黄芩汤合青黛散加减方保留灌肠联合美沙拉嗪对溃疡性结肠炎患者的肠黏膜保护效果  

Protective effect of modified Huangqin decoction and Qingdai San retention enema combined with Mesalazine on intestinal mucosa in patients with ulcerative colitis

作　　者：李洋 刘浩 LI Yang;LIU Hao

机构地区：[1]海阳市人民医院,山东烟台250000 [2]高密市中医院,山东潍坊261500

出　　处：《中医临床研究》2023年第33期93-97,共5页Clinical Journal Of Chinese Medicine

摘　　要：目的:观察黄芩汤合青黛散加减方保留灌肠联合美沙拉嗪治疗溃疡性结肠炎(Ulcerative Colitis,UC)患者的效果。方法:将98例UC患者按照随机数字表法分为对照组和观察组,各49例。对照组给予美沙拉嗪缓释颗粒口服,观察组在对照组基础上给予黄芩汤合青黛散加减方保留灌肠,对比两组的有效率、改良Mayo评分、炎症性肠道疾病问卷(Inflammatory Bowel Disease Questionnaire,IBDQ)评分、不良反应、血清中肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)、单核细胞趋化因子-1(Monocyte Chemo-attractant Protein-1,MCP-1)、胰岛素样生长因子-1(Insulin-like Growth Factor-1,IGF-1)水平。结果:观察组的总有效率为93.88%,明显高于对照组的79.59%(P<0.05);治疗14 d后,观察组的改良Mayo评分为(5.13±0.30)分,明显低于对照组的(5.82±0.37)分,IBDQ评分为(185.37±16.29)分,明显高于对照组的(178.26±15.48)分(P<0.05);观察组血清中TNF-α、MCP-1水平分别为(32.04±2.13)ng/mL、(142.50±12.39)pg/mL,均明显低于对照组的(38.11±2.86)ng/mL、(167.27±15.94)pg/mL(P<0.05);治疗7 d、治疗14 d后,观察组患者的IGF-1水平均明显高于对照组(P<0.05);对照组的不良反应发生率为8.16%(4/49),高于观察组的4.08%(2/49),差异无统计学意义[χ^(2)=0.710,P=0.399>(0.05)]。结论:黄芩汤合青黛散加减方保留灌肠联合美沙拉嗪治疗溃疡性结肠炎具有确切的肠黏膜保护效果,可能与通过调节TNF-α、MCP-1、IGF-1等表达以减轻肠黏膜的炎症损伤有关。Objective:To observe the effect of modified Huangqin decoction(黄芩汤)and Qingdai San(青黛散)retention enema combined with Mesalazine in the treatment of ulcerative colitis.Methods:Ninety-eight patients with ulcerative colitis were divided into the control group and the observation group according to random number table method,with 49 cases in each group.The control group was given Mesalazine sustained-release granules orally,and the observation group was given modified Huangqin decoction and Qingdai San retention enema on the basis of the treatment in the control group.The effective rate,modified Mayo score,Inflammatory Bowel Disease Questionnare(IBDQ)score,adverse reactions,serum tumor necrosis factor-α(TNF-α),monocyte chemokine-1(MCP-1),and insulin-like growth factor-1(IGF-1)levels were compared between the two groups.Results:The effective rate in the observation group was 93.88%,which was significantly higher than 79.59%in the control group(P<0.05).After 14 days of treatment,the modified Mayo score in the observation group was(5.13±0.30)points,which was significantly lower than that in the control group,(5.82±0.37)points,and the IBDQ score was(185.37±16.29)points,which was significantly higher than that in the control group,(178.26±15.48)points(P<0.05).The serum levels of TNF-αand MCP-1 in the observation group were(32.04±2.13)ng/mL and(142.50±12.39)pg/mL respectively,which were significantly lower than those in the control group,(38.11±2.86)ng/mL and(167.27±15.94)pg/mL,respectively(P<0.05).After 7 days and 14 days of treatment,the IGF-1 level in the observation group was significantly higher than that in the control group(P<0.05).The incidence of adverse reactions in the control group was 8.16%(4/49),which was higher than 4.08%(2/49)in the observation group,the difference was of no statistical significance[χ^(2)=0.710,P=0.399(>0.05)].Conclusion:Modified Huangqin decoction and Qingdai San retention enema combined with Mesalazine has a definite protective effect on intestinal mucosa of patien

关 键 词：溃疡性结肠炎 黄芩汤 青黛散 保留灌肠 美沙拉嗪 

分 类 号：R256.3[医药卫生—中医内科学]