槐花散合桃花汤加减对溃疡性结肠炎活动期寒热错杂证免疫炎症的调节作用

雷娜; 孔鹏飞; 陈思敏; 唐学贵

doi:10.13422/j.cnki.syfjx.20192232

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槐花散合桃花汤加减对溃疡性结肠炎活动期寒热错杂证免疫炎症的调节作用

临床 | 更新时间：2021-02-09

- 槐花散合桃花汤加减对溃疡性结肠炎活动期寒热错杂证免疫炎症的调节作用
- Regulatory Effect of Huaihuasan Combined with Taohuatang on Immune Inflammation During Active Period of Ulcerative Colitis with Cold-heat Syndrome
- 中国实验方剂学杂志 2020年26卷第7期页码：86-91
- 作者机构：
  
  1.成都中医药大学　附属医院，成都　 610072
  2.川北医学院　附属医院，四川南充　 637002
- 作者简介：
  
  [第一作者]　雷娜，在读硕士，医师，从事肛肠疾病中西医结合临床诊治和研究工作，E-mail：805055027@qq.com
  *唐学贵，博士，教授，博士生导师，从事中西医结合消化疾病的临床、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.20192232
  中图分类号： R25;R256;R256.3;R289
- 收稿日期：2019-07-24，
  
  网络出版日期：2019-08-16，
  
  纸质出版日期：2020-04-05
- 稿件说明：
移动端阅览
雷娜, 孔鹏飞, 陈思敏, 等. 槐花散合桃花汤加减对溃疡性结肠炎活动期寒热错杂证免疫炎症的调节作用[J]. 中国实验方剂学杂志, 2020,26(7):86-91.

Na LEI, Peng-fei KONG, Si-min CHEN, et al. Regulatory Effect of Huaihuasan Combined with Taohuatang on Immune Inflammation During Active Period of Ulcerative Colitis with Cold-heat Syndrome[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(7): 86-91.
雷娜, 孔鹏飞, 陈思敏, 等. 槐花散合桃花汤加减对溃疡性结肠炎活动期寒热错杂证免疫炎症的调节作用[J]. 中国实验方剂学杂志, 2020,26(7):86-91. DOI： 10.13422/j.cnki.syfjx.20192232.

Na LEI, Peng-fei KONG, Si-min CHEN, et al. Regulatory Effect of Huaihuasan Combined with Taohuatang on Immune Inflammation During Active Period of Ulcerative Colitis with Cold-heat Syndrome[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(7): 86-91. DOI： 10.13422/j.cnki.syfjx.20192232.

摘要

目的：

观察槐花散合桃花汤加减治疗溃疡性结肠炎(UC)活动期寒热错杂证的疗效及对免疫功能和炎症反应的调节作用。

方法：

将112例符合要求的患者按照随机数字表法分为观察组和对照组各56例。对照组轻度、中度患者，口服美沙拉嗪肠溶片，1.0 g/次，3次/d；重度或轻、中度患者服药4周后仍然疗效不佳者，采用醋酸泼尼松片，0.75 mg·kg

-1

·d

-1

，分3次口服。观察组西医治疗同对照组，并采用槐花散合桃花汤加减内服，1剂/d。两组疗程均为连续治疗4周。缓解期采用美沙拉嗪肠溶片，0.5 g/次，3次/d，长期维持治疗。采用改良mayo评分评价疾病活动情况，并记录临床缓解和临床有效情况，进行寒热错杂证评分，进行肠镜下黏膜表现评分和黏膜组织学的Geboes指数评分，检测外周血肿瘤坏死因子-

(TNF-

)，白细胞介素-8(IL-8)，IL-10；检测T淋巴细胞亚群水平(CD4

＋

，CD8

＋

)，以上指标治疗前后各评价1次，并记录治疗期间的不良反应，治疗后随访6个月，记录复发情况。

结果：

采用秩和检验分析中医证候疗效，观察组优于对照组(

＝1.915，

0.05)；观察组临床有效率为98.04%(50/51)，临床缓解率为94.12%(48/51)，黏膜愈合率为96.08%(49/51)，均分别高于对照组的84.00%(42/50)，78.00%(39/50)和82.00%(41/50)(

