清肠解毒汤联合美沙拉嗪肠溶片治疗湿热内蕴型慢性溃疡性结肠炎临床研究  

Clinical efficacy of Qingchang Jiedu Decoction combined with mesalazine enteric-coated tablets for chronic nonspecific ulcerative colitis of damp-heat type

作　　者：卫炜 周林冲 WEI Wei;ZHOU Linchong(Department of Rehabilitation Medicine,Qidong Hospital Affiliated to Nantong University(Qidong People's Hospital),Qidong,Jiangsu 226200)

机构地区：[1]南通大学附属启东医院(启东市人民医院)康复医学科,江苏启东226200

出　　处：《河北中医》2023年第7期1093-1096,1101,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：南通市科技计划项目(编号:MSZ18184)。

摘　　要：目的观察清肠解毒汤治疗湿热内蕴型慢性溃疡性结肠炎(CUC)的临床疗效。方法将80例湿热内蕴型CUC患者按照随机数字表法分为2组,对照组40例予美沙拉嗪肠溶片治疗,治疗组40例在对照组基础上联合清肠解毒汤治疗。2组均治疗3个月后统计疗效,比较2组治疗前后中医症状评分、Baron内镜评分、Geboes指数评分及炎症相关因子[包括红细胞沉降率(ESR)、C反应蛋白(CRP)、白细胞介素4(IL-4)、IL-6、IL-10及肿瘤坏死因子α(TNF-α)]水平变化情况,观察2组治疗期间头晕、恶心、呕吐不良反应发生情况。结果治疗组总有效率95.00%(38/40),不良反应总发生率7.50%(3/40),对照组总有效率77.50%(31/40),不良反应总发生率5.00%(2/40),治疗组总有效率高于对照组(P<0.05),但2组不良反应总发生率比较差异无统计学意义(P>0.05)。与本组治疗前比较,2组治疗后中医症状评分、Baron内镜评分及Geboes指数评分均降低(P<0.05),且治疗组治疗后中医症状评分、Baron内镜评分及Geboes指数评分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后ESR、CRP、IL-6及TNF-α水平均降低(P<0.05),IL-4及IL-10水平均升高(P<0.05),且治疗组治疗后ESR、CRP、IL-6及TNF-α水平均低于对照组(P<0.05),IL-4及IL-10水平均高于对照组(P<0.05)。结论清肠解毒汤联合美沙拉嗪肠溶片治疗湿热内蕴型CUC患者临床疗效确切,可有效改善患者中医症状,促进病变黏膜修复,无明显不良反应,其作用机制可能与抑制炎性反应有关。Objective To observe the clinical efficacy of Qingchang Jiedu Decoction for chronic nonspecific ulcerative colitis(UC)of damp-heat type.Methods Totally 80 patients with chronic nonspecific UC of damp-heat type were randomized 1∶1 to receive Qingchang Jiedu Decoction combined with mesalazine enteric-coated tablets(the treatment group)or mesalazine enteric-coated tablets(the control group).Treated for 3 months,the aim was to compare traditional Chinese medicine(TCM)symptom score,Baron endoscopy score,Geboes index score,inflammation-related factors(erythrocyte sedimentation rate[ESR],C-reactive protein[CRP],interleukin-4[IL-4],IL-6,IL-10,tumor necrosis factor-α[TNF-α]),adverse reactions(dizziness,nausea,vomiting).The curative effect was assessed.Results The overall effective rate was 95.00%(38/40)in the treatment group,higher than that of 77.50%(31/40)in the control group(P<0.05).The total incidence of adverse reactions in the treatment group was comparable to the control group(7.50%[3/40]vs 5.00%[2/40],[P>0.05],respectively).After treatment,TCM symptom scores,Baron endoscopy score,Geboes index score in groups were decreased(P<0.05),which decreased in the treatment group compared with the control group(P<0.05).Decreased ESR,CRP,IL-6,TNF-α,and increased IL-4 and IL-10 were detected in the two groups(all P<0.05),and the treatment group was superior to the control group for ESR,CRP,IL-6,TNF-α,IL-4,IL-10(all P<0.05).Conclusion For patients with chronic nonspecific UC of damp-heat type,Qingchang Jiedu Decoction combined with mesalazine enteric-coated tablets has a definite curative effect,which can effectively improve TCM symptoms and promote the repair of lesioned mucosa by inhibiting the inflammatory response,and without obvious adverse reactions.

关 键 词：结肠炎 溃疡性 慢性病 辨证论治 湿热内蕴 中西医结合疗法 

分 类 号：R574.621[医药卫生—消化系统]