溃结灌肠液气药灌肠联合术苓香连汤口服治疗溃疡性结肠炎临床疗效及对患者炎症因子水平的影响
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摘要
目的观察溃结灌肠液气药灌肠联合术苓香连汤口服治疗轻中度活动期大肠湿热型溃疡性结肠炎临床疗效及对患者炎症因子水平的影响。方法将77例轻中度活动期大肠湿热型溃疡性结肠炎患者随机分为2组。治疗组40例予溃结灌肠液气药灌肠联合术苓香连汤口服治疗;对照组37例予美沙拉嗪颗粒气药灌肠治疗。2组疗程均为4周。观察2组治疗前后Mayo评分及肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、IL-10水平变化,以及内镜下情况、缓解率、不良反应。结果治疗组总缓解率92.50%,对照组总缓解率81.08%,治疗组疗效优于对照组(P<0.05)。Mayo评分:治疗后2组各项指标评分均下降(P<0.05);治疗后2组总积分比较差异有统计学意义(P<0.05),治疗后治疗组排便次数评分及血便评分明显低于对照组(P<0.05),其余各指标评分比较差异均无统计学意义(P>0.05)。治疗后2组内镜下黏膜评分较本组治疗前均降低(P<0.05),且治疗组低于对照组(P<0.05)。治疗后2组TNF-α、IL-6水平均降低(P<0.05),IL-10水平升高(P<0.05),且治疗组降低TNF-α、IL-6,升高IL-10水平均优于对照组(P<0.05)。2组治疗过程中均未出现不良反应。结论溃结灌肠液气药灌肠联合术苓香连汤口服治疗轻中度活动期大肠湿热型溃疡性结肠炎疗效确切,且在改善临床症状、诱导缓解及改善炎症因子等相关指标方面优于美沙拉嗪。
Objective To observe the clinical efficacy of Kuijie enema liquid by air-pressured herb enema combined with Zhuling Xianglian decoction in the treatment of ulcerative colitis of large intestine damp-heat type in mild to moderate active stage and its effect on the level of inflammatory factors of patients. Methods 77 patients with ulcerative colitis of large intestine damp-heat type in mild to moderate active stage were randomly divided into two groups. 40 cases in treatment group were treated by Kuijie enema liquid by air-pressured herb enema combined with Zhuling Xianglian decoction. 37 cases in control group were treated by mesalazine granules by air-pressured herb enema. Both groups were treated for 4 weeks. The changes of Mayao score, tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) and IL-10 levels, endoscopic condition, remission rate and adverse reactions were observed before and after treatment in the two groups. Results The total remission rate was 92.50% in treatment group and 81.08% in control group. The clinical curative effect of the treatment group was better than that of the control group(P<0.05). Mayo score: After treatment, the scores of each index in both groups were decreased(P<0.05). After treatment, there was significant difference in the total score between the two groups(P<0.05). After treatment, the scores of defecation frequency and blood stool in the treatment group were significantly lower than those in the control group(P<0.05), while there was no significant difference in other indexes(P>0.05). After treatment, the scores of endoscopic mucosa in both groups were lower than those before treatment(P<0.05), and those in the treatment group were lower than those in the control group(P<0.05). After treatment, the levels of TNF-α and IL-6 were decreased in both groups(P<0.05), and IL-10 was increased(P<0.05), and the effect of treatment group on reducing TNF-αand IL-6 and increasing IL-10 levels was better than that of control group(P<0.05). There were no adverse reactions during the treatment in both groups.Conclusion Kuijie enema liquid by air-pressured herb enema combined with Zhuling Xianglian decoction is effective in treating ulcerative colitis of large intestine damp-heat type in mild to moderate active stage. It is superior to mesalazine in improving clinical symptoms, inducing remission and improving related indicators of inflammatory factors.