0.05)；观察组患者mayo，寒热错杂证、结肠黏膜和Geboes指数评分均低于对照组(

0.01)；观察组患者TNF-

，IL-8均低于对照组(

0.01)，IL-10水平高于对照组(

0.01)；观察组患者CD4

＋

，CD4

＋

/CD8

＋

均高于对照组，CD8

＋

较对照组低(

0.01)；观察组6个月内的复发率为10.42%(5/48)，低于对照组的30.77%(12/39)(

＝5.669，

0.05)；两组不良反应比较无统计学差异。

结论：

槐花散合桃花汤加减用于UC活动期寒热错杂证患者，可诱导UC进入缓解，抑制疾病的活度，减轻临床症状，并能调节免疫功能和炎症因子表达，减轻炎症反应，促进肠黏膜愈合，并能维持临床缓解和减少复发，临床疗效优于5-氨基水杨酸(5-ASA)/糖皮质激素的西医治疗方案。

Abstract

Objective:

To observe effect of addition and subtraction therapy of Huaihuasan combined with Taohuatang to ulcerative colitis with cold-heat complicated syndrome at active stage

and to study regulation effect to immune function and inflammatory response.

Method:

One hundred and twelve patients were randomly divided into control group and observation group by random number table. Patients with light and middle symptoms in control group got mesalazine slow release tablets

1.0 g/time

3 times/days

patients with severe symptoms or whose symptoms were not changed after getting for 4 weeks in control group got prednisone acetate tablets

0.75 mg·kg

-1

·d

-1

for 3 times. Based on the treatment in control group

patients in observation group added Huaihuasan combined with Taohuatang

1 dose/day. The course of treatment was 4 weeks. At remission period

mesalazine slow release tablets were used for maintain long-term maintenance therapy

0.5 g/times

3 times/days. Scores of disease activities were graded by improvement mayo

and clinical remission and clinical efficacy were recorded

scores of cold-heat complicated syndrome

mucous membrane under enteroscopy and histology of mucosa belongs to Geboes were graded. And levels of tumor necrosis factor-

(TNF-

) in peripheral blood

interleukin-8 (IL-8)

IL-10

T lymphocyte subsets (CD4

CD8

)

and adverse reactions

6 months' follow-up and recurrence were also be recorded.

Result:

Therapeutic effect of traditional Chinese medicine syndromes were analyzed by rank sum test

which in observation group was better than that in control group (

=1.915

0.05). Clinical effect in observation group was 98.04%(50/51) higher than 84.00%(42/50) in control group

clinical remission rate was 94.12%(48/51) higher than 78.00%(39/50) in control group

and mucosal healing rate was 96.08%(49/51) higher than 82.00%(41/50) in control group (

0.05). Scores of mayo

cold-heat complicated syndrome

colonic mucosa and index scores of Geboes were all lower than those in control group (

0.01). And levels of TNF-

IL-8 and CD8

were lower than those in control group (

0.01)

and levels of IL-10

CD4

and CD4

/CD8

were higher than those in control group (

0.01). Recurrence rate during 6 months in observation group was 10.42%(5/48) lower than 30.77%(12/39) in control group (

=5.669

0.05)

as for adverse reactions

there was no significant difference between two groups.

Conclusion:

Huaihuasan combined with Taohuatang can induce UC to remission period

inhibit the activity of disease

alleviate clinical symptoms

regulate immune function and expression of inflammatory factors

alleviate inflammatory reaction

promote intestinal mucosal healing

and can maintain clinical remission and reduce recurrence. The clinical efficacy is superior to that of 5-ASA/glucocorticoid in Western medicine.

关键词

Keywords

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