摘要
目的观察健脾清肠汤对溃疡性结肠炎(Ulcerative colitis,UC)患者临床症状、结肠病变及免疫功能影响。方法选取2020年1月—2022年1月期间上海市中西医结合医院以及上海中医药大学附属龙华医院就诊的102例UC患者为研究对象,应用简单随机数字法将患者随机分为对照组51例和观察组51例。对照组给以美沙拉嗪+双歧杆菌三联活菌治疗,观察组在对照组的基础上给以健脾清肠汤治疗。治疗1个疗程(2个月)后,观察比较两组患者临床疗效、不良反应情况,治疗前后Sutherland评分、Baron评分和结肠组织病理评分,炎症因子[白细胞计数,C-反应蛋白(C-reactive protein,CRP)、白细胞介素6(Interleukin-6,IL-6)、白细胞介素8(Interleukin-8,IL-8)、肿瘤坏死因子α(Tumor necrosis factor-α,TNF-α)],免疫功能指标(外周血T淋巴细胞亚群CD3^(+)和CD4^(+)的水平和免疫球蛋白IgG、IgA水平)。结果治疗后观察组总有效率94.12%(48/51)明显高于对照组84.31%(43/51),差异有统计学意义(P<0.05)。治疗后两组患者Sutherland评分、Baron评分和结肠组织病理评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组Sutherland评分、Baron评分和结肠组织病理评分均较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者白细胞计数和CRP水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组白细胞计数和CRP水平均较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者IL-6、IL-8和TNF-α水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组IL-6、IL-8和TNF-α水平均较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者CD3^(+)、CD4^(+)水平均较治疗前升高,IgG、IgA水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组CD3^(+)、CD4^(+)水平均较对照组明显升高,IgG、IgA水平均较对照组明显降低,差异有统计学意义(P<0.05)。治疗期间,观察组不良反应发生率明显低于对照组,差异有统计学意义(χ^(2)=4.883,P=0.027,P<0.05)。结论健脾清肠汤对溃疡性结肠炎安全有效,能显著降低患者的结肠病变评分,降低炎症因子的表达水平,提高机体的免疫功能,具有较高的应用价值。
Objective To explore the effect of Jianpi Qingchang Decoction(JQD)on the clinical symptoms,colonlesions,and immune function in patients with ulcerative colitis(UC).Methods A total of 102 UC patients in Shanghai TCM-Integrated Hospital,Shanghai University of TCM and Longhua Hospital,Shanghai University of TCM were randomized into control group(n=51)and observation group(n=51).The control group was treated with mesalazine and Bifidobacterium Triple Viable Capsules,and the observation group was treated with JQD,mesalazine,and Bifidobacterium Triple Viable Capsules.After a course of treatment(2 months),the clinical efficacy and incidence of adverse reactions were observed and compared in the two groups,and the Sutherland score,Baron score,histopathology score of colon,inflammatoryfactors[white blood cell count,C-reactive protein(CRP),interleukin-6(IL-6),interleukin-8(IL-8),and tumor necrosis factor-α(TNF-α)],and immune function indicators(peripheral blood T lymphocyte subsets CD3^(+)and CD4^(+)and immunoglobulin IgG and IgA)were compared between the two groups before and after treatment.Results The total effective rate in the observation group was 94.12%(48/51),as compared with the 84.31%(43/51)in the control group(P<0.05).Sutherland score,Baron score,and histopathology score of colon were lower than those before treatment in both groups(P<0.05)and lower in the observation group than in the control group after treatment(P<0.05).White blood cell count and CRP level were lower than those before treatment in both groups(P<0.05)and lower in the observation group than in the control group after treatment(P<0.05).After treatment,the levels of IL-6,IL-8,and TNF-αdecreased as compared with those before treatment(P<0.05),and the levels in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of CD3^(+)and CD4^(+)in the two groups were higher and the levels of IgG and IgA were lower than those before treatment(P<0.05).The levels of CD3^(+)and CD4^(+)in the observation group were higher than those in the control group,and the levels of IgG and IgA were lower than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(χ^(2)=4.883,P=0.027,P<0.05).Conclusion JQD is safe and effective in treatment of UC.It can significantly reduce the score of colonlesions and the expression of inflammatory factors,and improve the immune function,which has high application value.
作者
华云玮
林俊儒
李放
戴彦成
HUA Yun-wei;LIN Jun-ru;LI Fang;DAI Yan-cheng(Department of Spleen and Stomach Diseases,Shanghai TCM-Integrated Hospital,Shanghai University of TCM,Shanghai 200032;Emergency Department of Longhua Hospital,Shanghai University of TCM,Shanghai 200032;Department of spleenand Spleen Diseases,Guanghua Hospital Affiliated,Shanghai University of TCM,Shanghai 200052)
出处
《世界中西医结合杂志》
2022年第10期2057-2061,2066,共6页
World Journal of Integrated Traditional and Western Medicine
基金
上海市科学技术委员会项目(16ZR1433800)
上海市虹口区卫生健康委员会临床重点扶持专科建设项目(HKZK2020A01)。
关键词
溃疡性结肠炎
美沙拉嗪
健脾清肠汤
炎症因子
免疫功能
Ulcerative Colitis
Mesalazine
Jianpi Qingchang Decoction
Inflammatory Factors
Immune Function
