青白灌肠液对活动期溃疡性结肠炎患者临床疗效及炎性因子、黏附因子的影响

Effects of Qingbai Enema on Inflammatory Factors and Adhesion Factors in Patients with Active Ulcerative Colitis

目的观察青白灌肠液对活动期溃疡性结肠炎的临床疗效及对血清炎性因子、黏附因子的影响。方法选取符合诊断和纳入标准的活动期左半结肠型溃疡性结肠炎患者59例,按照随机数字表法分为两组,其中对照组给予美沙拉嗪肠溶片口服治疗,治疗组在对照组的基础上联合中药青白灌肠液治疗,两组疗程均为6周。分别观察两组患者临床疗效、Baron肠镜积分、结肠组织病理评分及血清白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、细胞间黏附分子-1(ICAM-1)、血管内皮细胞黏附分子-1(VCAM-1)的水平。结果治疗组总有效率为93.33%,明显高于对照组的82.76%(P<0.05);治疗组够明显改善结肠Baron内镜及组织病理评分(P<0.01),明显优于对照组(P<0.01);治疗组治疗后血清IL-1β、TNF-α、ICAM-1、VCAM-1较治疗前均显著降低(P<0.01),治疗后组间比较,治疗组明显优于对照组(P<0.01)。结论青白灌肠液联合美沙拉嗪能够显著改善湿热蕴结型活动期溃疡性结肠炎的临床症状及肠道黏膜评分,下调IL-1β、TNF-α、ICAM-1、VCAM-1水平,疗效显著。

Objective： To observe the clinical effect of Qingbai Enema in patients with active ulcerative colitis and its influence on serum inflammatory cytokines and adhesion factors. Methods： 59 patients with active left colonic ulcerative colitis of accumulated damp-heat type were divided into the control group（29 cases） and the treatment group（30 cases） according to random number table. The control group was treated with Mesalazin enteric-coated tablets and the treatment group was treated with Mesalazin enteric-coated tablets combined with Qingbai Enema;the course of treatment was 6 weeks in both groups. The clinical efficacy,Baron endoscopic score and colon tissue pathology score were observed;ELISA method was used to detect the levels of serum inflammatory factors（IL-1β,TNF-α） and adhesion factors（ICAM-1,VCAM-1）. Results： The total effective rate of the treatment group was 93.3%,the control group 82.76%;the difference was statistically significant（P 0.05）. Baron endoscopic score and colon tissue pathology score were improved in the treatment group after treatment（P 0.01）,obviously better than the control group（P 0.01）. After treatment,the serum IL-1β,TNF-α,ICAM-1 and VCAM-1 were significantly lower in the treatment group（P 0.01）,obviously better than the control group（P 0.01）. Conclusion： Qingbai Enema combined with Mesalazin enteric-coated tablets can obviously improve the clinical symptoms,Baron endoscopic score and colon tissue pathology score of patients with active ulcerative colitis of accumulated damp-heat type,down-regulation of the level of IL-1β,TNF-α,ICAM-1 and VCAM-1,with an obvious curative effect.