肺肠同治指导下中医药联合SASP灌肠对AUC Th1/Th2调节作用研究

Study on Effect of Regulation to Th1/Th2 in AUC Patients with Chinese Medicine Combined with SASP Enema under Guidance of Synchronous Treatment of Lung and Intestine

目的:通过肺肠同治方药联合柳氮磺胺吡啶(SASP)灌肠、单独治肠方药联合SASP灌肠及单独SASP灌肠对活动期溃疡性结肠炎(AUC)患者Th1/Th2调节作用的对照研究,证明肺肠同治理论的科学性。方法:将90例中医诊断为热毒炽盛证,西医诊断为AUC的患者随机分为3组,对照组、治肠组和肺肠同治组,每组30例,分别采用单纯SASP灌肠(对照组),白头翁汤、调胃承气汤配合SASP灌肠(治肠组),白头翁汤、凉膈散配合SASP灌肠(肺肠同治组),每日1次,持续60天,各组治疗前后分别进行肠镜检查以进行临床疗效评价,并检测结肠溃疡组织Th1/Th2相关指标。结果:各组临床疗效评价,肺肠同治组>治肠组>对照组,差异具有统计学意义(P<0.05或P<0.01)。与治疗前相比,各组治疗后,Th1(INF-γ、IL-2)皆降低,Th2(IL-4、IL-5)皆升高,Th1/Th2皆降低,差异具有统计学意义(P<0.01);各组治疗后比较,Th1:对照组>治肠组>肺肠同治组,Th2:肺肠同治组>治肠组>对照组,Th1/Th2:对照组>治肠组>肺肠同治组,差异具有统计学意义(P<0.01)。结论:肺肠同治理论对AUC中药灌肠疗法抗炎具有指导意义。

This study was aimed to prove the scientific method theory through revealing the effect of synchronous treatment of lung and intestine in the treatment of active ulcerative colitis （AUC） patients. A total of 90 cases with traditional Chinese medicine （TCM） diagnosis of heat-toxin syndrome and western medical diagnosis of AUC were randomly divided into the control group, treatment of intestine group, and synchronous treatment of lung and intestine group, with 30 cases in each group. SASP enema （control group）, SASP with Bai-Tou-Weng （BTW） decoction and Tiao-Wei Cheng-Qi （TWCQ） decoction enema （treatment of intestine group）, SASP with BTW decoction and Liang-Ge-San （LGS） enema （synchronous treatment of lung and intestine group） were given, respectively. The treatment was given once a day and continued for 60 days. Then, clinical therapeutic evaluation was given before and after the treatment with enteroscopy, Th1/Th2 of ulcerative colon tissues was detected. The results showed that the sequence of clinical effect from top to bottom was synchronous treatment of lung and intestine group, treatment of intestine group, control group, with statistical significance （P〈 0.05 or P〈 0.01）. Comparison of Th1/Th2 before and after treatment among each group showed that Th1 （INF-γ, IL-2） was decreased, Th2 （IL-4, IL-5） was increased （P〈 0.05）, Th1/Th2 was decreased, with statistical significance （P〈 0.01）. Comparison among each group after treatment showed that the sequence of Th1 from top to bottom was control group, treatment of intestine group, synchronous treatment of lung and intestine group; that of Th2 was synchronous treatment of lung and intestine group, treatment of intestine group, control group; that of Th1/Th2 was control group, treatment of intestine group, synchronous treatment of lung and in-testine group, with statistical significance （P〈 0.01）. It was concluded that synchronous treatment of lung and intes-tine had guiding significance on anti-inflammatory effect of enema therapy to AUC.