化浊解毒方治疗溃疡性结肠炎的临床疗效及对患者神经内分泌因子的影响
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摘要
[目的]探讨化浊解毒方治疗溃疡性结肠炎(UC)的临床疗效及可能作用机制。[方法]120例UC患者按随机数字表法分为观察组和对照组各60例,观察组给予化浊解毒方,对照组给予美沙拉嗪肠溶片(1.0 g/次,3次/d),疗程4周。观察治疗前后主要症状评分、结肠镜变化,检测患者治疗前后血清神经递质(VIP、SP)及炎性因子IL-10水平,治疗后判断临床疗效,观察试验期间不良反应。[结果]2组患者治疗后主要症状积分(除对照组黏液脓血便、腹泻症状外)、Baron内镜评分及血清SP水平均较本组治疗前降低,VIP、IL-10水平升高(P<0.05);且观察组治疗后主要症状积分、Baron内镜评分及血清SP水平低于对照组治疗后,VIP、IL-10水平高于对照组治疗后(P<0.05)。观察组总有效率为82.46%,对照组为60.71%,观察组优于对照组(P<0.05)。治疗过程中观察组不良事件发生率为8.77%,对照组为10.71%(P>0.05)。[结论]化浊解毒方治疗UC临床效果优于美沙拉嗪肠溶片,其机制可能与调节血清神经内分泌因子(SP、VIP、IL-10)水平有关。
[Objective]To explore the clinical effect and possible mechanism of Huazhuo Jiedu prescription in the treatment of ulcerative colitis.[Methods]120 patients with ulcerative colitis were randomly divided into observation group and control group.The observation group was treated with Huazhuo Jiedu prescription and the control group was treated with Mesalazine enteric coated tablet(1.0 g each time,3 times a day),continuous treatment lasted 4 weeks.Observe the main symptom score and colonoscopic changes before and after treatment.Measure the neurotransmitter serotonin(VIP,SP)and inflammatory cytokines(IL-10)before and after treatment.Judge clinical efficacy after treatment and observe adverse reactions during the trial.[Results]After treatment,the main symptom scores(except the mucous pus,blood stool and diarrhea symptoms in the control group),Baron endoscopy scores and serum SP levels in the two groups were all lower than those before treatment and the levels of VIP,IL-10 were significantly increased(P<0.05);The main symptom scores,Baron endoscopy scores and serum SP levels in observation group were lower than in control group after treatment.Compared with control group,the levels of VIP,IL-10 in observation group were significantly increased after treatment(P<0.05).The total effective rate was 82.46% in the observation group and 60.71% in the control group,which was better than the control group(P<0.05).During the treatment,the incidence of adverse events was 8.77% in the observation group and 10.71% in the control group(P>0.05).[Conclusion]The therapeutic effect of Huazhuo Jiedu prescription on ulcerative colitis is better than that of Mesalazine enteric coated tablet.The mechanism may be related to the regulation of serum neuroendocrine factors(SP,VIP,IL-10).
[Objective]To explore the clinical effect and possible mechanism of Huazhuo Jiedu prescription in the treatment of ulcerative colitis.[Methods]120 patients with ulcerative colitis were randomly divided into observation group and control group.The observation group was treated with Huazhuo Jiedu prescription and the control group was treated with Mesalazine enteric coated tablet(1.0 g each time,3 times a day),continuous treatment lasted 4 weeks.Observe the main symptom score and colonoscopic changes before and after treatment.Measure the neurotransmitter serotonin(VIP,SP)and inflammatory cytokines(IL-10)before and after treatment.Judge clinical efficacy after treatment and observe adverse reactions during the trial.[Results]After treatment,the main symptom scores(except the mucous pus,blood stool and diarrhea symptoms in the control group),Baron endoscopy scores and serum SP levels in the two groups were all lower than those before treatment and the levels of VIP,IL-10 were significantly increased(P<0.05);The main symptom scores,Baron endoscopy scores and serum SP levels in observation group were lower than in control group after treatment.Compared with control group,the levels of VIP,IL-10 in observation group were significantly increased after treatment(P<0.05).The total effective rate was 82.46% in the observation group and 60.71% in the control group,which was better than the control group(P<0.05).During the treatment,the incidence of adverse events was 8.77% in the observation group and 10.71% in the control group(P>0.05).[Conclusion]The therapeutic effect of Huazhuo Jiedu prescription on ulcerative colitis is better than that of Mesalazine enteric coated tablet.The mechanism may be related to the regulation of serum neuroendocrine factors(SP,VIP,IL-10).
引文
[1] 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(2018年·北京)[J].中国实用内科杂志,2018,38(9):796-813.
[2] 中华医学会消化病学分会炎症性肠病协作组.对我国炎症性肠病诊断治疗规范的共识意见[J].胃肠病学,2007,12(8):488-495.
[3] 中华中医药学会脾胃病分会.溃疡性结肠炎中医诊疗共识(2009)[J].中国中西医结合杂志,2010,30(5):527-532.
[4] 中国中西医结合学会消化系统疾病专业委员会.溃疡性结肠炎中西医结合诊疗共识[J].现代消化及介入诊疗,2011,16(1):66-70.
[5] 郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:129-134.
[6] Baron JH,Connell AM,Lennard-dones.Variation between observers in describing mucosal appearances in proctocolitis[J].BMJ,1964,1:189-192.
[7] 袁川评,王玮,柳巨雄.神经-内分泌-免疫网络与炎症性肠病[J].世界华人消化杂志,2010,18(19):2024-2028.
[8] Thompson AI,Lees CW.Genetics of ulcerative colitis[J].Inflamm Bowel Dis,2011,17(3):831-848.
[9] 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.
[10] 裴林,李佃贵,曹东义,等.浊毒浅识[J].河北中医,2010,32(1):24-25.
[2] 中华医学会消化病学分会炎症性肠病协作组.对我国炎症性肠病诊断治疗规范的共识意见[J].胃肠病学,2007,12(8):488-495.
[3] 中华中医药学会脾胃病分会.溃疡性结肠炎中医诊疗共识(2009)[J].中国中西医结合杂志,2010,30(5):527-532.
[4] 中国中西医结合学会消化系统疾病专业委员会.溃疡性结肠炎中西医结合诊疗共识[J].现代消化及介入诊疗,2011,16(1):66-70.
[5] 郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:129-134.
[6] Baron JH,Connell AM,Lennard-dones.Variation between observers in describing mucosal appearances in proctocolitis[J].BMJ,1964,1:189-192.
[7] 袁川评,王玮,柳巨雄.神经-内分泌-免疫网络与炎症性肠病[J].世界华人消化杂志,2010,18(19):2024-2028.
[8] Thompson AI,Lees CW.Genetics of ulcerative colitis[J].Inflamm Bowel Dis,2011,17(3):831-848.
[9] 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.
[10] 裴林,李佃贵,曹东义,等.浊毒浅识[J].河北中医,2010,32(1):24-25.