探讨芍药汤联合痛泻要方对溃疡性结肠炎患者炎症细胞因子及免疫功能的研究
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摘要
目的:探讨芍药汤联合痛泻要方对溃疡性结肠炎患者炎性因子和免疫功能的影响。方法:选择2015年2月至2017年2月间我院收治的溃疡性结肠炎患者90例作为观察对象,随机均分为观察组和对照组各45例,对照组给予痛泻要方治疗,观察组给予芍药汤联合痛泻要方治疗,两组患者均连续治疗4周。观察两组患者治疗后的炎性因子、T淋巴细胞亚群水平变化情况及临床疗效。结果:治疗后观察组和对照组的治疗有效率分别为95. 56%和73. 33%,观察组高于对照组且差异有统计学意义(P<0. 05);治疗后两组患者的TNF-α、IL-6及IL-8显著下降,观察组下降幅度更大,与治疗前及组间比较,差异均有统计学意义(P<0. 05);治疗后两组患者的CD4~+、CD4~+/CD8~+、NK水平明显升高,而CD8~+水平下降,观察组与治疗前及组间比较,差异均有统计学意义(P<0. 05);观察组治疗后总不良反应发生率为15. 56%,明显低于对照组的35. 56%,组间比较差异有统计学意义(P<0. 05)。两组随访6个月,复发率差异无统计学意义(χ~2=1. 800,P=0. 180)。结论:芍药汤联合痛泻要方治疗溃疡性结肠炎患者临床疗效确切,可明显减轻机体炎性反应、提高机体免疫功能下降,降低不良反应发生率。值得临床推广使用。
Objective: To investigate the effect of Shaoyao decoction combined with Tongxie decoction on inflammatory factors and immune function in patients with ulcerative colitis. Methods: From February 2015 to February 2017,90 patients with ulcerative colitis were randomly divided into observation group( n = 45) and control group( n = 45). The observation group was treated with Shaoyao decoction combined with Tongxiexiao recipe,and the two groups were treated continuously for 4 weeks. To observe the changes of T lymphocyte subsets after treatment in two groups. Results: The effective rates of observation group and control group were 95. 56% and73. 33%,respectively,which were higher than those of control group( P< 0. 05). Compared with before treatment and between groups,the difference was statistically significant( P<0. 05). After treatment,the level of CD4~+CD4~+/CD8~+NK in the two groups was significantly increased,while the level of CD8 was decreased. There was significant difference between the observation group and the pre-treatment and between groups( P<0. 05). The incidence of total adverse reactions in the observation group was 15. 56%,which was significantly lower than that in the control group( 35. 56%). The difference between the two groups was statistically significant( P<0. 05). The two groups were followed up for 6 months. There was no significant difference in recurrence rate between the two groups. Conclusion:The clinical effect of Shaoyao decoction combined with Tongxiesieyao recipe in the treatment of ulcerative colitis is definite,which can obviously reduce the inflammatory reaction,increase the decrease of immune function and reduce the incidence of adverse reactions. It is worth popularizing in clinic.
Objective: To investigate the effect of Shaoyao decoction combined with Tongxie decoction on inflammatory factors and immune function in patients with ulcerative colitis. Methods: From February 2015 to February 2017,90 patients with ulcerative colitis were randomly divided into observation group( n = 45) and control group( n = 45). The observation group was treated with Shaoyao decoction combined with Tongxiexiao recipe,and the two groups were treated continuously for 4 weeks. To observe the changes of T lymphocyte subsets after treatment in two groups. Results: The effective rates of observation group and control group were 95. 56% and73. 33%,respectively,which were higher than those of control group( P< 0. 05). Compared with before treatment and between groups,the difference was statistically significant( P<0. 05). After treatment,the level of CD4~+CD4~+/CD8~+NK in the two groups was significantly increased,while the level of CD8 was decreased. There was significant difference between the observation group and the pre-treatment and between groups( P<0. 05). The incidence of total adverse reactions in the observation group was 15. 56%,which was significantly lower than that in the control group( 35. 56%). The difference between the two groups was statistically significant( P<0. 05). The two groups were followed up for 6 months. There was no significant difference in recurrence rate between the two groups. Conclusion:The clinical effect of Shaoyao decoction combined with Tongxiesieyao recipe in the treatment of ulcerative colitis is definite,which can obviously reduce the inflammatory reaction,increase the decrease of immune function and reduce the incidence of adverse reactions. It is worth popularizing in clinic.
