四神丸复方联合美沙拉嗪治疗轻中度溃疡性结肠炎效果观察及其对症状昼夜节律变化的影响  

Efficacy of Sishen pill compound combined with mesalazine in the treatment of mild to moderate ulcerative colitis and its effect on the circadian rhythm of symptoms

作　　者：万雪梅[1] 谢子妍 曾进浩 周雪雷[2] 董朝强 Wan Xuemei;Xie Ziyan;Zeng Jinhao;Zhou Xuelei;Dong Chaoqiang(Department of Infectious Diseases,Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610039,Sichuan Province,China;Department of Gastroenterology,Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610039,Sichuan Province,China)

机构地区：[1]成都中医药大学附属医院感染科,成都610039 [2]成都中医药大学附属医院消化科,成都610039

出　　处：《中国基层医药》2023年第8期1165-1169,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：四川省中医药管理局科技计划(2020JC0047)。

摘　　要：目的研究四神丸复方联合美沙拉嗪治疗轻中度溃疡性结肠炎(UC)的临床疗效及其对症状昼夜节律变化的影响。方法选取成都中医药大学附属医院2018年1月至2020年12月收治的轻中度UC患者136例,采用前瞻性随机对照试验,按随机数字表法分为治疗组68例和对照组68例,治疗组采用四神丸复方联合美沙拉嗪治疗,对照组单纯应用美沙拉嗪治疗,两组患者治疗12周。比较两组临床疗效及治疗前后晨起腹痛分级、晨起腹泻评分、粪便性状评分、Mayo评分、血红蛋白、超敏C反应蛋白的变化。结果治疗组总有效率为91.18%(62/68),高于对照组的72.06%(49/68),差异有统计学意义(χ^(2)=8.28,P<0.05)。治疗后,治疗组晨起腹泻评分、晨起腹痛评分、粪便性状评分、Mayo评分、血红蛋白、超敏C反应蛋白分别为(0.47±0.56)分、(0.53±0.56)分、(3.01±0.72)分、(7.13±1.38)分、(108.04±12.21)g/L、(4.00±2.19)mg/L,对照组分别为(0.84±0.56)分、(1.12±0.56)分、(4.40±0.76)分、(3.25±1.44)分、(102.15±12.61)g/L、(6.07±3.66)mg/L,两组差异均有统计学意义(t=3.59、5.95、10.06、9.62、2.78、3.99,均P<0.05)。结论四神丸复方联合美沙拉嗪可有效改善轻中度UC患者活动期的临床症状,升高血红蛋白水平,降低C反应蛋白水平,提高UC治疗的有效率,改善轻中度UC患者晨起腹痛症状、腹泻节律性次数、大便性状等症状。Objective To investigate the efficacy of Sishen pill compound combined with mesalazine in the treatment of mild to moderate ulcerative colitis and its effect on the circadian rhythm of symptoms.Methods A total of 136 patients with mild to moderate ulcerative colitis who received treatment in Hospital of Chengdu University of Traditional Chinese Medicine from January 2018 to December 2020 were included in this prospective randomized controlled trial.These patients were divided into a treatment group(n=68)and a control group(n=68).The treatment group was treated with Sishen pill compound combined with mesalazine.The control group was treated with mesalazine alone.All patients were treated for 12 weeks.Clinical efficacy,as well as morning abdominal pain grade,morning diarrhea score,fecal trait score,Mayo score,hemoglobin,and hypersensitive C-reactive protein pre-and post-treatment,were compared between the two groups.Results Total response rate in the treatment group was significantly higher than that in the control group[91.18%(62/68)vs.72.06%(49/68),χ^(2)=8.28,P<0.05].After treatment,morning diarrhea score,morning abdominal pain score,fecal trait score,Mayo score,hemoglobin,and hypersensitive C-reactive protein in the treatment group were(0.47±0.56)points,(0.53±0.56)points,(3.01±0.72)points,(7.13±1.38)points,(108.04±12.21)g/L,(4.00±2.19)mg/L,respectively,and they were(0.84±0.56)points,(1.12±0.56)points,(4.40±0.76)points,(3.25±1.44)points,(102.15±12.61)g/L,and(6.07±3.66)mg/L respectively in the control group.There were significant differences in these indexes between the treatment and control groups(t=3.59,5.95,10.06,9.62,2.78,3.99,all P<0.05).Conclusion Sishen pill compound combined with mesalazine can effectively reduce clinical symptoms of active ulcerative colitis,increase hemoglobin level,decrease C-reactive protein level,improve the efficiency of treatment,reduce symptoms and the number of diarrhea rhythms,and improve stool symptoms of mild to moderate ulcerative colitis patients.

关 键 词：结肠炎 溃疡性 四神丸 氨水杨酸 昼夜节律 腹痛 腹泻 血红蛋白 C反应蛋白质 

分 类 号：R574.62[医药卫生—消化系统]