溃结灵颗粒配合柳氮磺胺吡碇治疗大肠湿热型溃疡性结肠炎30例

Clinical Observation on 30 Cases of Ulcerative Colitis of Damp Heat in the Large Intestine Stagnation Type Treated with Kuijieling Granules Combinated SASP

目的:观察中药溃结灵颗粒配合柳氮磺胺吡啶对活动期溃疡性结肠炎的疗效,并探讨溃结灵治疗溃疡性结肠炎的机制。方法:活动期UC(大肠湿热证)患者随机分为中西药结合组(溃结灵+SASP)和柳氮磺胺吡啶组(SASP),以中医证候疗效、肠黏膜病变、主要症状积分作为观察指标;观测肠黏膜组织内的嗜酸性粒细胞计数及肥大细胞脱颗粒现象及两组病例治疗前后免疫指标T、B细胞亚群的变化情况。结果:治疗组中医证候疗效、肠黏膜疗效高于对照组(P<0.05)。治疗组和对照组在改善腹泻、腹痛、腹胀、脓血便、黏液便、里急后重症状方面,两组自身比较治疗后较治疗前均有明显改善(P<0.01,P<0.05)。两组间比较治疗组在改善腹泻、腹痛、腹胀、里急后重方面较对照组作用明显(P<0.01,P<0.05)。而对于改善脓血便、黏液便症状方面两组间的差异无显著性意义(P>0.05)。两组治疗后嗜酸性粒细胞浸润明显减少(P<0.05,P<0.01)。对于细胞脱颗粒,治疗组治疗后有明显下降(P<0.05),对照组治疗后无明显变化(P>0.05)。治疗组治疗后患者的B淋巴细胞明显下降(P<0.01),外周血总T细胞和Ts明显上升(P<0.01)。对照组疗前疗后对比差别无显著性意义(P>0.05)。结论:溃结灵配合柳氮磺胺吡啶有确切的治疗UC的作用,效果显著,这可能与它能减轻炎症、有显著的免疫调节作用有关。

Objective： To observe the effect and to explore the mechanism of Kuijie ling Granules （KG） Combinated SASP in treating ulcerative colitis （UC） during the active period by the clinical experiment. Methods ： The patients of active UC （ damp - heat syndrome） were randomly divided into 2 groups to observe pathologleal changes of the mueosa, syndrome effect and main symptoms scores and to survey the oxyphilie cells counting in the mueosa, the phenomenon of mastocyte degranulation and to observe the change about T and B cell subtribe. Results ： The KG ＋ SASP group had better effect than SASP group in syndrome and the mueosa effect （ P 〈 0.05 ）. The KG ＋ SASP group had better effect than SASP group about eliminating the syndrome such as diarrhea, abdomenaehe, burbulenee and tenesmus （ P 〈 0.05 ）. There was no difference in eliminating the syndrome about sanguinopurulent stool and pituitous stool（ P 〉 0. 05）. About the KG ＋ SASP group,there was a obvious decline in the oxyphilie cells counting ,mastocyte degranulation and B cell subtribe（ P 〈0.05）. Conclusion： KG has definite effect on UC,whieh may berelated with relieving the inflammation and adjusting the eytokines.