黄芪颗粒联合双歧杆菌四联活菌片治疗溃疡性结肠炎临床研究
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摘要
目的:观察黄芪颗粒联合双歧杆菌四联活菌片治疗溃疡性结肠炎的临床疗效及对患者免疫功能、炎症水平、凝血功能的影响。方法:将溃疡性结肠炎患者72例随机分为观察组和对照组,各36例;对照组采用双歧杆菌四联活菌片进行治疗,观察组患者在对照组基础上加用黄芪颗粒进行治疗;2组疗程均为8周,观察比较2组临床疗效,并评估2组患者免疫功能(血清lgG、lgA、lgM)水平、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-8、IL-4、IL-10、IL-13]水平及凝血功能[纤维蛋白原(Fib)水平、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)及凝血酶时间(TT)]。结果:总有效率观察组为91.67%,对照组为69.44%,两组比较,差异有统计学意义(P <0.05)。治疗后,2组血清中lgA、lgG的水平均较治疗前下降(P <0.05);且观察组上述两项指标明显低于对照组(P <0.05)。2组患者血清lgM水平治疗前后变化不大(P> 0.05)。治疗后,2组患者血清TNF-α、IL-6、IL-8的水平均较治疗前降低(P <0.05),IL-4、IL-10、IL-13的水平较治疗前升高(P <0.05);且观察组上述各项指标改善均优于对照组(P <0.05)。治疗后,2组APTT、TT较治疗前明显缩短(P <0.05),PT较治疗前明显延迟(P<0.05),Fib水平较治疗前明显降低(P <0.05);且观察组上述各项指标改善均优于对照组(P <0.05)。结论:黄芪颗粒联合双歧杆菌四联活菌片治疗溃疡性结肠炎疗效显著,并能显著改善患者免疫功能、炎症水平及凝血功能,疗效优于单纯西药治疗。
Objective: To observe the clinical effect of astragalus granule combined with bifidobacterium tetravaccine tablets for ulcerative colitis,and its effect on the immune function,inflammatory level and coagulation function of patients.Methods:Divided 72 cases of patients with ulcerative colitis into the observation group and the control group randomly,36 cases in each group. The control group received bifidobacterium tetravaccine tablets,while the observation group additionally received astragalus granule. The treatment for both groups lasted for 8 weeks. Observed and compared the clinical effect in both groups, and evaluated the levels of immune function(serum Ig G, Ig A, Ig M), inflammatory factors [tumor necrosis factor-α(TNF-α), interleukin(IL)-6, IL-8, IL-4, IL-10, IL-13] and coagulation function [the level of fibrinogen(Fib),prothrombin time(PT), activated partial thromboplastin time(APTT) and thrombin time(TT)]. Results: The total effective rate was 91.67% in the observation group and 69.44% in the control group, difference being significant(P < 0.05). After treatment,the levels of Ig A and Ig G in both groups were lower than those before treatment(P < 0.05);each index above in the observation group was significantly lower than that in the control group(P < 0.05). There was no significant difference being found in the level of serum Ig M of patients in both groups(P > 0.05). After treatment,the levels of TNF-α,IL-6 and IL-8 in serum of patients in both groups were all lower than those before treatment(P < 0.05),and the levels of IL-4,IL-10 and IL-13 were higher than those before treatment(P < 0.05);each index above in the observation group was improved better than that in the control group(P < 0.05). After treatment,APTT and TT in both groups were significantly shorter than those before treatment(P < 0.05),PT was significantly postponed when comparing with that before treatment(P < 0.05),and the level of Fib was significantly lower than that before treatment(P < 0.05); each index above in the observation group was improved better than that in the control group(P < 0.05). Conclusion: Astragalus granule combined with bifidobacterium tetravaccine tablets has significant clinical effect in treating ulcerative colitis, which can evidently improve the immune function,inflammatory level and coagulation function of patients. It has better clinical effect than the treatment with simple western medicine.
