愈疡方治疗溃疡性结肠炎的临床观察及对抗菌肽LL-37和炎症因子表达的影响  

Clinical Observation of Yuyangfang in the Treatment of Ulcerative Colitis and Its Effects on Antimicrobial Peptide LL-37 and Inflammatory Factor Expression

作　　者：丁康[1] 赵学龙[2] 武晗 杨霞[1] 蒋进广[4] 武永连 DING Kang;ZHAO Xuelong;WU Han;YANG Xia;JIANG Jinguang;WU Yonglian(Department of Colorectal Surgery,Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Nanjing 210002,China;Department of Pharmacy,Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Nanjing 210002,China;Department of Pharmacy,China Pharmaceutical University,Nanjing 210001,China;Department of Colorectal Surgery,Suqian Municipal Hospital of Traditional Chinese Medicine,Suqian 223801,China;Department of Colorectal Surgery,Yingshang Hospital of Traditional Chinese Medicine,Fuyang 236200,China)

机构地区：[1]南京中医药大学附属南京中医院肛肠科,江苏南京210002 [2]南京中医药大学附属南京中医院药学部,江苏南京210002 [3]中国药科大学药学院,江苏南京210001 [4]宿迁市中医院肛肠科,江苏宿迁223801 [5]颍上县中医院肛肠科,安徽阜阳236200

出　　处：《现代中药研究与实践》2024年第6期71-75,共5页Research and Practice on Chinese Medicines

基　　金：2020年江苏省中医药科技发展计划一般项目(YB2020029);2022年江苏省自然科学基金(BK20221178);2023年江苏省中医肛肠疾病临床医学创新中心重点项目(苏中医科教函[2023]1号)GCCXZX-2021;南京大学中国医院改革发展研究院2023年全国范围内拟立项课题(NDYG029、NDYG025);江苏省医院协会2023年度医院管理创新课题(JSYGY-3-2023-515,JSYGY-2-2023-507)

摘　　要：目的评价愈疡方治疗轻中度大肠湿热型溃疡性结肠炎的临床疗效及其对抗菌肽LL-37和炎症因子表达的影响。方法按照区组随机原则设计临床试验,将南京市中医院及颍上县中医院75例溃疡性结肠炎患者随机分为治疗组(40例)和对照组(35例),对照组予基础治疗,治疗组予基础治疗+愈疡方保留灌肠,疗程为8周,记录治疗前后症状积分、改良Truelove和Witts评分及Mayo内镜评分、实验室检查指标、抗菌肽LL-37和炎症因子。结果治疗后治疗组总有效率优于对照组(P<0.05),两组间主要症状评分比较差异无统计学意义(P>0.05);两组True-Love和Witts疾病严重程度及Mayo内镜评分均降低(P<0.05),且治疗组改善程度优于对照组(P<0.05)。实验室检查中,两组C反应蛋白、血红蛋白、淋巴细胞在治疗前后差异均无统计学意义(P>0.05),粪便钙卫蛋白和血沉均下降(P<0.05),治疗组粪便钙卫蛋白的改善情况优于对照组(P<0.05)。治疗组治疗后抗菌肽LL-37及炎症因子TNF-α和IL-6均有明显改善(P<0.05)。结论愈疡方可改善轻中度大肠湿热型溃疡性结肠炎患者的临床症状及内镜下表现,其机制可能是通过调控抗菌肽LL-37及炎性因子的表达来实现的。Objective To evaluate the clinical efficacy of Yuyangfang in treating mild to moderate dampheat type ulcerative colitis and its influence on the expression of antimicrobial peptide LL-37 and inflammatory factors.Methods A clinical trial was designed based on district group random principles.75 ulcerative colitis patients from the Traditional Chinese Medicine Hospital in Nanjing City and Yingshang District were randomly divided into an observation group(40 patients)and a control group(35 patients).The control group received basic treatment,while the observation group received basic treatment plus Yuyangfang retention enema for an 8-week course.Symptoms scores,modified Truelove and Witts scoring,Mayo endoscopic score,laboratory test indices,antimicrobial peptide LL-37,and inflammatory factors were recorded before and after treatment.Results The overall effectiveness of the treatment in the observation group was superior to that of the control group(P<0.05).There was no significant statistical difference in the main symptom scores between the two groups(P>0.05).Both groups showed a decrease in True-Love,Witts disease severity and Mayo endoscopic scores(P<0.05).The observation group showed greater improvements than the control group(P<0.05).Laboratory tests revealed no significant differences in C-reactive protein,hemoglobin,and lymphocytes before and after treatment in both groups(P>0.05).Fecal calprotectin and erythrocyte sedimentation rate decreased(P<0.05),with greater improvement in fecal calprotectin in the observation group(P<0.05).Post-treatment,the observation group showed significant improvements in antimicrobial peptide LL-37 and inflammatory factors TNF-α,IL-6(P<0.05).Conclusion Yuyangfang is safe and effective in treating mild to moderate damp-heat type ulcerative colitis,potentially improving clinical symptoms and endoscopic appearances by regulating the expression of antimicrobial peptide LL-37 and inflammatory factors.

关 键 词：溃疡性结肠炎 愈疡方 抗菌肽LL-37 炎症因子 

分 类 号：R285.6[医药卫生—中药学]