柴胡疏肝散合参苓白术散对肝郁脾虚型克罗恩病的临床疗效及对免疫功能的影响
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摘要
目的观察柴胡疏肝散合参苓白术散对肝郁脾虚型克罗恩病的临床疗效和对免疫功能的影响。方法将100例肝郁脾虚型克罗恩病患者随机分为观察组和对照组,各50例。对照组给予常规西医治疗,观察组在对照组基础上采用柴胡疏肝散合参苓白术散的中医治疗。比较两组患者治疗前后的营养指标、免疫指标、血清炎性因子水平,观察两组患者的临床疗效和安全性。结果治疗后,观察组的治疗总有效率为94.00%,高于对照组的78.00%(P <0.05);观察组的ALB、 TP、 Hb、 HCT水平均优于对照组(P <0.05), Th17细胞值、 CD4+CD25+调节性T细胞值均高于对照组(P <0.05);观察组的TNF-α、 IL-17、 IL-6、CRP水平均低于对照组, IL-10水平高于对照组(P均<0.05)。结论柴胡疏肝散合参苓白术散治疗肝郁脾虚型克罗恩病疗效显著,可改善患者的营养障碍,减轻炎性反应,提高免疫功能,且药物安全性较好。
Objective To observe the clinical efficacy of Chaihushugan powder and Shenlingbaizhu powder on Crohn's disease of liver depression and spleen deficiency type and the influence on immune function. Methods 100 cases of patients with Crohn's disease of liver depression and spleen deficiency type were randomly divided into observation group and control group, with 50 cases in each group.The control group was treated with conventional western medicine, while the observation group was treated with Chaihushugan powder and Shenlingbaizhu powder on the basis of the control group. The nutritional indicators, immune indicators and levels of serum inflammatory factors before and after treatment were compared between the two groups. The clinical efficacy and safety of the two groups were observed.Results After treatment, the total effective rate of the observation group was 94.00%, higher than 78.00% of the control group(P <0.05). The ALB, TP, Hb and HCT levels of the observation group were better than those of the control group(P <0.05), and the of Th17 cell value and CD4~+ CD25~+ regulatory T cell value were higher than those of the control group(P <0.05). The TNF-α, IL-17, IL-6 and CRP levels of the observation group were lower than those of the control group, and the IL-10 level was than higher that of the control group(all P <0.05).Conclusions Chaihushugan powder and Shenlingbaizhu powder has significant curative effect in the treatment of Crohn's disease of liver depression and spleen deficiency type, which can improve the nutritional disorder, relileve the inflammatory reaction and improve the immune function, with good drug safety.
Objective To observe the clinical efficacy of Chaihushugan powder and Shenlingbaizhu powder on Crohn's disease of liver depression and spleen deficiency type and the influence on immune function. Methods 100 cases of patients with Crohn's disease of liver depression and spleen deficiency type were randomly divided into observation group and control group, with 50 cases in each group.The control group was treated with conventional western medicine, while the observation group was treated with Chaihushugan powder and Shenlingbaizhu powder on the basis of the control group. The nutritional indicators, immune indicators and levels of serum inflammatory factors before and after treatment were compared between the two groups. The clinical efficacy and safety of the two groups were observed.Results After treatment, the total effective rate of the observation group was 94.00%, higher than 78.00% of the control group(P <0.05). The ALB, TP, Hb and HCT levels of the observation group were better than those of the control group(P <0.05), and the of Th17 cell value and CD4~+ CD25~+ regulatory T cell value were higher than those of the control group(P <0.05). The TNF-α, IL-17, IL-6 and CRP levels of the observation group were lower than those of the control group, and the IL-10 level was than higher that of the control group(all P <0.05).Conclusions Chaihushugan powder and Shenlingbaizhu powder has significant curative effect in the treatment of Crohn's disease of liver depression and spleen deficiency type, which can improve the nutritional disorder, relileve the inflammatory reaction and improve the immune function, with good drug safety.
引文
[1]巫协宁,吴坚炯.克罗恩病和自身免疫[J].胃肠病学和肝病学杂志, 2018, 27(10):1081-1085.
[2]王玥,姜相君. 71例克罗恩病住院患者临床特点分析[J].胃肠病学和肝病学杂志, 2018, 27(8):892-895.
[3]王英,李燕村,金延强,等.从“肺合大肠”探讨克罗恩病罕见肺部表现的病因病机理论基础[J].广州中医药大学学报, 2016, 33(6):877-880.
[4]唐旭东.消化系统常见疾病中医诊疗指南(基层医生版与患者科普版)的研制[C].//2017第十九届中国科协年会论文集. 2017:1.
[5]冉志华.炎症性肠病诊断与治疗的共识意见(2012年广州)克罗恩病诊断的部分解读[J].胃肠病学, 2012, 17(12):721-723.
