肠炎清合剂治疗慢性复发型溃疡性结肠炎大肠湿热证的临床观察

丛龙玲; 吕永慧; 姚嘉茵; 吴宇金; 詹原泉

doi:10.13422/j.cnki.syfjx.20192031

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肠炎清合剂治疗慢性复发型溃疡性结肠炎大肠湿热证的临床观察

临床 | 更新时间：2021-02-09

- 肠炎清合剂治疗慢性复发型溃疡性结肠炎大肠湿热证的临床观察
- Clinical Efficacy of Changyanqing Mixture on Chronic Recurrent Ulcerative Colitis with Damp-heat Ayndrome of Large Intestine
- 中国实验方剂学杂志 2020年26卷第4期页码：120-125
- 作者机构：
  
  1.广州市中医医院，广州　 510130
  2.中山大学　附属第六医院，广州　 510655
- 作者简介：
  
  [第一作者]　丛龙玲，硕士，主治医师，从事中西医结合消化疾病的临床、教学与科研工作，E-mail：214470374@qq.com
  *吴宇金，副主任医师，从事中西医结合消化疾病的临床、教学与科研工作，E-mail：1411468321@qq.com
- 基金信息：
  
  广东省中医药局科研项目(20173029);广州市中医药和中西医结合科技项目(0025965A10621061)
- DOI：10.13422/j.cnki.syfjx.20192031
  中图分类号： R24:R289:R256:R442.2
- 收稿日期：2019-05-16，
  
  网络出版日期：2019-06-28，
  
  纸质出版日期：2020-02-20
- 稿件说明：
移动端阅览
丛龙玲, 吕永慧, 姚嘉茵, 等. 肠炎清合剂治疗慢性复发型溃疡性结肠炎大肠湿热证的临床观察[J]. 中国实验方剂学杂志, 2020,26(4):120-125.

Long-ling CONG, Yong-hui LYU, Jia-yin YAO, et al. Clinical Efficacy of Changyanqing Mixture on Chronic Recurrent Ulcerative Colitis with Damp-heat Ayndrome of Large Intestine[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(4): 120-125.
丛龙玲, 吕永慧, 姚嘉茵, 等. 肠炎清合剂治疗慢性复发型溃疡性结肠炎大肠湿热证的临床观察[J]. 中国实验方剂学杂志, 2020,26(4):120-125. DOI： 10.13422/j.cnki.syfjx.20192031.

Long-ling CONG, Yong-hui LYU, Jia-yin YAO, et al. Clinical Efficacy of Changyanqing Mixture on Chronic Recurrent Ulcerative Colitis with Damp-heat Ayndrome of Large Intestine[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(4): 120-125. DOI： 10.13422/j.cnki.syfjx.20192031.

摘要

目的：

观察肠炎清合剂对慢性复发型溃疡性结肠炎(UC)大肠湿热证患者诱导缓解效果及维持治疗对复发的影响，并从神经-内分泌-免疫炎症网络方面探讨了其作用机制。

方法：

将112例符合要求的患者随机分成对照组55例和观察组57例。对照组内服美沙拉嗪肠溶片，1.0 g/次，4次/d；Mayo评分系统≥7分者，加服醋酸泼尼松片，0.75 mg·kg

-1

·d

-1

；加用双歧杆菌活菌散剂，1包/次，2次/d，餐后温水冲服。观察组在对照组治疗的基础上服用肠炎清合剂，1包/次，分早晚2次服用。两组疗程均为连续治疗6周，再每周门诊复诊1次。进入缓解期后，两组患者均给予美沙拉嗪肠溶片，0.5 g/次，3次/d，维持治疗；观察组仍内服肠炎清合剂内服，至大肠湿热证评分减少≥90%以上。记录进入6周内缓解期的人数和缓解时间；进行治疗前后结肠镜检查，并进行Geboes指数和Baron法评价；进行治疗前后大肠湿热证评分和Mayo评分；检测治疗前后外周血白细胞介素-6(IL-6)，IL-8，IL-10，IL-17，血管活性肠肽(VIP)，胃动素(MTL)和神经肽Y(NPY)；随访24周，记录复发情况。