Objective To observe the clinical efficacy of Kuijie enema liquid by air-pressured herb enema combined with Zhuling Xianglian decoction in the treatment of ulcerative colitis of large intestine damp-heat type in mild to moderate active stage and its effect on the level of inflammatory factors of patients. Methods 77 patients with ulcerative colitis of large intestine damp-heat type in mild to moderate active stage were randomly divided into two groups. 40 cases in treatment group were treated by Kuijie enema liquid by air-pressured herb enema combined with Zhuling Xianglian decoction. 37 cases in control group were treated by mesalazine granules by air-pressured herb enema. Both groups were treated for 4 weeks. The changes of Mayao score, tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) and IL-10 levels, endoscopic condition, remission rate and adverse reactions were observed before and after treatment in the two groups. Results The total remission rate was 92.50% in treatment group and 81.08% in control group. The clinical curative effect of the treatment group was better than that of the control group(P<0.05). Mayo score: After treatment, the scores of each index in both groups were decreased(P<0.05). After treatment, there was significant difference in the total score between the two groups(P<0.05). After treatment, the scores of defecation frequency and blood stool in the treatment group were significantly lower than those in the control group(P<0.05), while there was no significant difference in other indexes(P>0.05). After treatment, the scores of endoscopic mucosa in both groups were lower than those before treatment(P<0.05), and those in the treatment group were lower than those in the control group(P<0.05). After treatment, the levels of TNF-α and IL-6 were decreased in both groups(P<0.05), and IL-10 was increased(P<0.05), and the effect of treatment group on reducing TNF-αand IL-6 and increasing IL-10 levels was better than that of control group(P<0.05). There were no adverse reactions during the treatment in both groups.Conclusion Kuijie enema liquid by air-pressured herb enema combined with Zhuling Xianglian decoction is effective in treating ulcerative colitis of large intestine damp-heat type in mild to moderate active stage. It is superior to mesalazine in improving clinical symptoms, inducing remission and improving related indicators of inflammatory factors.
引文
[1] Jiang XL,Cui HF.An analysis of 10218 ulcerative colitis cases in China[J].World J Gastroenterol,2002,8(1):158-161.
[2] Yi F,Jie Z,Luckheeram RV,et al.The prevalence and risk factors of cytomegalovirus infection in inflammatory bowel disease in Wuhan,Central China[J].Virol J,2013,10(1):43.
[3] Wang Y,Ouyang Q.Ulcerative colitis in China:retrospective analysis of 3100 hospitalized patients[J].J Gastroenterol Hepatol,2007,22(9):1450-1455.
[4] 郑烈,戴彦成,张亚利,等.中医药对NF-κB信号通路介导溃疡性结肠炎治疗进展[J].中华中医药学刊,2016,34(7):1585-1587.
[5] Li MC,He SH.IL-10 and its related cytokines for treatment of inflammatory bowel disease[J].World J Gastroenterol,2004,10(5):620-625.
[6] Moynagh PN.TLR signalling and activation of IRFs:revisiting old friends from the NF-κB pathway:Trends in Immunology[J].Trends Immunol,2005,26(9):469-476.
[7] 王新月,王建云.溃疡性结肠炎中医药治疗的关键问题与优势对策[J].中华中医药杂志,2012,27(2):263-267.
[8] 中华医学会消化病学分会炎症性肠病学组.炎症性肠病诊断与治疗的共识意见(2012年·广州)[J].中华内科杂志,2012,51(10):818-831.
[9] 中华中医药学会脾胃病分会.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.
[10] 沈骏,冉志华,童锦禄,等.炎症性肠病内镜分级和评分标准的一致性研究[J].中华消化内镜杂志,2008,25(5):239-244.
[11] Dignass A,Eliakim R,Magro F,et al.Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 1:definitions and diagnosis[J].J Crohns Colitis,2012,6(10):965-990.
[12] 董俊刚,刘喜平,李培清,等.参苓白术散治疗溃疡性结肠炎研究进展[J].辽宁中医杂志,2018,45(8):1785-1788.
[13] 申睿,刘苗,朱向东,等.中医药治疗溃疡性结肠炎实验研究进展[J].中草药,2018,49(7):1721-1725.
[14] 冯卓,韩昌鹏,李盈,等.祛湿清肠方内服联合中药灌肠治疗轻中度活动期溃疡性结肠炎大肠湿热证临床观察[J].中国实验方剂学杂志,2018,24(5):149-154.
[15] 裴玲燕,张纯芳,付骞卉,等.翻白草对UC模型大鼠血清IL-4,IL-5,IL-6,IL-10及TNF-α影响的实验研究[J].航天医学与医学工程,2017,30(6):425-430.