Objective: To observe the clinical effect of astragalus granule combined with bifidobacterium tetravaccine tablets for ulcerative colitis,and its effect on the immune function,inflammatory level and coagulation function of patients.Methods:Divided 72 cases of patients with ulcerative colitis into the observation group and the control group randomly,36 cases in each group. The control group received bifidobacterium tetravaccine tablets,while the observation group additionally received astragalus granule. The treatment for both groups lasted for 8 weeks. Observed and compared the clinical effect in both groups, and evaluated the levels of immune function(serum Ig G, Ig A, Ig M), inflammatory factors [tumor necrosis factor-α(TNF-α), interleukin(IL)-6, IL-8, IL-4, IL-10, IL-13] and coagulation function [the level of fibrinogen(Fib),prothrombin time(PT), activated partial thromboplastin time(APTT) and thrombin time(TT)]. Results: The total effective rate was 91.67% in the observation group and 69.44% in the control group, difference being significant(P < 0.05). After treatment,the levels of Ig A and Ig G in both groups were lower than those before treatment(P < 0.05);each index above in the observation group was significantly lower than that in the control group(P < 0.05). There was no significant difference being found in the level of serum Ig M of patients in both groups(P > 0.05). After treatment,the levels of TNF-α,IL-6 and IL-8 in serum of patients in both groups were all lower than those before treatment(P < 0.05),and the levels of IL-4,IL-10 and IL-13 were higher than those before treatment(P < 0.05);each index above in the observation group was improved better than that in the control group(P < 0.05). After treatment,APTT and TT in both groups were significantly shorter than those before treatment(P < 0.05),PT was significantly postponed when comparing with that before treatment(P < 0.05),and the level of Fib was significantly lower than that before treatment(P < 0.05); each index above in the observation group was improved better than that in the control group(P < 0.05). Conclusion: Astragalus granule combined with bifidobacterium tetravaccine tablets has significant clinical effect in treating ulcerative colitis, which can evidently improve the immune function,inflammatory level and coagulation function of patients. It has better clinical effect than the treatment with simple western medicine.
引文
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[6] SIMPSON H L, RHODES J M, CAMPBELL B J.Mo1787Soluble Plantain(Banana)Fibre Inhibits the Epithelial IL-8 and Cytotoxicity Response to Ulcerative Colitis(UC)MucosallyAssociated Escherichia coli[J].Gastroenterology,2015,148(4):S711.
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[9]刘跃平,王志敏,柳茂森,等.黄芩汤加减联合培菲康胶囊对溃疡性结肠炎的干预效果及对免疫功能的影响[J].中华中医药学刊,2015,27(6):1522-1526.
[2]黎莉,杨卫文,谭松,等.溃疡性结肠炎患者外周血及结肠黏膜TNF-α、IL-6和IL-2变化的临床意义[J].中国现代医学杂志,2016,26(14):42-47.
[3]王威.炎症性肠病回盲部溃疡内镜下特征性表现与鉴别诊断[J].中国内镜杂志,2016,22(6):13-15.
[4]沈洪,朱磊,张露.溃疡性结肠炎中医药疗效评价策略[J].中医杂志,2016,57(2):126-130.
[5]汪芸,崔丁鹿.溃疡性结肠炎脾胃气虚证的研究进展[J].现代中西医结合杂志,2015,24(25):2845-2847.
[6] SIMPSON H L, RHODES J M, CAMPBELL B J.Mo1787Soluble Plantain(Banana)Fibre Inhibits the Epithelial IL-8 and Cytotoxicity Response to Ulcerative Colitis(UC)MucosallyAssociated Escherichia coli[J].Gastroenterology,2015,148(4):S711.
[7] THOMAS B,PAUL R,MARC F,et al.Targeting TNF-αfor the treatment of inflammatory bowel disease[J].Expert Opinion on Biological Therapy,2014,14(1):75-101.
[8]王艳,李俊霞,王化虹,等.溃疡性结肠炎肠道菌群失调与免疫球蛋白水平的相关性[J].实用医学杂志,2016,32(10):1631-1634.
[9]刘跃平,王志敏,柳茂森,等.黄芩汤加减联合培菲康胶囊对溃疡性结肠炎的干预效果及对免疫功能的影响[J].中华中医药学刊,2015,27(6):1522-1526.