安肠利湿泄浊方联合复方谷氨酰胺肠溶胶囊治疗活动期溃疡性结肠炎的临床疗效及作用机制探讨  

Clinical Efficacy and Mechanism of Anchang Lishi Xiehao Prescription(安肠利湿泄浊方)Combined with Compound Glutamine Enteric-Coated Capsule in Treatment of Active Ulcerative Colitis

作　　者：余胜[1] 钱海华[2] 蒋贞贞 张丹[2] YU Sheng;QIAN Haihua;JIANG Zhenzhen;ZHANG Dan(The First Affiliated Hospital of Anhui Medical University,Hefei 230031,Anhui,China;Jiangsu Provincial Hospital of Traditional Chinese Medicine,Nanjing 214504,Jiangsu,China)

机构地区：[1]安徽医科大学第一附属医院,安徽合肥230031 [2]江苏省中医院,江苏南京214504

出　　处：《中华中医药学刊》2025年第3期215-218,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81904203)。

摘　　要：目的评价安肠利湿泄浊方联合复方谷氨酰胺肠溶胶囊治疗活动期溃疡性结肠炎的临床疗效及作用机制探讨。方法以2020年3月—2023年3月医院收治的活动期溃疡性结肠炎患者100例为研究对象,依据随机对照法将患者分为试验组和对照组,每组50例。对照组采用美沙拉嗪结合复方谷氨酰胺肠溶胶囊治疗;试验组在对照组治疗的基础上,口服安肠利湿泄浊方治疗。两组患者一个治疗周期为7 d,共治疗4个周期。比较两组治疗前后腹泻、脓血便。腹痛、纳呆和腹胀等中医证候积分变化,比较两组患者止泻时间、退热时间和症状体征消失时间,比较两组治疗前后血清二胺氧化酶(Serum diamine oxidase,DAO)、D-乳酸(D-lactic acid,D-LA)、低氧诱导因子-1α(Hypoxia-inducible factor-1α,HIF-1α)、白细胞介素-6(Interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)和肿瘤坏死因子-α(Tumor necrosis factors-α,TNF-α)水平变化。结果试验组治疗疗效为94%(47/50),对照组治疗疗效为80%(40/50),试验组治疗疗效优于对照组(P<0.05);两组治疗后腹泻、脓血便。腹痛、纳呆和腹胀等中医证候积分较治疗前显著降低,且试验组降低幅度优于对照组(P<0.05);试验组患者的止泻时间、退热时间和症状体征消失时间优于对照组(P<0.05);两组治疗后肠黏膜屏障功能相关指标DAO、D-LA、HIF-1α较治疗前显著降低,且试验组降低幅度优于对照组(P<0.05);两组治疗后炎性因子IL-6、CRP和TNF-α水平较治疗前降低,且试验组降低幅度优于对照组(P<0.05)。结论安肠利湿泄浊方结合复方谷氨酰胺肠溶胶囊治疗溃疡性结肠炎更具可行性和有效性,可显著改善患者的临床症状,缩短止泻时间、退热时间和症状体征消失时间,提高治疗疗效,其作用机制推测与降低体内炎症因子水平、促进肠黏膜的修复有关。Objective To evaluate the clinical efficacy and mechanism of Anchang Lishi Xiehao Prescription(安肠利湿泄浊方)combined with Compound Glutamine Enteric-Coated Capsule in the treatment of active ulcerative colitis.Methods A total of 100 patients with active ulcerative colitis admitted to the hospital from March 2020 to March 2023 were selected as the research objects.According to the randomized control method,the patients were divided into observation group and reference group,with 50 cases in each group.The reference group was treated with mesalazine combined with Compound Glutamine Enteric-Coated Capsules.In the observation group,the basis of treatment in the reference group was oral treatment with Anchang Lishi Xiehao Prescription.The treatment cycle was 7 days,and there was a total of 4 cycles of treatment.The diarrhea,pus and blood stool be-fore and after treatment were compared between the two groups.The changes of TCM syndrome scores such as abdominal pain,nausea and abdominal distension were compared between the two groups.The serum levels of diamine oxidase(DAO),D-lactic acid(D-LA),hypoxic-induced-factor-1α(HIF-1α),interleukin-6(IL-6),C-reactive protein(CRP)and tumor nec-rosis factor-α(TNF-α)were compared between the two groups before and after treatment.Results The therapeutic effect of the observation group was 94%(47/50),which was better than that(80%,40/50)of the reference group(P<0.05).Diarrhea,pus and blood stool were relieved in both groups.The scores of TCM syndromes such as abdominal pain,nausea and abdominal dis-tension were significantly lower than those before treatment,and the reduction of the observation group was better than that of the reference group(P<0.05).The antidiarrheal time,febrile time and disappearance time of symptoms and signs in the observation group were better than those in the reference group(P<0.05).The indexes related to intestinal mucosal barrier function(DAO,D-LA and HIF-1α)were significantly decreased after treatment in both groups compared with those before

关 键 词：安肠利湿泄浊方 复方谷氨酰胺肠溶胶囊 溃疡性结肠炎 肠黏膜 机制 

分 类 号：R259.462[医药卫生—中西医结合]