理肠汤对脾虚湿困型溃疡性结肠炎患者肠道微生态、代谢产物及炎症因子的影响
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摘要
目的:探讨理肠汤对脾虚湿困型溃疡性结肠炎(Ulcerative colitis,UC)患者肠道微生态及其代谢产物的影响。方法:将77例轻、中度UC患者随机分为治疗组和对照组,治疗组用理肠汤联合柳氮磺胺吡啶肠溶片进行干预,对照组用柳氮磺胺吡啶肠溶片干预,对比2组患者有效率、疾病活动指数(DAI)评分、结肠镜检查(Baron)评分、生活质量评定(IBDQ)量表积分、肠道微生态、短链脂肪酸、血清脑肠肽及炎症因子的含量变化。结果:与对照组比较,治疗组总有效率较高,能更好的降低脾虚湿困型患者Baron评分、提高IBDQ量表积分,提高肠道双歧杆菌、消化球菌含量,降低酵母菌含量,提高乙酸、VIP含量,降低SP含量,降低血清TNF-α含量,提高IL-10含量,差异均有统计学意义(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 explore the effect of Lichang tang on intestinal microecology and its metabolites of ulcerative colitis(UC) of spleen deficiency leading to damp encumbrance type. Methods: Divided 77 cases of patients with mild to moderate UC into the treatment group and the control group randomly. The control group received Lichang tang combined with sulfasalazine enteric-coated tablets for intervention, while the control group only received sulfasalazine enteric-coated tablets. Compared the effective rate, and the changes of disease active index(DAI) scores,Baron scores,inflammatory bowel disease questionnaire(IBDQ) scores,and the contents of intestinal microecology, short chain fatty acids, brain-gut peptide and inflammatory factor in serum in the two groups. Results: The total effective rate in the treatment group was higher than that in the control group. The therapy adopted in the treatment group better decreased the Baron score, increased IBDQ scores,increased the contents of bifidobacterium and peptococcus in intestine, decrease the content of yeast,increase the contents of acetic acid and VIP,decreased the contents of SP and serum TNF-α,and increased the content of IL-10 of UC patients of spleen deficiency leading to damp encumbrance type,differences being significant(P < 0.05). No adverse reaction was found during the treatment. Conclusion: Lichang tang is safe and effective in treating UC patients of spleen deficiency leading to damp encumbrance type.
Objective: To explore the effect of Lichang tang on intestinal microecology and its metabolites of ulcerative colitis(UC) of spleen deficiency leading to damp encumbrance type. Methods: Divided 77 cases of patients with mild to moderate UC into the treatment group and the control group randomly. The control group received Lichang tang combined with sulfasalazine enteric-coated tablets for intervention, while the control group only received sulfasalazine enteric-coated tablets. Compared the effective rate, and the changes of disease active index(DAI) scores,Baron scores,inflammatory bowel disease questionnaire(IBDQ) scores,and the contents of intestinal microecology, short chain fatty acids, brain-gut peptide and inflammatory factor in serum in the two groups. Results: The total effective rate in the treatment group was higher than that in the control group. The therapy adopted in the treatment group better decreased the Baron score, increased IBDQ scores,increased the contents of bifidobacterium and peptococcus in intestine, decrease the content of yeast,increase the contents of acetic acid and VIP,decreased the contents of SP and serum TNF-α,and increased the content of IL-10 of UC patients of spleen deficiency leading to damp encumbrance type,differences being significant(P < 0.05). No adverse reaction was found during the treatment. Conclusion: Lichang tang is safe and effective in treating UC patients of spleen deficiency leading to damp encumbrance type.
引文
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[16]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.
[17]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.
[18]赵天平,吴焕淦.炎症性肠病的中枢神经机制[C]//中国针灸学会针刺麻醉分会.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论文集,武汉:[出版者不详],2007.
[19]孟良艳,陈秀琴,石达友,等.四君子汤对脾虚大鼠肠道菌群多样性的影响[J].畜牧兽医学报,2013,44(12):2029-2035.
[2]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,2016,29(4):71-74.
[3]邵铁娟,李海昌,谢志军,等.基于脾主运化理论探讨脾虚湿困与肠道菌群紊乱的关系[J].中华中医药杂志,2014,29(12):3762-3765.
[4]赵晓霞,郭胜,李宝鹤,等.芍药汤对溃疡性结肠炎大鼠ICAM-1、TNF-α、IL-10影响的实验研究[J].中国中医药科技,2008,15(3):174-175.
[5]江学良,崔慧斐.对我国炎症性肠病诊断治疗规范的共识意见的解析[J].世界华人消化杂志,2008,16(11):1141-1143.
[6]欧阳钦,潘国宗,温忠慧,等.对炎症性肠病诊断治疗规范的建议(2000年)[J].现代实用医学,2003,15(10):656-659.
[7]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.
[8]夏剑,邓夫生,张明,等.姜黄素对溃疡性结肠炎小鼠肠黏膜内NF-κB及TNF-α表达的影响[J].世界华人消化杂志,2005,13(2):255-257.
[9]谢中华,汪铁军,郑元秀,等.舒血宁注射液联合常规疗法治疗活动期溃疡性结肠炎患者疗效观察[J].中国中西医结合杂志,2014,34(10):1164-1167.
[10]戴彦成,郑烈,张亚利,等.健脾清肠方对溃疡性结肠炎患者生活质量作用的随机对照试验(英文)[J].中华中医药杂志,2016,31(5):1926-1932.
[11]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.
[12]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.
[13]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002.
[14]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].Journal of Gastroenterology,2011,46(4):479.
[15]Walker AW,Sanderson JD,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.
[16]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.
[17]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.
[18]赵天平,吴焕淦.炎症性肠病的中枢神经机制[C]//中国针灸学会针刺麻醉分会.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论文集,武汉:[出版者不详],2007.
[19]孟良艳,陈秀琴,石达友,等.四君子汤对脾虚大鼠肠道菌群多样性的影响[J].畜牧兽医学报,2013,44(12):2029-2035.