结果：

经6周治疗后，观察组临床有效率为100%，黏膜愈合率为96.4%，均分别高于对照组的89.09%和81.82%(

0.05)，两组患者内镜应答率均为100%；经6周治疗后，观察组临床缓解率为91.23%，高于对照组的76.36%(

＝4.581，

0.05)，观察组平均缓解时间短于对照组(

0.01)；治疗后观察组结肠黏膜评分，Geboes指数、大肠湿热证评分和Mayo评分均低于对照组(

0.01)；观察组患者外周血IL-6，IL-8和IL-17水平均低于对照组(

0.01)，IL-10水平高于对照组(

0.01)；观察组患者外周血VIP，MTL水平均低对照组(

0.01)，NPY水平高于对照组(

0.01)；观察组复发率为17.54%，低于对照组的38.18%(

＝5.955，

0.05)；观察组平均复发时间长于对照组(

0.01)。

结论：

在常规西医治疗的基础上，肠炎清合剂用于慢性复发型UC大肠湿热证的治疗，可诱导病情缓解，缩短病程，并能降低复发率，推迟复发时间，并对神经-内分泌-免疫炎症网络具有调节作用，从而可改善病情。

Abstract

Objective:

To observe the clinical efficacy of Changyanqing mixture on chronic recurrent ulcerative colitis (UC) with damp-heat syndrome of large intestine and the effect on the recurrence of disease

in order to discuss the mechanism of action in terms of the neuro-endocrine-immune inflammation network.

Method:

One hundred and twelve patients were randomly divided into control group (55 cases) and observation group (57 cases) by random number table. Patients in control group got mesalazine slow release tablets

0.1 g/time

4 times/days

and those the score of Mayo≥7 were added with prednisone acetate tablets

0.75 mg·kg

-1

·d

-1

and bifidobacterium viable powder with warm water after dinner

1 pack/day

2 times/days. In addition to the therapy of control group

patients in observation group were also given Changyanqing mixture in the morning and evening

1 pack/day. A course of treatment was 6 weeks

and patients got further consultation once a week. During the remission stage

patients in both groups got mesalazine slow release tablets

0.5 g/time

3 times/days

and patients in observation group were added with Changyanqing mixture until the score of damp-heat syndrome of large intestine reduced by more than 90%. The number of patients entering the remission stage of 6 weeks and the time of remission stage were recorded. Before and after treatment

colonoscopy was detected

and Geboes index

Baron

damp-heat syndrome of large intestine and Mayo were scored. And levels of peripheral blood interleukin-6 (IL-6)

IL-8

IL-10

IL-17

vasoactive intestinal peptide (VIP)

motilin (MTL) and neuropeptide (NPY) were detected

and relapse at the 24-week follow-up was recorded.

Result:

After the 6-week treatment

the clinical efficacy in observation group was 100%

which was higher than 89.09%in control group (

0.05). And the healing rate of mucosa was 96.4%

which was higher than 81.82%in control group (

0.05). And the response rate in two groups was 100%. At the 6

month after the treatment

the clinical remission rate in observation group was 91.23%

which was higher than 76.36%in control group (

=4.581

0.05). And the average remission time was shorter than that in control group (

0.01). After treatment

scores of colonic mucosa

Geboes index

colonic mucosa and Mayo were all lower than those in control group (

0.01). And levels of IL-6

IL-8

IL-17

VIP and MTL were lower than those in control group (

0.01)

while levels of IL-10 and NPY were higher than those in control group (

0.01). The relapse rate in observation group was 17.54%

which was lower than 38.18%in control group (

=5.955

0.05). And the mean recurrence time was longer than that in control group (

0.01).

Conclusion:

In addition to the routine western medicine therapy

Changyanqing mixture can alleviate the condition of patients by shortening the course of the disease

reducing the recurrence rate

delaying the recurrence time

and regulating the nerve-endocrine-immune inflammation network.

关键词

Keywords

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