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目的:探讨基于浊毒理论应用自拟中药泄浊解毒饮治疗溃疡性结肠炎(UC)的疗效及对血清脑肠肽、炎症因子的影响。方法:将110例UC患者按照随机数字表法分为2组,每组55例,对照组给予美沙拉嗪治疗,治疗组在对照组治疗基础上口服中药泄浊解毒饮,两组均连续治疗8周。比较两组治疗前后主要中医证候积分、血清炎症因子、脑肠肽水平,并比较两组临床有效率、黏膜愈合率和内镜应答率。结果:治疗后治疗组主要中医证候腹痛、腹泻、腹胀、黏液脓血便、里急后重积分均低于对照组,血清肿瘤坏死因子-α(TNF-α)白细胞介素(IL)-33、P物质(SP)水平低于对照组,IL-10、血管活性肠肽(VIP)、生长抑素(SS)水平高于对照组,临床有效率、黏膜愈合率均高于对照组,差异均有统计学意义(P<0.05)。结论:基于浊毒理论自拟中药泄浊解毒饮治疗UC可有效调节炎症因子和脑肠肽水平,改善患者症状,促进肠黏膜修复,疗效显著。
Abstract：Objective: To investigate the therapeutic effect of traditional Chinese medicine Xiezhuojiedu decoction on ulcerative colitis(UC) based on zhuodu theory and its effect on serum brain-gut peptide and inflammatory factors. Methods: A total of 110 cases of UC patients were divided into 2 groups according to the random number table method, with 55 cases in each group. The control group was treated with mesalazine, and the treatment group was given oral administration of Chinese medicine Xiezhuojiedu decoction on the basis of the control group. Both groups received continuous treatment for 8 weeks. Integral of TCM syndromes, serum inflammatory factor and brain-gut peptide before and after treatment were compared between the two groups. The clinical efficiency, mucosal healing rate and endoscopic response rate of the two groups were compared. Results: After treatment, integral of the main TCM syndromes abdominal pain, diarrhea, abdominal distention, mucous hematochezia, tenesmus of the treatment group were lower than the control group(P<0.01), the levels of serum(Tumor necrosis factor-α,(TNF-α), Interleukin(IL)-33, Substance P(SP)were lower than the control group(P<0.01), the levels of IL-10, vasoactive intestinal peptide(VIP), Somatostatin(SS) were higher than the control group(P<0.01), the clinical efficiency and mucosal healing rate were higher than control group(P<0.05), The difference was statistically significant. Conclusion: Based on the Zhuodu theory, the Xiezhuojiedu decoction can effectively regulate the levels of inflammatory factor and brain-gut peptide in the treatment of UC, improve the symptoms of patients, and promote the repair of intestinal mucosa, and it's effective in treatment.
1 Yamamoto T,Iida T,Ikeya K,et al.Correction:A multicenter retrospective study aiming to identify patients who respond well to adsorptive granulomonocytapheresis in moderately to severely active ulcerative colitis[J].Clin Transl Gastroenterol,2018,9(11):205.
2 Schirmer M,Denson L,Vlamakis H,et al.Compositional and temporal changes in the gut microbiome of pediatric ulcerative colitis patients are linked to disease course[J].Cell Host Microbe,2018,24(4):600-610.e4.
3 Ng SC,Bernstein CN,Vatn MH,et al.Geographical variability and environmental risk factors in inflammatory bowel disease[J].Gut,2013,62(4):630-649.
4 朱蕾蕾,李莉,顾志坚,等.基于数据挖掘的中医内服及灌肠治疗溃疡性结肠炎方药规律分析[J].上海中医药杂志,2019,53(7):10-14.
5 沈洪,邢敬.中西医结合治疗溃疡性结肠炎的优势及临床应用[J].医学研究生学报,2019,32(6):586-590.
6 中华医学会消化病学分会炎症性肠病协作组.对我国炎症性肠病诊断治疗规范的共识意见(2007年,济南)[J].中华消化杂志,2007,27(8):545-550.
7 中华中医药学会脾胃病分会.溃疡性结肠炎中医诊疗共识意见[J].中华中医药杂志,2010,25(6):891-895.
8 郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002.
9 D'Haens G,Sandborn WJ,Feagan BG,et al.A review of activity indices and efficacy end points for clinical trials of medical therapy in adults with ulcerative colitis[J].Gastroenterology,2007,132(2):763-786.
10 陈金敏,高山,童旭东.非侵入性分子标志物对溃疡性结肠炎内镜活动度的判断价值[J].胃肠病学,2019,24(5):298-301.
11 战晶玉,房莹莹,于卓,等.连草泻痢胶囊对活动期溃疡性结肠炎患者血清炎性因子及肠道黏膜屏障的影响[J].中国中西医结合消化杂志,2019,27(7):509-513,519.
12 陈大光,曹晖,李令,等.芍药汤对溃疡性结肠炎大鼠结肠组织机械屏障及细胞因子的影响[J].安徽中医药大学学报,2019,38(4):67-71.
13 王凤仪,赵党生,蒲晓薇,等.芍药汤对湿热内蕴型溃疡性结肠炎大鼠模型结肠组织中AP-1,TNF-α表达的影响[J].中国实验方剂学杂志,2019,25(16):7-11.
14 Chen J,He Y,Tu L,et al.Dual immune functions of IL-33 in inflammatory bowel disease[J].Histol Histopathol,2019:18149.
15 张华,王思静,马学宽,等.新塔花水提物对ApoE-/-动脉粥样硬化模型小鼠血清中IL-6、IL-10表达的影响[J].中华中医药杂志,2019,34(7):3258-3261.
16 李博林,张纨,王志坤,等.化浊解毒方治疗溃疡性结肠炎的临床疗效及对神经-内分泌-免疫网络的影响[J].中国中西医结合杂志,2019,39(2):184-188.
17 王思雨,崔曰新,张景珍,等.千金子制霜前后对大鼠消化间期复合肌电及胃肠激素的影响[J].中国中医药信息杂志,2019,26(7):44-47.
基本信息:
DOI：10.13210/j.cnki.jhmu.20190910.002
中图分类号:R259
引用信息:
[1]季芳,鞠宝兆,高文艳.基于浊毒理论治疗溃疡性结肠炎的疗效及对血清脑肠肽、炎症因子的影响[J].海南医学院学报,2019,25(20):1557-1561.DOI:10.13210/j.cnki.jhmu.20190910.002.
基金信息:
辽宁省博士启动基金项目(20111093)~~
2019-09-11
2019-09-11
2019-09-11