中药多途径治疗溃疡性结肠炎的疗效及对炎症因子的影响

Clinical efficacy of Chinese Materia medica via multi-route treating ulcerative colitis and its effect on inflammatory factors

关键词:  中药  多途径  溃疡性结肠炎  美沙拉嗪  炎症因子

Key words:  Chinese material medica  multi-route treating  ulcerative colitis  mesalazine  inflammatory factor

摘要:

目的 研究中药多途径治疗溃疡性结肠炎的疗效及对炎症因子的影响。方法 选取2016年2月-2017年11月收治的136例溃疡性结肠炎患者，按随机数表法分成对照组（美沙拉嗪口服联合灌肠治疗）与研究组（中药煎液内服+中药灌肠+中药穴位贴敷治疗），各68例。分析2组治疗前和治疗12周后炎症因子水平、T淋巴细胞亚群水平（CD₃⁺、CD₄⁺、CD₈⁺、CD₄⁺/CD₈⁺）、结肠镜及病理检查评分、中医症状（腹痛、腹泻、黏液脓血便、里急后重评分及总积分）评分、治疗有效率及复发率。结果 治疗后，研究组白细胞介素-6、肿瘤坏死因子-α、超敏C反应蛋白水平低于对照组，白细胞介素-10高于对照组，差异具有统计学意义（P<0.05）；研究组CD₃⁺、CD₈⁺水平明显低于对照组，CD₄⁺与CD₄⁺/CD₈⁺明显高于对照组（P<0.05）；研究组结肠镜、病理检查评分均明显优于对照组（P<0.05）；2组治疗后中医症状均明显好转，研究组治疗后中医症状评分均明显低于对照组（P<0.05）；研究组治疗总有效率明显高于对照组（P<0.05）；治疗后随访6个月，研究组复发率明显低于对照组（P<0.05）。结论 中药多途径治疗溃疡性结肠炎的临床疗效确切，有利于降低炎症反应，提升肠道黏膜免疫功能，促进溃疡愈合，改善中医症状，安全性高，复发率低，值得临床应用。

Abstract:

Objective To study the efficacy of Chinese material medica via multi-route treating ulcerative colitis and its effect on inflammatory factors. Methods A total of 136 patients with ulcerative colitis admitted from February 2016 to November 2017 were randomly divided into the control group (mesalazine oral combined enema treatment) and the study group (Chinese material medica decoction oral administration+Chinese material medica enema+Chinese material medica acupoint sticking treatment), 68 cases in each group. The levels of inflammatory factors, T lymphocyte subsets, colonoscopy and pathological examination scores, TCM symptoms (abdominal pain, diarrhea, mucus pus and bloody stool, re-score and total score), treatment efficiency and recurrence rate were analyzed before and after 12 weeks of treatment in both groups. Results After treatment, the levels of interleukin-6, tumor necrosis factor-α, and high-sensitivity C-reactive protein in the study group were lower than the control group, and interleukin-10 was significantly higher than the control group (P<0.05). After treatment, the levels of CD₃⁺ and CD₈⁺ in the study group were significantly lower than the control group, CD₄⁺ and CD₄⁺/CD₈⁺ were significantly higher than the control group (P<0.05). The scores of colonoscopy and pathological examination in the study group were significantly better than the control group (P<0.05). The symptoms of TCM were significantly improved after treatment in both groups. The scores of TCM symptoms in the study group were significantly lower than the control group (P<0.05). The total effective rate of the study group was significantly higher than the control group (P<0.05). Six months after treatment, recurrence rate of the study group was significantly lower than that of the control group (P<0.05). Conclusion The clinical efficacy of Chinese material medica via multi-route treating ulcerative colitis is clear, which is beneficial to reduce inflammation, improve intestinal mucosal immune function, promote ulcer healing, improve TCM symptoms, and have high safety and low recurrence rate, which is worthy for clinical application.