体质结合辨证分型中医疗法辅助治疗活动期溃疡性结肠炎的效果及对炎症免疫的影响  

Effect of Traditional Chinese Medicine Combined with Constitution and Syndrome Differentiation in the Treatment of Active Ulcerative Colitis and Its Impact on Inflammation and Immunity

作　　者：孙岩 井晓峰[1] 陆莎[1] 李梅素[1] 赵黎 李家明 SUN Yan;JING Xiaofeng;LU Sha;LI Meisu;ZHAO Li;LI Jiaming(Department of Public Health,Shijiazhuang Traditional Chinese Medicine Hospital,Shijiazhuang 050000,China)

机构地区：[1]石家庄市中医院公共卫生科,石家庄050000

出　　处：《临床误诊误治》2025年第2期67-71,89,共6页Clinical Misdiagnosis & Mistherapy

基　　金：河北省中医药管理局科研计划项目(2020313)。

摘　　要：目的探讨体质结合辨证分型中医疗法辅助治疗活动期溃疡性结肠炎(UC)的效果及对炎症、免疫的影响。方法收集2021年7月至2022年1月活动期UC患者60例,按照随机数字表法分为中医组和西医组各30例。西医组给予美沙拉嗪肠溶片治疗,在此基础上,中医组给予体质结合辨证分型的中医疗法治疗,疗程均为6周。比较2组治疗效果,治疗前后中医证候积分、肿瘤坏死因子-α(TNF-α)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、CD3+、CD4+、CD8+、CD4+/CD8+水平,以及治疗期间不良反应。结果中医组总有效率为96.67%(29/30)高于西医组的66.67%(20/30),差异有统计学意义(P<0.01);治疗6周后,中医组腹泻、脓血便、腹痛、里急后重积分低于西医组(P<0.01);治疗6周后,中医组TNF-α、IL-2、IL-6、CD8+低于西医组,CD3+、CD4+、CD4+/CD8+高于西医组(P<0.01);2组治疗期间不良反应总发生率比较无差异(P>0.05)。结论体质结合辨证分型的中医疗法辅助治疗活动期UC效果良好,可有效减轻患者炎症损伤,提高免疫水平,从而改善症状,促进病情好转,且安全性好。Objective To investigate the effect of traditional Chinese medicine(TCM)combined with constitution and syndrome differentiation in the treatment of active ulcerative colitis(UC)and its impact on inflammation and immunity.Methods A total of 60 active UC patients treated from July 2021 to January 2022 were collected and divided into the TCM group and the Western medicine group,with 30 patients in each group,according to random number table method.The Western medicine group was treated with Mesalazine enteric-coated tablets,on the basis of which,the TCM group was treated with TCM combined with constitution and syndrome differentiation.The course of treatment was 6 weeks.The therapeutic effect,TCM syndrome score,tumor necrosis factor-α(TNF-α),interleukin-2(IL-2),interleukin-6(IL-6),CD3+,CD4+,CD8+,and CD4+/CD8+levels before and after treatment,and the occurrence of adverse reactions during treatment were compared between the two groups.Results The total effective rate of the TCM group was 96.67%(29/30),which was higher than that of the Western medicine group[66.67%(20/30)],showing significant difference(P<0.01).At 6 weeks after treatment,the scores of diarrhea,abdominal pain,pus and blood stools and posterior tenesia in the TCM group were lower than those in the Western medicine group(P<0.01).At 6 weeks after treatment,IL-2,TNF-α,IL-6 and CD8+in the TCM group were lower than those in the Western medicine group,while CD4+,CD3+and CD4+/CD8+were higher than those in the Western medicine group(P<0.01).There was no difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion TCM combined with constitution and syndrome differentiation to assist Western medicine is effective in the treatment of active UC patients,which can effectively reduce inflammatory damage,improve the level of immunity,thereby improving the clinical symptoms of patients,and promote the improvement of the condition,with good safety.

关 键 词：溃疡性结肠炎 活动期 中医疗法 体质 证型 肿瘤坏死因子-α CD3+ 药物毒性 

分 类 号：R574.62[医药卫生—消化系统]