度,且可能与下调血清炎症因子表达,缓解局部炎症反应有关。Objective To analyze the clinical effect of Jianpi Qingchang Decoction retention enema combined with mesalazine in the treatment of mild to moderate ulcerative colitis(UC).Methods A total of 104 patients with mild to moderate UC admitted to Hebei Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from April 2020 to April 2021 were taken as study objects.They were divided into a control group and a treatment group by a random number table method,with 52 cases in each group.The control group was treated with mesalazine,and the treatment group was treated with mesalazine and Jianpi Qingchang Decoction retention enema.Both groups were treated for eight weeks.The two groups were compared in terms of clinical comprehensive efficacy,traditional Chinese medicine(TCM)syndrome efficacy,safety,as well as disease activity index before and after treatment,serum inflammatory indicators(tumor necrosis factor-α(TNF-o))and Interleukin-1s(IL-1r)level variation.Results(1)Clinical comprehensive efficacy:The overall effective rate in the treatment group was 94.12%,which was higher than 80.0%in the control group,with the difference being statistically significant(P<0.05).(2)TCM syndrome efficacy:The total effective rate in the treatment group was 92.16%,higher than 76.0%in the control group(P<0.05).(3)Disease activity index:After treatment,the scores of defecation frequency,hematochezia,endoscopic findings,and physician′s overall evaluation in the two groups were lower than those before treatment(P<0.05),and the treatment group was lower than the control group(P<0.05).(4)Inflammatory response indicators:After treatment,the levels of serum TNF-αand IL-1βin the two groups were lower,and the treat-ment group was lower than the control group(P<0.05).(5)Safety:There was no significant difference in the incidence of adverse reactions between the treatment group and the control group(P>0.05).Conclusion Jianpi Qingchang Decoction combined with mesalazine has a significant effect in the treatment of mild to moderate

关 键 词：轻中度溃疡性结肠炎 美沙拉嗪 健脾清肠方 保留灌肠 炎症反应 

分 类 号：R574.62[医药卫生—消化系统]