化浊解毒方治疗溃疡性结肠炎的临床疗效及对神经—内分泌—免疫网络的影响

Clinical Effect of Huazhuo Jiedu Recipe on Ulcerative Colitis and Its Influence on Nerve-Endocrine-Immune Network

目的观察化浊解毒方治疗溃疡性结肠炎(UC)的临床疗效及可能作用机制。方法将80例UC患者按随机数字表法分为治疗组和对照组,每组40例,治疗组给予化浊解毒方,对照组给予美沙拉嗪肠溶片(每次1 g,每日3次),疗程4周。观察治疗前后临床症状、生活质量及结肠镜变化,同时检测两组患者治疗前后血清免疫球蛋白A、G、M(IgA、IgG、IgM),血清细胞因子IL-10、TNF-α及血浆神经递质P物质(SP)、血管活性肠肽(VIP)含量的变化。结果治疗4周后,治疗组总有效率为81. 58%(31/38),高于对照组[56. 41%(22/39),χ2=4. 5703,P <0. 05)];治疗组0级、Ⅰ级例数均多于对照组,两组肠镜总体等级分布比较,差异有统计学意义(P <0. 05)。与本组治疗前比较,治疗后患者全身症状、肠道症状、情感功能、社会功能评分及总评分均升高(P <0. 05);血清IgA、IgG、TNF-α及血浆SP含量降低,血清IL-10及血浆VIP含量升高(P <0. 05);血清IgM含量降低但差异无统计学意义(P> 0. 05)。与对照组治疗后比较,治疗组全身症状、肠道症状、情感功能评分及总评分均升高,血清IgA、IgG含量降低,血清IL-10及血浆VIP含量升高(P <0. 05);社会功能评分、血清IgM、TNF-α及血浆SP含量差异无统计学意义(P> 0. 05)。结论化浊解毒方能够有效缓解UC患者临床症状,改善镜下病理变化,提高患者生活质量,其机制可能与调控细胞因子的分泌,调节神经递质,进而改善免疫功能有关。

Objective To observe the effect of Huazhuo Jiedu Recipe on ulcerative colitis and to explore the mechanisms involved. Methods Totally 80 patients were assigned to the treatment group and the control group by random adigit table,40 cases in each group. Patients in the treatment group were treated with Huazhuo Jiedu Recipe;patients in the control group were treated with Mesalazine Slow Release Tablets,1 g each time,3 times per day. The therapy course was 4 weeks for all. Clinical symptoms,survival quality,colonoscopy change were observed. The changes of the content of serum immunoglobulin A,G,M( Ig A,Ig G,Ig M),interleukin-10( IL-10),tumour necrosis factor-α( TNF-α) and plasma substance P( SP),vasoactive intestinal peptide( VIP) were detected before and after treatment in the two groups. Results The therapeutic efficacy of the treatment group[81. 58%( 31/38) ] was better than the control group[56. 41%( 22/39),χ2=4. 5703,P < 0. 05] after 4 weeks of treatment. The cases of level 0,level Ⅰ were more than the control group,and the distribution showed statistic significance(P < 0. 05). After treatment,compared with before treatment,scores of the systemic symptoms,intestinal symptoms,emotional function,social function and total score were increased significantly(P < 0. 05);the level of serum Ig A,Ig G,TNF-α and plasma SP levels decreased,serum IL-10 and plasma VIP levels increased(P <0. 05). The content of serum Ig M decreased,but the difference was not statistically significant(P > 0. 05). After treatment,compared with the control group,scores of the systemic symptoms,intestinal symptoms,emotional function and total score were increased in the treatment group(P < 0. 05),the level of serum Ig A,Ig G were decreased in the treatment group. While the level of serum IL-10 and plasma VIP in the treatment group were increased(P < 0. 05) and the scoring of social function,serum Ig M,TNF-α,plasma SP showed no statistic significance(P > 0. 05). Conclusions Huazhuo Jiedu Recipe could alleviate the clinical symptoms and improve pathological changes under the microscope,and improve survival quality in patients with ulcerative colitis. The mechanism may be related to the regulation of cytokine secretion and neurotransmitters,and improvement of immune function.