健脾解毒化瘀方联合英夫利昔单抗治疗克罗恩病患者疗效及对肠道菌群的影响  

Effect of Jianpi Jiedu Huayu Decoction(健脾解毒化瘀方)Combined with Infliximab of Patients with Crohn′s Disease and Its Influence on Intestinal Flora

作　　者：缪旺冬 罗维军 赵喜颖[2] 王芹 MIAO Wangdong;LUO Weijun;ZHAO Xiying;WANG Qin(Longhua District People′s Hospital of Shenzhen,Shenzhen 518109,Guangdong,China;Guangdong Hospital of Traditional Chinese Medicine,Guangzhou 510006,Guangdong,China)

机构地区：[1]深圳市龙华区人民医院,广东深圳518109 [2]广东省中医院,广东广州510006

出　　处：《辽宁中医杂志》2024年第8期144-148,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(20191283)。

摘　　要：目的探讨健脾解毒化瘀方联合英夫利昔单抗对克罗恩病患者疗效及肠道菌群的影响。方法选取94例克罗恩病患者,使用随机数字表法分成观察组与对照组各47例。对照组给予英夫利昔单抗。在此基础上,观察组口服健脾解毒化瘀方联合英夫利昔单抗治疗。比较治疗前后两组患者主要中医证候评分、粪便中肠道菌群(双歧杆菌、乳酸杆菌、肠球菌、肠杆菌)数量、血清肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)和C反应蛋白(C-reactive protein,CRP)水平。结果所有患者均顺利完成该次研究,无脱落病例。观察组总有效率95.74%(45/47),高于对照组[82.98%(39/47)],差异有统计学意义(P<0.05)。与治疗前比较,治疗后两组腹痛拒按、腹泻急迫、腹胀、神疲乏力等证候积分降低,而且观察组积分低于对照组,差异有统计学意义(P<0.05)。与治疗前比较,治疗后两组血清TNF-α、CRP水平降低,而且观察组水平低于对照组,差异有统计学意义(P<0.05)。与治疗前比较,治疗后两组双歧杆菌、乳酸杆菌数量升高,肠球菌、肠杆菌数量降低,而且观察组双歧杆菌、乳酸杆菌数量高于对照组,肠球菌、肠杆菌数量低于对照组,差异有统计学意义(P<0.05)。结论健脾解毒化瘀方联合英夫利昔单抗应用于克罗恩病整体疗效确切,促进腹痛等症状的缓解,减轻肠黏膜炎症状态,其作用可能与其显著纠正肠道菌群失衡、改善肠黏膜屏障功能有关。Objective To investigate the effect of Jianpi Jiedu Huayu Decoction(健脾解毒化瘀方)combined with infliximab in the treatment of patients with Crohn′s disease and its influence on intestinal flora.Methods Ninety-four patients with Crohn′s disease were randomly divided into observation group and control group with 47 cases in each group.The control group was given infliximab,and on this basis,the observation group was treated with Jianpi Jiedu Huayu Decoction combined with infliximab.The therapeutic effect of all subjects was observed after continuous treatment.The scores of major TCM syndromes,fecal intestinal flora(bifidobacterium,Lactobacillus,enterococcus,enterobacterium),the levels of serum tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)were compared between the two groups before and after treatment.Results All subjects completed the study successfully without shedding cases.The total effective rate of the observation group was 95.74%(45/47),higher than that of the control group[82.98%(39/47)],and the comparison was statistically significant(P<0.05).Compared with thsoe before treatment,the scores of symptoms such as abdominal pain rejection,diarrhea urgency,abdominal distension and fatigue in the two groups were decreased after treatment,and the scores in the observation group were lower than those in the control group after treatment,and the comparison was statistically significant(P<0.05).Compared with those before treatment,the serum levels of TNF-αand CRP in the two groups were decreased after treatment,and the serum levels in the observation group were lower than those in the control group after treatment,and the comparison was statistically significant(P<0.05).Compared with those before treatment,the numbers of bifidobacterium and lactobacillus in the two groups after treatment were increased,while the numbers of enterococcus and enterobacterium were decreased.After treatment,the numbers of bifidobacterium and lactobacillus in the observation group were higher than those in the co

关 键 词：健脾解毒化瘀方 英夫利昔单抗 克罗恩病 肠道菌群 

分 类 号：R256[医药卫生—中医内科学]