芍黄安肠汤治疗重度活动期溃疡性结肠炎大肠湿热证患者的疗效及对肠黏膜屏障、炎症因子和免疫功能的影响  

Therapeutic effect of Shaohuang Anchang decoction on severe active ulcerative colitis with large intestinal dampness-heat pattern and its influence on intestinal mucosal barrier,inflammatory factors and immune function

作　　者：吕涛 张琨 李晨 Lyu Tao;Zhang Kun;Li Chen(Department of Traditional Chinese Medicine,The First Affiliated Hospital with Nanjing Medical University(Jiangsu Province Hospital),Nanjing 210029,China;Nanjing University of Chinese Medicine,Nanjing 210023,China;Department of Gastroenterology,Xuzhou City Hospital of TCM,Xuzhou 221000,China)

机构地区：[1]南京医科大学第一附属医院(江苏省人民医院)中医科,210029 [2]南京中医药大学,210023 [3]徐州市中医院消化科,江苏省221000

出　　处：《中华消化病与影像杂志（电子版）》2024年第1期16-20,共5页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

基　　金：江苏省"333"高层次人才培养工程(苏人才办[2022]2号);徐州市医学重点人才项目(XWRCHT20220057);徐州市科技局推动科技创新项目(KC22183);徐州市中医药科技发展计划项目(XZYB2021001)。

摘　　要：目的评估芍黄安肠汤治疗重度活动期溃疡性结肠炎(UC)大肠湿热证患者的疗效,及对肠黏膜屏障、炎症因子和免疫功能指标的影响。方法选取2019年5月至2021年1月南京医科大学第一附属医院收治的190例重度活动期UC大肠湿热证患者作为研究对象,随机分为对照组95例和观察组95例。对照组给予常规口服美沙拉嗪缓释颗粒配合美沙拉嗪栓剂纳肛治疗,观察组在对照组治疗基础上给予芍黄安肠汤治疗,两组均以4周为1疗程,治疗2疗程。比较两组患者中医临床疗效评分、生存质量评分(IBDQ)、肠黏膜屏障损伤评分、血清D-乳酸、内皮素(ET)和二氨氧化酶(DAO)水平、外周血肿瘤坏死因子(TNF-α)、白细胞介素(IL)-1β和IL-6水平、外周血CD3+、CD4+、CD8*细胞比例和CD4+/CD8+比值的差异。结果观察组患者总有效率(93.7%)显著高于对照组(81.1%)(P<0.05);治疗后观察组患者总评分、肠道症状评分、全身状况评分、社会功能评分及情感功能评分显著高于对照组(P<0.05);治疗后观察组患者肠黏膜屏障损伤评分、D-乳酸、DAO和ET水平显著低于对照组(P<0.05);治疗后观察组患者TNF-α、IL-1β和IL-6水平显著低于对照组(P<0.05);治疗后观察组患者CD3+、CD4+和CD4+/CD8+水平显著高于对照组,CD8+水平显著低于对照组(P<0.05)。结论芍黄安肠汤对重度活动期UC大肠湿热证患者疗效显著,其作用机制可能与促进肠黏膜屏障修复,减轻炎症因子水平,纠正免疫平衡有关。ObjectiveTo evaluate the therapeutic effect of Shaohuang Anchang decoction on patients with severe active ulcerative colitis (UC) of large intestinal dampness-heat pattern, and its influence on intestinal mucosal barrier, inflammatory factors and immune function indicators.MethodsA total of 190 patients with UC large intestinal dampness-heat pattern in severe active period admitted to the First Affiliated Hospital with Nanjing Medical University from May 2019 to January 2021 were selected as research objects, and randomly divided into control group (95 cases) and observation group (95 cases). The control group was treated with conventional mesalazine sustained-release granules combined with mesalazine suppository for anal therapy. The observation group was treated with Shaohuang Anchang decoction on the basis of the control group. The two groups were treated with 4 weeks as a course of treatment and 2 courses of treatment. The clinical efficacy score, quality of life score (IBDQ), intestinal mucosal barrier damage score, serum D-lactic acid, endothelin (ET) and diamine oxidase (DAO) levels, peripheral blood tumor necrosis factor-α (TNF-α), interleukin (IL)-1β and IL-6 levels, the ratio of peripheral blood CD3+, CD4+, CD8+ cells and the ratio of CD4+/CD8+ were compared between the two groups.ResultsThe total effective rate in the observation group (93.7%) was significantly higher than that in the control group (81.1%) (P<0.05). After treatment, the total score, intestinal symptom score, general condition score, social function score and emotional function score in the observation group were significantly higher than those in the control group (P<0.05). After treatment, the intestinal mucosal barrier injury score, D-lactic acid, DAO and ET levels in the observation group were significantly lower than those in the control group (P<0.05). After treatment, TNF-α, IL-1β and IL-6 levels in the observation group were significantly lower than those in the control group (P<0.05). After treatment, the levels of CD3+, C

关 键 词：溃疡性结肠炎 芍黄安肠汤 大肠湿热证 肠黏膜屏障 炎症因子 免疫反应 

分 类 号：R259[医药卫生—中西医结合]