基于“微生物-脑-肠轴”观察理肠汤对脾虚湿困型溃疡性结肠炎患者的作用
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摘要
[目的]探讨理肠汤通过"微生物-脑-肠轴"对溃疡性结肠炎(UC)患者的作用。[方法 ]治疗组以理肠汤联合柳氮胺吡啶肠溶片,单纯服用柳氮磺胺吡啶肠溶片为对照组,干预脾虚湿困型UC患者,对比2组患者肠道微生态、血清脑肠肽、短链脂肪酸的改善情况。并对比患者结肠镜下黏膜评分的改善程度。[结果]治疗组在双歧杆菌、乳杆菌、酵母菌的改善方面明显优于对照组(P<0.05);对SP、SS、乙酸、丙酸的调节优于对照组(P<0.05);对患者肠镜下黏膜变脆易损及黏膜损害改善也明显优于对照组(P<0.05)。且在治疗过程中未发现临床不良事件的发生。[结论]理肠汤对脾虚湿困型UC患者安全有效。
[Objective]To investigate the effect of Lichang decoction on patients with ulcerative colitis(UC)through " microbial-brain-gut axis".[Methods]The treatment group was treated with Lichang decoction combined with sulfasalazine enteric-coated tablets,and the single administration of salazylaminopyridine enterolysis tablets was used as the control group to intervene in wet-trapped UC patients with spleen deficiency,the improvement of intestinal microecology,serum brain-gut peptide and short-chain fatty acid in the two groups were compared,and the degree of improvement of the colonic mucosal score in patients were compared.[Results]The treatment group was significantly better than the control group in the improvement of Bifidobacterium,Lactobacillus and Yeast(P<0.05).The regulation of SP,SS,acetic acid and propionic acid was better than that of the control group(P<0.05).The mucosal embrittlement and mucosal damage of the patients under the colonoscopy was also significantly better than the control group(P<0.05).No clinical adverse events were found during the treatment.[Conclusion]Lichang decoction is safe and effective for patients for spleen-deficiency and dampness-type UC patients.
[Objective]To investigate the effect of Lichang decoction on patients with ulcerative colitis(UC)through " microbial-brain-gut axis".[Methods]The treatment group was treated with Lichang decoction combined with sulfasalazine enteric-coated tablets,and the single administration of salazylaminopyridine enterolysis tablets was used as the control group to intervene in wet-trapped UC patients with spleen deficiency,the improvement of intestinal microecology,serum brain-gut peptide and short-chain fatty acid in the two groups were compared,and the degree of improvement of the colonic mucosal score in patients were compared.[Results]The treatment group was significantly better than the control group in the improvement of Bifidobacterium,Lactobacillus and Yeast(P<0.05).The regulation of SP,SS,acetic acid and propionic acid was better than that of the control group(P<0.05).The mucosal embrittlement and mucosal damage of the patients under the colonoscopy was also significantly better than the control group(P<0.05).No clinical adverse events were found during the treatment.[Conclusion]Lichang decoction is safe and effective for patients for spleen-deficiency and dampness-type UC patients.
引文
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[2] Shimoda M,Horiuchi K,Sasaki A,et al.Epithelial Cell-Derived a Disintegrin and Metalloproteinase-17Confers Resistance to Colonic Inflammation Through EGFR Activation[J].EBio Med,2016,5:114-124.
[3] Hanauer S B.Inflammatory bowel disease:epidemiology,pathogenesis,and therapeutic opportunities[J].Inflam Bowel Dis,2006,12(5):S3-S9.
[4] Nishii S,Higashiyama M,Ogata S,et al.Human intestinal spirochetosis mimicking ulcerative colitis[J].Clin J Gastroenterol,2018,11(2):145-149.
[5]孙平良,钟元帅,李裕波,等.溃疡性结肠炎中医病因病机研究进展[J].中医研究,29(4):71-74.
[6]赵新芳,甘霞,林红,等.化毒愈肠方内服和灌肠治疗溃疡性结肠炎的疗效及对血清IL-22和IL-23的影响[J].中国实验方剂学杂志,2016,22(4):178-181.
[7]王振疆,陈渝萍,黄剑迎,等.结肠宁对溃疡性结肠炎患者肠道微生态的影响[J].广东医学,37(13):2033-2035.
[8]傅丽霞.双歧杆菌四联活菌片治疗腹泻型肠易激综合征患者的疗效及对血清脑肠肽水平的影响[J].中国微生态学杂志,2017,29(2):179-181.
[9]李国法.麦芽纤维对UC大鼠大肠内容物中SCFAs及结肠组织、血清中EGF含量的影响[D].杭州:浙江中医药大学,2011.
[10]李静,柳玉强,袁元.健脾清肠方联合美沙拉嗪对改善溃疡性结肠炎患者生活质量的影响[J].中国中西医结合消化杂志,2018,26(9):783-787.
[11]单海燕,张雪莹,谷海燕,等.电针联合五音疗法治疗伴焦虑抑郁状态溃疡性结肠炎40例临床观察[J].中国中西医结合消化杂志,2018,26(9):775-777.
[12]赵天平,吴焕淦.炎症性肠病的中枢神经机制[G]//第九届全国针刺麻醉针刺镇痛及针刺调整效应学术研讨会,2007.
[13]Andoh A,Imaeda H,Aomatsu T,et al.Comparison of the fecal microbiota profiles between ulcerative colitis and Crohn's disease using terminal restriction fragment length polymorphism analysis[J].J Gastroenterol,2011,46(4):479-486.
[14]Walker A W,Sanderson J D,Churcher C,et al.Highthroughput clone library analysis of the mucosa-associated microbiota reveals dysbiosis and differences between inflamed and non-inflamed regions of the intestine in inflammatory bowel disease[J].Bmc Microbiology,2011,11(1):7.
[15]王振疆,陈渝萍,黄剑迎,等.结肠宁对溃疡性结肠炎患者肠道微生态的影响[J].广东医学,2016,37(13):2033-2035.
[16]Arpaia N,Campbell C,Fan X,et al.Metabolites produced by commensal bacteria promote peripheral regulatory T-cell generation[J].Nature,2013,504(7480):451-455.