摘要
目的探讨美沙拉嗪联合补中益气汤治疗慢性溃疡性直肠炎的临床疗效,并初步分析其作用机制。方法选择2017年6月至2018年6月本院收治的84例慢性溃疡性直肠炎患者随机均分为观察组和对照组,每组各42例。对照组予美沙拉嗪肠溶片口服联合美沙拉嗪栓剂纳肛治疗,观察组在对照组基础上加用补中益气汤。比较两组临床疗效、治疗前后肠道菌群紊乱情况及血清IL-33、IL-10水平。结果观察组治疗后排便次数、便血、内镜发现和医师总体评价得分均优于对照组,差异均有统计学意义(均P <0.05)。治疗前,两组患者肠道肠球菌、乳酸杆菌、双歧杆菌数量以及血清IL-33、IL-10水平对比,差异均无统计学意义(均P> 0.05)。治疗后,观察组肠道乳酸杆菌、双歧杆菌数值高于对照组;血清IL-33水平低于对照组,IL-10水平高于对照组,差异均有统计学意义(均P <0.05)。结论美沙拉嗪联合补中益气汤治疗慢性溃疡性直肠炎疗效优于单用美沙拉嗪,可能与补中益气汤有助于纠正肠道菌群紊乱、减轻机体炎症反应有关。
Objectives To investigate the effect of mesalazine combined with Buzhongyiqi decoction in treating chronic ulcerative proctitis and to determine its mechanism. Methods 84 patients with chronic ulcerative proctitis treated in our hospital between June 2017 and June 2018 were recruited and randomly assigned to treatment group and control group, with 42 patients in each group. Patients in the control group received oral mesalazine enteric-coated tablets combined with mesalazine suppositories.Patients in the treatment group received in addition Buzhongyiqi decoction. Clinical effectiveness, intestinal flora disturbance and serum levels of interleukin 33(IL-33) and 10(IL-10) before and after treatment were compared between the two groups. Results Frequency of defecation, hematochezia, endoscopy findings and overall evaluation scores of physicians after treatment were all significant better in treatment group than in control group(P < 0.05). Before treatment, there was no significant difference in the number of enterococcus, lactobacillus and bifidobacterial in intestines and serum levels of IL-33 and IL-10(P > 0.05). After treatment, the number of lactobacillus and bifidobacterial was significantly higher, IL-33 significantly lower and IL-10 significantly higher, in treatment group than in control group(P < 0.05). Conclusion mesalazine combined with Buzhongyiqi decoction was more effective than using mesalazine alone in treatment chronic ulcerative proctitis. This was possibly related to the effect of Buzhongyiqi decoction correcting intestinal flora disturbance and alleviating inflammation.
引文
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