化毒愈肠方治疗溃疡性结肠炎40例

Huadu Yuchang Decoction in Treating 40 Cases with Ulcerative Colitis

目的:观察化毒愈肠方治疗溃疡性结肠炎(UC)(脾虚湿蕴证)的临床疗效及对肠黏膜核转录因子-κB(NF-κB)和β-防御素(HBD-2)及血清促炎性因子的影响。方法:将80例UC患者随机按数字法分为对照组和观察组各40例。对照组采用美沙拉嗪肠溶片,吞服勿咀嚼,1 g/次,4次/d。对于中度患者反应不佳者加用泼尼松龙片,10 mg/次,3次/d。观察组在对照组治疗的基础上加服化毒愈肠方,1剂/d,常规水煎煮2次,分早晚2次内服。两组疗程均为8周。进行治疗前后脾虚湿蕴证评分、结肠镜及黏膜组织学评分;采用免疫组化SP法检测肠黏膜NF-κB和HBD-2阳性表达情况,检测治疗前后血清白细胞介数-1(IL-1)、白细胞介数-8(IL-8)及肿瘤坏死因子-α(TNF-α)。结果:治疗后观察组脾虚湿蕴证、结肠镜和肠黏膜组织评分均低于对照组(P<0.01);治疗后观察组肠黏膜NF-κB和HBD-2阳性表达情况均低于对照组(P<0.01);治疗后观察组血清IL-1,IL-8和TNF-α水平均低于对照组(P<0.01);经Ridit分析,观察组临床综合疗效优于对照组(P<0.05);观察组中医证候疗效优于对照组(P<0.05)。结论:化毒愈肠方能改善UC患者的症状,促进溃疡愈合,临床疗效显著,其作用机制可能是通过抑制炎症细胞因子,保护肠道黏膜屏障功能来实现的。

Objective： To observe the clinical effect of Huadu Yuchang decoction and its influence on nuclear transcription factor-κB（ NF-κB） of intestinal mucosa, human β-defensin-2（ HBD-2） and serous proinflammatory cytokine in treating ulcerative colitis（ UC） which belonged to spleen deficiency and dampness syndrome in tradition Chinese medical（ TCM） syndromes. Method： Eighty patients with UC were randomly divided into control group（ 40 cases） and observation group（ 40 cases） by random number table. Patients in control group took mesalazine enter-coated tablets,to swallow not chew,1 g per time,4 times per day. Moderate patients who were in bad condition added prednisolone tablets,10 mg per time,3 times per day. Based on the treatment of control group,patients in observation group added Huadu Yuchang decoction after decocting for two times,1 dose per day,divided for 2 times. The patients in two groups received 8-week period of treatment. Scores of spleen deficiency and dampness syndrome,colonoscopy and gastric histology were graded before and after treatment. Condition of positive expression of intestinal mucosa NF-κB and HBD-2 were detected by immunohistochemistry SP method,and serous interleukin-1（ IL-1）,interleukin-8（ IL-8） and tumor necrosis factor-α（ TNF-α） were detected. Result： After treatment,scores of spleen deficiency and dampness syndrome,colonoscopy and gastric histology in observation group were lower than those in control group（ P〈0.01）.Condition of positive expression of intestinal mucosa NF-κB and HBD-2 in observation group were lower than those in control group（ P〈0.01）. Levels of IL-1,IL-8 and TNF-α were lower than those in control group（ P〈0.01）.According to ridit analysis,the comprehensive curative effect in observation group was superior to that in control group（ P〈0.05）. Syndromes curative effect of TCM syndromes in observation group was better than that in control group（ P〈0.05）. Conclusion： Huadu Yuchang decoction could ameliorate symptoms,improve peptic ulcer healing,and therefore had obvious clinical effect in patients with UC. Its mechanism of action may be related to inhibiting proinflammatory cytokines and protecting barrier function of intestine mucosa.