薏苡附子败酱散保留灌肠结合柳氮磺胺吡啶治疗溃疡性结肠炎临床研究

Clinical study of enema aplication of Yiyi-Fuzi-Baijiang powder combined with oral sulfasalazine in treating ulcerative colitis

目的 评价薏苡附子败酱散保留灌肠结合口服柳氮磺胺吡啶肠溶片治疗溃疡性结肠炎的疗效.方法 将符合入选标准的溃疡性结肠炎患者按随机数字表法分为2组,每组42例.对照组口服柳氮磺胺吡啶,观察组在对照组基础上配合薏苡附子败酱散加减保留灌肠.2组均治疗4周.采用ELISA法检测血清IL-6、IL-8、TNF-α浓度,观察治疗前后疾病活动指数评分变化,评价临床疗效.结果 治疗后,观察组疾病活动指数评分[（3.89±0.91）分比（4.91±1.08）分,t=3.082]低于对照组（P=0.042）;观察组血清TNF-α[（20.82±4.31）ng/L比（26.51±5.25）ng/L,t=3.602]、IL-6[（31.73±4.82）ng/L比（40.18±5.63）ng/L,t=3.817]、IL-8[（35.39±4.62）ng/L比（40.59±5.35）ng/L,t=3.341]水平低于对照组（P〈0.05）.观察组总有效率为92.9%（39/42）、对照组为73.8%（31/42）,2组比较差异有统计学意义（χ2=4.200,P=0.040）.结论 薏苡附子败酱散保留灌肠结合柳氮磺胺吡啶肠溶片可减轻脾肾阳虚型溃疡性结肠炎患者症状,抑制炎症反应.

Objective Evaluation of enema application of Yiyi-Fuzi-Baijiang powder combined with oral sulfasalazine enteric-coated tablets in treating ulcerative colitis. Methods The patients with ulcerative colitis were randomly divided into 2 groups, 42 cases in each group. The control group was treated with sulfasalazine, and the observation group with sulfasalazine and Yiyi-Fuzi-Baijiang powder. Both groups were treated for 4 weeks. ELISA method was used to detect the levels of IL-6, IL-8 and TNF-α. The changes of disease activity index （Sutherland DAI） were observed before and after treatment, and the clinical efficacy was evaluated. Results After treatment, the Sutherland DAI （3.89 ± 0.91 vs. 4.91 ± 1.08, t=3.082） in the observation group was significantly lower than that in the control group （P=0.042）. The level of TNF-α （20.82 ± 4.31 ng/L vs. 26.51 ± 5.25 ng/L, t=3.602）, IL-6 （31.73 ± 4.82 ng/L vs. 40.18 ± 5.63 ng/L, t=3.817）, and IL-8 （35.39 ± 4.62 ng/L vs. 40.59 ± 5.35 ng/L, t=3.341） in the observation group were significantly lower than those in the control group （P〈0.05）. The total efficiency of observation group was 92.9% （39/42）, and the control group was 73.8% （31/42）. There was significant difference between the two groups （χ2=4.200, P=0.040）. Conclusions The Yiyi-Fuzi-Baijiang powder combined with sulfasalazine could relieve the clinical symptoms of ulcerative colitis patients with spleen-kidney yang deficiency, and inhibition inflammatory response.