清热化湿愈疡方联合美沙拉嗪肠溶片治疗大肠湿热型溃疡性结肠炎临床效果的随机对照研究  

Clinical efficacy study of Qingre Huashi Yuyang formula combined with mesalazine entericcoated tablets in the treatment of damp-heat ulcerative colitis of large intestine:a randomized clinical trial

作　　者：胡小娟 程国宝[1] 姚卫建[1] 张杰 肖遥 曹赣[1] Hu Xiaojuan;Cheng Guobao;Yao Weijian;Zhang Jie;Xiao Yao;Cao Gan(Department of Traditional Chinese Medicine Proctology,Jiangsu Taixing People’s Hospital,Taixing 225400,Jiangsu,China)

机构地区：[1]江苏省泰兴市人民医院中医肛肠科,江苏泰兴225400

出　　处：《结直肠肛门外科》2024年第5期589-594,共6页Journal of Colorectal & Anal Surgery

摘　　要：目的探讨清热化湿愈疡方联合美沙拉嗪肠溶片在大肠湿热型溃疡性结肠炎治疗中的应用价值。方法纳入江苏省泰兴市人民医院2020年6月至2023年6月收治的150例大肠湿热型溃疡性结肠炎患者作为研究对象,按照随机数字表法分为对照组(n=75,采用激素或柳氮磺吡啶联合美沙拉嗪肠溶片治疗)和观察组(n=75,在对照组基础上联用清热化湿愈疡方治疗)。比较两组临床疗效,肠道双歧杆菌、乳酸杆菌的菌落数量,不良反应发生情况和治疗前、治疗后的改良Mayo评分、中医症状积分、炎症指标(血清内毒素又称脂多糖、肿瘤坏死因子-α、白细胞介素-6、前列腺素E2)、免疫指标(D-乳酸、γ-干扰素)。结果观察组的总有效率(94.7%)高于对照组(82.7%),不良反应发生率(4%)低于对照组(13.3%),差异有统计学意义(P<0.05)。治疗前,两组改良Mayo评分、中医症状积分、血清脂多糖、肿瘤坏死因子-α、白细胞介素-6、前列腺素E2水平、血清D-乳酸、γ-干扰素水平和肠道双歧杆菌、乳酸杆菌的菌落数量比较差异无统计学意义(P>0.05)。治疗后,两组改良Mayo评分、中医症状积分、血清脂多糖、肿瘤坏死因子-α、白细胞介素-6、前列腺素E2水平和血清D-乳酸、γ-干扰素水平均降低,观察组的改良Mayo评分、中医症状积分、血清脂多糖、肿瘤坏死因子-α、白细胞介素-6、前列腺素E2水平和血清D-乳酸、γ-干扰素水平均低于对照组,差异有统计学意义(P<0.05);两组肠道双歧杆菌、乳酸杆菌的菌落数量均增加,观察组肠道双歧杆菌、乳酸杆菌的菌落数量均多于对照组,差异有统计学意义(P<0.05)。结论清热化湿愈疡方联合美沙拉嗪肠溶片治疗大肠湿热型溃疡性结肠炎患者疗效显著,可有效减轻肠道炎症反应,改善肠道菌群紊乱,安全性高,具有临床应用推广的价值。Objectives To explore the application value of Qingre Huashi Yuyang Formula combined with mesalazine enteric-coated tablets in the treatment of damp-heat ulcerative colitis of large intestine.Methods A total of 150 patients with damp-heat ulcerative colitis of large intestine admitted to Jiangsu Taixing People’s Hospital from June 2020 to June 2023 were enrolled and randomized into a control group(n=75,treated with hormones or sulfasalazine combined with mesalazine enteric-coated tablets)and an observation group(n=75,treated with Qingre Huashi Yuyang Formula in addition to the control group’s treatment).The clinical efficacy,colony counts of intestinal bifidobacterium and lactobacillus,incidence of adverse reactions,and modified Mayo scores,traditional Chinese medicine symptom scores,inflammatory indicators(serum endotoxin,also known as lipopolysaccharide,tumor necrosis factor-α,interleukin-6,prostaglandin E2),and immune indicators(D-lactic acid,interferon-γ)before and after treatment were compared between the two groups.Results The total effective rate in the observation group(94.7%)was higher than that in the control group(82.7%),and the incidence of adverse reactions(4%)was lower than that in the control group(13.3%),with statistically significant differences(P<0.05).Before treatment,there were no statistically significant differences in modified Mayo scores,traditional Chinese medicine symptom scores,levels of serum lipopolysaccharide,tumor necrosis factor-α,interleukin-6,prostaglandin E2,D-lactic acid,interferon-γ,and colony counts of intestinal bifidobacterium and lactobacillus between the two groups(P>0.05).After treatment,the modified Mayo scores,traditional Chinese medicine symptom scores,levels of serum lipopolysaccharide,tumor necrosis factor-α,interleukin-6,prostaglandin E2,D-lactic acid,and interferon-γdecreased in both groups,and the observation group showing lower levels than the control group,with statistically significant differences(P<0.05).Additionally,the colony counts of bifidobacte

关 键 词：溃疡性结肠炎 清热化湿愈疡方 美沙拉嗪肠溶片 大肠湿热型 

分 类 号：R657.1[医药卫生—外科学]