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纸质出版日期:2016
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齐雪阳, 张勤生, 张春燕. 芍药汤加减保留灌肠联合美沙拉嗪肠溶片治疗大肠湿热证溃疡性结肠炎[J]. 中国实验方剂学杂志, 2016,22(19):149-153.
QI Xue-yang, ZHANG Qin-sheng, ZHANG Chun-yan. Clinical Effect of Modified Treatment of Shaoyao Tang Retention Enema Combined with Mesalazine on Ulcerative Colitis with Large Intestine Damp-heat[J]. Chinese journal of experimental traditional medical formulae, 2016, 22(19): 149-153.
齐雪阳, 张勤生, 张春燕. 芍药汤加减保留灌肠联合美沙拉嗪肠溶片治疗大肠湿热证溃疡性结肠炎[J]. 中国实验方剂学杂志, 2016,22(19):149-153. DOI: 10.13422/j.cnki.syfjx.2016190149.
QI Xue-yang, ZHANG Qin-sheng, ZHANG Chun-yan. Clinical Effect of Modified Treatment of Shaoyao Tang Retention Enema Combined with Mesalazine on Ulcerative Colitis with Large Intestine Damp-heat[J]. Chinese journal of experimental traditional medical formulae, 2016, 22(19): 149-153. DOI: 10.13422/j.cnki.syfjx.2016190149.
目的:探讨芍药汤加减保留灌肠联合美沙拉嗪肠溶片的中西医结合方案治疗大肠湿热型溃疡性结肠炎(UC)的临床疗效及对免疫炎症反应的影响。方法:将160例符合条件的UC患者随机按数字表法分为对照组和观察组各80例。对照组采用美沙拉嗪肠溶片,吞服勿咀嚼,1 g/次,4次/d;及氢化可的松琥珀酸钠盐灌肠液100~200 mg
保留灌肠。观察组采用美沙拉嗪肠溶片内服及芍药汤加减保留灌肠。两组保留灌肠每周5 d,休息2 d,均连续治疗8周。进行治疗前后Sutherland疾病活动指数,Baron评分,Geboes指数和大肠湿热证评分;采用IBDQ量表评价患者治疗前后生活质量;检测治疗前后肿瘤坏死因子-α(TNF-α),白细胞介素-4(IL-4),IL-1β,IL-10,转化生长因子-β(TGF-β)和基质金属蛋白酶-1(MMP-1)水平。结果:观察组疾病综合疗效总有效率为90%,高于对照组的76.25%,差异有统计学意义(P<0.05);观察组中医证候总有效率为92.5%,高于对照组的75%,差异有统计学意义(P<0.01);治疗后观察组Sutherland疾病活动指数,Baron评分,Geboes指数和大肠湿热证评分均低于对照组(P<0.01);治疗后观察组IBDQ量表之肠道症状、全身症状、情感能力、社会能力4个维度评分和总分均高于对照组(P<0.01);治疗后观察组血清IL-1β和TNF-α水平低于对照组,IL-4和IL-10高于对照组(P<0.01);治疗后观察组TGF-β高于对照组,MMP-1低于对照组(P<0.01)。结论:芍药汤加减保留灌肠联合美沙拉嗪肠溶片口服治疗活动期大肠湿热型UC患者,能改善临床症状,提高肠黏膜愈合,提高患者的生活质量,调节患者的免疫功能和炎症反应。
Objective: To discuss the clinical efficacy of modified treatment of Shaoyao Tang retention enema combined with mesalazine in treating large intestine damp-heat type ulcerative colitis(UC)
and investigate its effects on immuno-inflammatory responses. Method: One hundred and sixty UC patients were randomly divided into control group(80 cases) and observation group(80 cases) by random number table. Patients in control group took mesalazine enteric-coated tablets by swallowwing
1 g/time
4 times/day
hydrocortisone sodium succinate for enema
100-200 mg. Patients in observation group took modified treatment of Shaoyao Tang retention enema combined with mesalazine. For both groups
enema was retained for 5 days a week and 2 days for rest
with continuous treatment courses of 8 weeks. Before and after treatment
scores of Sutherland disease activity index
Baron scores
Geboes indexes and large intestine damp-heat syndrome scores were graded. Patients' quality of life were evaluated by IBDQ scale. Levels of tumor necrosis factor-α(TNF-α)
interleukin-4(IL-4)
interleukin-1β(IL-1β)
interleukin-10(IL-10)
transforming growth factor(TGF-β)
and matrix metalloproteinase-1(MMP-1) were detected before and after treatment. Result: The total effect rate of comprehensive efficacy was 90%in observation group
higher than 76.25%in control group
with statistically significant difference between two groups(P<0.05). The total effect rate of TCM syndrome was 92.5%in observation group
higher than 75%in control group
with statistically significant difference between two groups(P<0.01). After treatment
the scores of Sutherland disease activity index
Baron scores
Geboes indexes and large intestine damp-heat syndrome scores in observation group were all lower than those in control group(P<0.01). The individual scores and total scores of intestinal symptoms
general symptoms
emotional capability and social competence in IBDQ scale of observation group were higher than those in control group(P<0.01). Levels of serum IL-1β
TNF-α and MMP-1 were lower than those in control group
and levels of IL-4
IL-10 and TGF-β were higher than those in control group(P<0.01). Conclusion: Modified treatment of Shaoyao Tang retention enema combined with mesalazine can improve clinical symptoms
patients' quality of life and healing quality of intestinal mucosa
and regulate immuno-inflammatory responses in treatment of UC with large intestine damp-heat at active stage.
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