[6]余慧芬,唐李,李妍.克罗恩病非手术治疗的研究进展[J].医学与哲学, 2018, 39(20):43-45.
[7]李冠炜,任建安.重视我国克罗恩病流行病学的研究[J].肠外与肠内营养, 2017, 24(3):135-137.
[8]陈聪,李品,彭莉,等.国医大师王琦从“脾胃外感”论治克罗恩病验案一则[J].环球中医药, 2018, 11(5):720-721.
[9]吴璐一,季光,赵继梦,等.中医药治疗克罗恩病的研究与思考[J].环球中医药, 2014, 7(5):393-397.
[10]陈锦锋.克罗恩病中医证治探讨[J].中医药导报, 2017, 23(5):9-11.
[11]巫协宁.克罗恩病发病机制的初步探索[J].国际消化病杂志,2017, 37(3):135-139.
[12]程滢瑞,吴霜,杨柏霖.克罗恩病发病机制的研究进展[J].现代中西医结合杂志, 2014, 23(36):4089-4092.
[13]巫协宁.饮食、肠道菌群、免疫等因素在克罗恩病发病机制中的作用[J].国际消化病杂志, 2016, 36(6):325-328.
[14] Wang YN, Zhang Y, Wang Y, et al. The beneficial effect of total glucosides of paeony of psoriathic arthritis links to circulating Tregs and Th1 Cell functions[J]. Phyther Res, 2014, 28(3):372-381.
[15] Poniedzialek B, Rzymski P, Karczewski J. Increased apoptosis of regulatory T cells in Crohn's disease[J]. Hepato-gastroenterology, 2014,61(130):382-384.
[16]金玲,杨钦河,张玉佩,等.疏肝健脾方药对非酒精性脂肪性肝炎大鼠肝组织TNF-α、 IL-6及IL-1的影响[J].暨南大学学报(自然科学与医学版), 2012, 33(2):161-166.
[17]梁菊玲.参苓白术散治疗肠道菌群失调相关疾病研究进展[J].亚太传统医药, 2017, 13(13):56-58.
[2]王玥,姜相君. 71例克罗恩病住院患者临床特点分析[J].胃肠病学和肝病学杂志, 2018, 27(8):892-895.
[3]王英,李燕村,金延强,等.从“肺合大肠”探讨克罗恩病罕见肺部表现的病因病机理论基础[J].广州中医药大学学报, 2016, 33(6):877-880.
[4]唐旭东.消化系统常见疾病中医诊疗指南(基层医生版与患者科普版)的研制[C].//2017第十九届中国科协年会论文集. 2017:1.
[5]冉志华.炎症性肠病诊断与治疗的共识意见(2012年广州)克罗恩病诊断的部分解读[J].胃肠病学, 2012, 17(12):721-723.
[6]余慧芬,唐李,李妍.克罗恩病非手术治疗的研究进展[J].医学与哲学, 2018, 39(20):43-45.
[7]李冠炜,任建安.重视我国克罗恩病流行病学的研究[J].肠外与肠内营养, 2017, 24(3):135-137.
[8]陈聪,李品,彭莉,等.国医大师王琦从“脾胃外感”论治克罗恩病验案一则[J].环球中医药, 2018, 11(5):720-721.
[9]吴璐一,季光,赵继梦,等.中医药治疗克罗恩病的研究与思考[J].环球中医药, 2014, 7(5):393-397.
[10]陈锦锋.克罗恩病中医证治探讨[J].中医药导报, 2017, 23(5):9-11.
[11]巫协宁.克罗恩病发病机制的初步探索[J].国际消化病杂志,2017, 37(3):135-139.
[12]程滢瑞,吴霜,杨柏霖.克罗恩病发病机制的研究进展[J].现代中西医结合杂志, 2014, 23(36):4089-4092.
[13]巫协宁.饮食、肠道菌群、免疫等因素在克罗恩病发病机制中的作用[J].国际消化病杂志, 2016, 36(6):325-328.
[14] Wang YN, Zhang Y, Wang Y, et al. The beneficial effect of total glucosides of paeony of psoriathic arthritis links to circulating Tregs and Th1 Cell functions[J]. Phyther Res, 2014, 28(3):372-381.
[15] Poniedzialek B, Rzymski P, Karczewski J. Increased apoptosis of regulatory T cells in Crohn's disease[J]. Hepato-gastroenterology, 2014,61(130):382-384.
[16]金玲,杨钦河,张玉佩,等.疏肝健脾方药对非酒精性脂肪性肝炎大鼠肝组织TNF-α、 IL-6及IL-1的影响[J].暨南大学学报(自然科学与医学版), 2012, 33(2):161-166.
[17]梁菊玲.参苓白术散治疗肠道菌群失调相关疾病研究进展[J].亚太传统医药, 2017, 13(13):56-58.