[16] 丁康,张辉,谭妍妍,等.基于蛋白芯片技术探讨丁氏溃结灌肠液对结肠炎大鼠肠道组织差异蛋白表达的影响[J].中国药理学通报,2017,33(10):1473-1478.
[17] 赵敏,李睿瑛,张亚杰,等.丁氏溃结灌肠液改善DSS诱导大鼠肠道炎症反应的机制研究[J].时珍国医国药,2017,28(1):95-97.
[18] 张苏闽,刘轩良.溃结灌肠液对溃疡性结肠炎模型大鼠结肠组织中set9及血清TNF-α的影响[J].山东中医药大学学报,2014,38(5):477-479.
[19] 刘青梅,韩辅,陈曦,等.肠康饮对溃疡性结肠炎大鼠血清IL-6、IL-10的影响[J].世界中西医结合杂志,2008,3(5):266-268.
[2] Yi F,Jie Z,Luckheeram RV,et al.The prevalence and risk factors of cytomegalovirus infection in inflammatory bowel disease in Wuhan,Central China[J].Virol J,2013,10(1):43.
[3] Wang Y,Ouyang Q.Ulcerative colitis in China:retrospective analysis of 3100 hospitalized patients[J].J Gastroenterol Hepatol,2007,22(9):1450-1455.
[4] 郑烈,戴彦成,张亚利,等.中医药对NF-κB信号通路介导溃疡性结肠炎治疗进展[J].中华中医药学刊,2016,34(7):1585-1587.
[5] Li MC,He SH.IL-10 and its related cytokines for treatment of inflammatory bowel disease[J].World J Gastroenterol,2004,10(5):620-625.
[6] Moynagh PN.TLR signalling and activation of IRFs:revisiting old friends from the NF-κB pathway:Trends in Immunology[J].Trends Immunol,2005,26(9):469-476.
[7] 王新月,王建云.溃疡性结肠炎中医药治疗的关键问题与优势对策[J].中华中医药杂志,2012,27(2):263-267.
[8] 中华医学会消化病学分会炎症性肠病学组.炎症性肠病诊断与治疗的共识意见(2012年·广州)[J].中华内科杂志,2012,51(10):818-831.
[9] 中华中医药学会脾胃病分会.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.
[10] 沈骏,冉志华,童锦禄,等.炎症性肠病内镜分级和评分标准的一致性研究[J].中华消化内镜杂志,2008,25(5):239-244.
[11] Dignass A,Eliakim R,Magro F,et al.Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 1:definitions and diagnosis[J].J Crohns Colitis,2012,6(10):965-990.
[12] 董俊刚,刘喜平,李培清,等.参苓白术散治疗溃疡性结肠炎研究进展[J].辽宁中医杂志,2018,45(8):1785-1788.
[13] 申睿,刘苗,朱向东,等.中医药治疗溃疡性结肠炎实验研究进展[J].中草药,2018,49(7):1721-1725.
[14] 冯卓,韩昌鹏,李盈,等.祛湿清肠方内服联合中药灌肠治疗轻中度活动期溃疡性结肠炎大肠湿热证临床观察[J].中国实验方剂学杂志,2018,24(5):149-154.
[15] 裴玲燕,张纯芳,付骞卉,等.翻白草对UC模型大鼠血清IL-4,IL-5,IL-6,IL-10及TNF-α影响的实验研究[J].航天医学与医学工程,2017,30(6):425-430.
[16] 丁康,张辉,谭妍妍,等.基于蛋白芯片技术探讨丁氏溃结灌肠液对结肠炎大鼠肠道组织差异蛋白表达的影响[J].中国药理学通报,2017,33(10):1473-1478.
[17] 赵敏,李睿瑛,张亚杰,等.丁氏溃结灌肠液改善DSS诱导大鼠肠道炎症反应的机制研究[J].时珍国医国药,2017,28(1):95-97.
[18] 张苏闽,刘轩良.溃结灌肠液对溃疡性结肠炎模型大鼠结肠组织中set9及血清TNF-α的影响[J].山东中医药大学学报,2014,38(5):477-479.
[19] 刘青梅,韩辅,陈曦,等.肠康饮对溃疡性结肠炎大鼠血清IL-6、IL-10的影响[J].世界中西医结合杂志,2008,3(5):266-268.