引文
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[10]vila-Román J,Talero E,Rodríguez-Luna A,et al.Antiinflammatory effects of an oxylipin-containing lyophilised biomass from a microalga in a murine recurrent colitis model[J].Br JNutr,2016,116(12):2044-2052.
[11]Hedl M,Proctor DD,Abraham C.JAK2 disease-risk variants are gain of function and JAK signaling threshold determines innate receptor-induced proinflammatory cytokine secretion in macrophages[J].J Immunol,2016,197(9):3695-3704.
[12]周萍,曾志华,管江.芍药汤加减结合针刺治疗溃疡性结肠炎湿热蕴结证活动期临床研究[J].中成药,2016,38(7):1477-1480.Zhou P,Zeng ZH,Guan J.Clinical study on active period of damp-heat accumulation syndrome of ulcerative colitis treated with peony medicinal decoction plus acupuncture[J].Chin Traditional Patent Med,2016,38(7):1477-1480.
[2]Eichele DD,Kharbanda KK.Dextran sodium sulfate colitis murine model:An indispensable tool for advancing our understanding of inflammatory bowel diseases pathogenesis[J].World JGastroenterol,2017,23(33):6016-6029.
[3]张声生,沈洪,郑凯,等.溃疡性结肠炎中医诊疗专家共识意见(2017)[J].中华中医药杂志,2017,32(8):3585-3589.Zhang SS,Shen H,Zheng K,et al.Consensus opinion of experts in Chinese medicine diagnosis and treatment of ulcerative colitis(2017)[J].Chin J Traditional Chin Med,2017,32(8):3585-3589.
[4]张莹,熊晶晶,黄永坤,等.美沙拉秦、蒙脱石散和酪酸梭菌对溃疡性结肠炎大鼠血细胞因子的影响[J].中国免疫学杂志,2015,31(2):240-246,249.Zhang Y,Xiong JJ,Huang YK,et al.Effects of mesalazine,montmorillonite and Clostridium butyricum on blood cytokines in rats with ulcerative colitis[J].Chin J Immunol,2015,31(2):240-246,249.
[5]薛春霞.溃疡性结肠炎患者的中医病机及血清炎症因子水平变化及其意义[J].环球中医药,2014,7(S1):84-85.Xue CX.Changes of TCM pathogenesis and serum inflammatory factors in patients with ulcerative colitis and their significance[J].Global Chin Med,2014,7(S1):84-85.
[6]宋晖.溃疡性结肠炎的诊断与中、西医治疗新进展[J].环球中医药,2014,7(S2):125.Song H.Diagnosis of ulcerative colitis and new progress in the treatment of Chinese and Western medicine[J].Global Chin Med,2014,7(S2):125.
[7]沈凤,李德中.IL-10基因多态性与溃疡性结肠炎易感性的关系及对临床预后的影响[J].中国免疫学杂志,2016,32(9):1369-1373.Shen F,Li DZ.Relationship between IL-10 gene polymorphism and susceptibility to ulcerative colitis and its effect on clinical prognosis[J].Chin J Immunol,2016,32(9):1369-1373.
[8]Pittman ME,Jessurun J,Yantiss RK.Differentiating posttransplant inflammatory bowel disease and other colitides in renal transplant patients[J].Am J Surg Pathol,2017,41(12):1666-1674.
[9]Lipov E,Candido K.Efficacy and safety of stellate ganglion block in chronic ulcerative colitis[J].World J Gastroenterol,2017,23(17):3193-3194.
[10]vila-Román J,Talero E,Rodríguez-Luna A,et al.Antiinflammatory effects of an oxylipin-containing lyophilised biomass from a microalga in a murine recurrent colitis model[J].Br JNutr,2016,116(12):2044-2052.
[11]Hedl M,Proctor DD,Abraham C.JAK2 disease-risk variants are gain of function and JAK signaling threshold determines innate receptor-induced proinflammatory cytokine secretion in macrophages[J].J Immunol,2016,197(9):3695-3704.
[12]周萍,曾志华,管江.芍药汤加减结合针刺治疗溃疡性结肠炎湿热蕴结证活动期临床研究[J].中成药,2016,38(7):1477-1480.Zhou P,Zeng ZH,Guan J.Clinical study on active period of damp-heat accumulation syndrome of ulcerative colitis treated with peony medicinal decoction plus acupuncture[J].Chin Traditional Patent Med,2016,38(7):1477-1480.