痛泻汤结合针刺治疗溃疡性结肠炎临床效果及对血清炎症因子、肠道菌群的影响  

Clinical Effect of Tongxia Decoction(痛泻汤)Combined with Acupuncture on Ulcerative Colitis and Its Influence on Serum Inflammatory Factors and Intestinal Flora

作　　者：叶佳 刘畅[1] 朱梅萍[1] YE Jia;LIU Chang;ZHU Meiping(Department of Gastroenterology,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院消化内科,上海201203

出　　处：《辽宁中医杂志》2024年第6期159-162,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：上海市科学技术委员会“医学引导类(中,西医)科技支撑”项目(17401935100)。

摘　　要：目的观察痛泻汤结合针刺治疗溃疡性结肠炎临床效果及对血清炎症因子、肠道菌群的影响。方法研究纳入120例溃疡性结肠炎患者(2020年1月—2022年12月收治)进行该次分组试验,以随机数字表法将患者分为观察组(美沙拉嗪肠溶片+痛泻汤结合针刺治疗)与对照组(美沙拉嗪肠溶片治疗),每组60例。对比两组治疗效果、治疗前后中医证候(腹泻、血便或脓血便、腹痛、里急后重、肛门灼热等)积分变化、治疗前后患者白细胞介素-4(interleukin-4,IL-4)与白细胞介素-17(interleukin-17,IL-17)等血清炎症因子水平变化、治疗前后患者肠道菌群(肠球菌与大肠杆菌、双歧杆菌与乳酸杆菌)数量变化、疾病活动指数(disease activity index,DAI)以及炎症性肠病问卷评分(inflammatory bowel disease questionnaire,IBDQ)变化、不良反应。结果与对照组比较,观察总有效率更高[96.67%(58/60)vs 85.00%(51/60)](P<0.05);各组患者的不良反应发生率均较低(P>0.05);各组患者治疗前中医证候(腹痛、腹泻及血便或脓血便、里急后重、肛门灼热等)积分、IL-4及IL-17水平、肠道菌群数量、DAI及IBDQ评分等指标比较均无统计学意义(均P>0.05)。治疗后两组患者中医证候(腹泻、血便或脓血便、腹痛、里急后重、肛门灼热等)积分、IL-4及IL-17水平、肠道菌群数量、DAI及IBDQ评分等指标均改善,观察组指标改善均优于对照组(P<0.05)。结论痛泻汤结合针刺治疗溃疡性结肠炎疗效佳,患者治疗后血清炎症因子水平显著降低,肠道菌群恢复正常,肠道功能恢复较好,患者生活质量提升,治疗安全可靠。Objective To observe the clinical effect of Tongxia Decoction(痛泻汤)combined with acupuncture on ulcerative colitis and its effect on serum inflammatory factors and intestinal flora.Methods A total of 120 patients with ulcerative colitis(admitted from January 2020 to December 2022)were included in this study for this grouping experiment.The patients were randomly divided into observation group(mesalazine enteric-coated tablets+Tongxie Decoction combined with acupuncture treatment)and control group(mesalazine enteric-coated tablets)with 60 cases in each group.The treatment effect,changes in scores of TCM syndromes(diarrhea,blood stool or empyema,abdominal pain,posterior tenesia,anal burning,etc.)before and after treatment,changes in serum inflammatory factors such as interleukin-4(IL-4)and interleukin-17(IL-17)before and after treatment,changes in the number of intestinal flora(enterococcus and Escoli,bifidobacterium and lactobacillus)of patients before and after treatment,disease activity index(DAI)and inflammatory bowel disease questionnaire score(IBDQ)changes and adverse reactions of two groups were compared.Results The total effective rate of the observation group was higher than that of the control group[96.67%(58/60)vs 85.00%(51/60)](P<0.05).The incidence of adverse reactions was lowin both groups(P>0.05).The scores of TCM syndromes(abdominal pain,diarrhea,blood stools or pus and blood stools,posterior tenesia,anal burning,etc.),the levels of IL-4 and IL-17,the number of intestinal flora,DAI and IBDQ scores and other indexes were compared in both groups before treatment(P>0.05).After treatment,the scores of TCM syndromes(diarrhea,bloody stools or empyema,abdominal pain,posterior tenesia,anal burning,etc.),the levels of IL-4 and IL-17,the number of intestinal flora,DAI and IBDQ scores were all improved in each group.After treatment,the indexes in the observation group were better than those in the control group(P<0.05).Conclusion Tongxia Decoction combined with acupuncture has a good curative effect in th

关 键 词：溃疡性结肠炎 痛泻汤 针刺 治疗效果 血清炎症因子 肠道菌群 

分 类 号：R255[医药卫生—中医内科学]