加味三仁汤对溃疡性结肠炎急性期(湿热内蕴证)患者肠黏膜屏障功能、炎症因子及氧化应激水平的影响  

Effects of Modified Sanren Decoction on Intestinal Mucosal Barrier Function,Inflammatory Factors,and Oxidative Stress Levels in Patients with Acute Ulcerative Colitis(Syndrome of Internal Amassment of Dampness-Heat)

作　　者：陈小敏 周广泉 丁月琴 王勇 Chen Xiaomin;Zhou Guangquan;Ding Yueqin;Wang Yong(Hai'an Hospital of Traditional Chinese Medicine,Jiangsu,Hai'an 226600,China)

机构地区：[1]江苏省海安市中医院,江苏海安226600

出　　处：《中国中医急症》2025年第3期463-467,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：江苏省中医药科技发展计划项目(YB2023305)。

摘　　要：目的观察加味三仁汤对溃疡性结肠炎(UC)急性期(湿热内蕴证)患者及对肠黏膜屏障功能、炎症因子及氧化应激的影响。方法将86例患者随机分为对照组与观察组各43例。对照组口服美沙拉秦肠溶片,观察组在对照组基础上给予加味三仁汤治疗,疗程均为4周。进行改良Mayo评分、炎症性肠病患者生活质量问卷(IBDQ)、湿热内蕴证评分;比较治疗后C反应蛋白(CRP)达标率、临床应答率和临床缓解率;检测治疗前后检测缺氧诱导因子-1α(HIF-1α)、二胺氧化酶(DAO)、D-乳酸(D-LA)、肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1β、IL-6、IL-17a、谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)及丙二醛(MDA)水平。结果治疗后,两组湿热内蕴证积分和改良Mayo评分下降(P<0.05),IBDQ评分升高(P<0.05),均以观察组更为明显(P<0.05);观察组在治疗后1、2、4周的CRP达标率、临床应答率均高于对照组(P<0.05);观察组在治疗后2、4周的临床缓解率均高于对照组(P<0.05);观察组TNF-α、IL-1β、IL-6、IL-17a、MDA、HIF-1α、DAO和D-LA水平低于对照组(P<0.05),GSH-Px、SOD水平高于对照组(P<0.05)。结论加味三仁汤治疗急性期UC(湿热内蕴证)患者,能起到抗炎、抗氧化应激作用,从而保护肠黏膜屏障功能,控制了疾病活动度,减轻临床症状,提高生活质量,短期和中期治疗效果优于单纯西医治疗。Objective:To observe the effects of Modified Sanren Decoction on intestinal mucosal barrier function,inflammatory factors,and oxidative stress levels in patients with acute ulcerative colitis(UC)(syndrome of internal amassment of dampness-heat).Methods:A total of 86 patients were randomly divided into a control group and an observation group,with 43 cases in each group.The control group was treated orally with mesalazine enteric-coated tablets,while the observation group received additional treatment with Modified Sanren Decoction on the basis of the control group.The treatment duration for both groups was 4 weeks.Modified Mayo scores,inflammatory bowel disease quality of life questionnaire(IBDQ),and syndrome of internal amassment of dampness-heat scores were assessed.After treatment,the rates of C-reactive protein(CRP)normalization,clinical response,and clinical remission were compared.Levels of hypoxia-inducible factor-1α(HIF-1α),diamine oxidase(DAO),Dlactic acid(D-LA),tumor necrosis factor-α(TNF-α),interleukin(IL)-1β,IL-6,IL-17a,glutathione peroxidase(GSH-Px),superoxide dismutase(SOD),and malondialdehyde(MDA)were measured before and after treatment.Results:After treatment,the syndrome of internal amassment of dampness-heat scores and modified Mayo scores decreased significantly in both groups(P<0.05),while IBDQ scores increased significantly(P<0.05).These improvements were more significant in the observation group(P<0.05).The CRP normalization rates and the clinical response rate at 1,2,and 4 weeks after treatment were higher in the observation group than in the control group(P<0.05).Clinical remission rates at 2 and 4 weeks after treatment were higher in the observation group(P<0.05).TNF-α,IL-1β,IL-6,IL-17a,MDA,HIF-1α,DAO,and D-LA levels were lower in the observation group compared with the control group(P<0.05),while GSH-Px and SOD levels were higher in the observation group(P<0.05).Conclusion:Modified Sanren Decoction for acute UC(syndrome of internal amassment of dampnessheat)exhibits anti-inflamma

关 键 词：溃疡性结肠炎 急性期 湿热内蕴证 炎症反应 氧化应激 肠道黏膜功能 

分 类 号：R574.62[医药卫生—消化系统]