当归芍药散合槐花散加减治疗溃疡性结肠炎活动期大肠湿热证的临床观察

刘芳; 雷娜; 唐学贵

doi:10.13422/j.cnki.syfjx.20191832

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当归芍药散合槐花散加减治疗溃疡性结肠炎活动期大肠湿热证的临床观察

临床 | 更新时间：2021-02-09

- 当归芍药散合槐花散加减治疗溃疡性结肠炎活动期大肠湿热证的临床观察
- Clinical Observation of Addition and Subtraction Therapy of Danggui Shaoyaosan Combined with Huaihuasan to Ulcerative Colitis with Syndrome of Dampness-heat in Large Intestine During Active Stage
- 中国实验方剂学杂志 2019年25卷第20期页码：82-87
- 作者机构：
  
  1.川北医学院　附属医院，四川　南充　 637001；
  2.成都中医药大学，成都　 610015
- 作者简介：
  
  刘芳，硕士，讲师，从事中西医结合肛肠的临床、教学与科研工作，E-mail：486058056@qq.com
  唐学贵，博士，教授，博士生导师，从事中西医结合肛肠的临床、教学与科研工作，E-mail: Txg668nc@sohu.com
- 基金信息：
  
  国家自然科学基金项目(81573990)
- DOI：10.13422/j.cnki.syfjx.20191832
  中图分类号： R289; R5; R57; R574
- 收稿日期：2019-04-16，
  
  网络出版日期：2019-05-28，
  
  纸质出版日期：2019-10-20
- 稿件说明：
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刘芳, 雷娜, 唐学贵. 当归芍药散合槐花散加减治疗溃疡性结肠炎活动期大肠湿热证的临床观察[J]. 中国实验方剂学杂志, 2019,25(20):82-87.

Fang LIU, Na LEI, Xue-gui TANG. Clinical Observation of Addition and Subtraction Therapy of Danggui Shaoyaosan Combined with Huaihuasan to Ulcerative Colitis with Syndrome of Dampness-heat in Large Intestine During Active Stage[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(20): 82-87.
刘芳, 雷娜, 唐学贵. 当归芍药散合槐花散加减治疗溃疡性结肠炎活动期大肠湿热证的临床观察[J]. 中国实验方剂学杂志, 2019,25(20):82-87. DOI： 10.13422/j.cnki.syfjx.20191832.

Fang LIU, Na LEI, Xue-gui TANG. Clinical Observation of Addition and Subtraction Therapy of Danggui Shaoyaosan Combined with Huaihuasan to Ulcerative Colitis with Syndrome of Dampness-heat in Large Intestine During Active Stage[J]. Chinese journal of experimental traditional medical formulae, 2019, 25(20): 82-87. DOI： 10.13422/j.cnki.syfjx.20191832.

摘要

目的：

观察当归芍药散合槐花散加减治疗溃疡性结肠炎(UC)活动期大肠湿热证及对脑肠肽神经递质和炎细胞因子的影响。

方法：

共纳入130例随机按数字表法分成对照组和观察组各65例。对照组口服美沙拉嗪肠溶片1.0 g/次，3次/d；重度患者给予醋酸泼尼松片，0.75 mg·kg

－1

·d

－1

，分次口服。观察组在对照组治疗的基础上给予当归芍药散合槐花散加减内服，1剂/d。两组疗程均为连续治疗4周。进行治疗前后症状评分，Mayo评分、结肠黏膜评分和炎症性肠病问卷(IBDQ)评分；对于进入缓解期的患者进行6个月的随访，记录复发情况；检测治疗前后血管活性肠肽(VIP)，P物质(SP)，生长抑素(SS)，白细胞介素-1(IL-1)，IL-6，IL-4和IL-10。

结果：

经4周的治疗，观察组临床缓解率为93.22%，优于对照组的80.7%(

＝4.035，

0.05)；观察组患者各症状评分均低于对照组(

0.01)；观察组患者Mayo评分和结肠黏膜评分均低于对照组(

0.01)；观察组患者IBDQ量表各个维度评分和IBDQ总分均高于对照组(

0.01)；对临床缓解患者进行6个月随访，观察组复发率为18.18%，低于对照组的36.96%(

＝4.509，

0.05)，且复发时间长于对照组(

0.01)；观察组患者血清IL-1，IL-6水平均低于对照组(

0.01)，IL-4，IL-10水平均高于对照组(

0.01)；观察组患者血浆VIP和SS均高于对照组(

0.01)，SP水平低于对照组(

0.01)。

结论：

在西医常规治疗的基础上，当归芍药散合槐花散加减治疗UC(大肠湿热证)活动期患者，近期可控制疾病活动，促进结肠黏膜修复，远期可推迟复发，降低复发率，并可调节脑肠肽神经递质和促炎/抑炎细胞因子水平。

Abstract

Objective:

To observe the effects of addition and subtraction therapy of Danggui Shaoyaosan combined with Huaihuasan on ulcerative colitis (UC) with syndrome of dampness-heat in large intestine during active stage

and the effects on brain-gut petide neurotransmitter and inflammatory cytokines.

Method:

A total of 130 cases were included and randomly divided into control group and observation group

65 cases in each group. In the control group

the patients received oral administration of mesalazine enteric-coated tablets

1.0 g/time and 3 times/days. Severe patients received prednisone acetate tablets (0.75 mg·kg

-1

·d

-1

) in several times by oral administration. Based on the treatment in control group

patients in observation group also received addition and subtraction therapy of Danggui Shaoyaosan combined with Huaihuasan

1 dose/day. Both groups were treated for 4 weeks. Symptom scores

Mayo scores

colonic mucosa scores and Inflammatory Bowel Disease Questionnaire (IBDQ) scores were assessed before and after treatment. Patients in remission stage were followed up for 6 months to record the recurrence. Before and after treatment

vasoactive intestinal peptide (VIP)

substance P (SP)

somatostatin (SS)

interleukin-1 (IL-1)

IL-6

IL-4 and IL-10 were detected.

Result:

After 4 weeks of treatment

the clinical remission rate was 93.22%in the observation group

better than 80.7%in the control group (

=4.035

0.05). The scores of various symptoms in the observation group were lower than those in the control group (

0.01). The Mayo scores and colonic mucosal scores in the observation group were lower than those in the control group (

0.01). The IBDQ scores in all dimensions and the total IBDQ scores in the observation group were higher than those in the control group (

0.01). In 6 months of follow up for the patients in clinical remission stage

the recurrence rate in the observation group was 18.18%

lower than 36.96%in the control group (

=4.509

0.05)

and the recurrence time was longer than that in the control group (

0.01). The levels of serum IL-1 and IL-6 in the observation group were lower than those in the control group (

0.01)

and the levels of IL-4 and IL-10 were higher than those in the control group (

0.01). Plasma VIP and SS levels in the observation group were higher than those in the control group (

0.01)

while SP levels were lower than those in the control group (

0.01).

Conclusion:

On the basis of conventional western medicine treatment

addition and subtraction therapy of Danggui Shaoyaosan combined with Huaihuasan in the treatment of UC (dampness-heat in large intestine) during active stage can control the disease activity in a short term

promote restoration of the colonic mucosa. And delay the recurrence in a long term

reduce the recurrence rate

regulate ghrelin neurotransmitters and pro-and anti-inflammatory cytokines levels.

关键词

Keywords

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