健脾清热活血方治疗溃疡性结肠炎对肠黏膜屏障修复的随机对照研究

Randomized Controlled Study of Jianpiqingrehuoxue Decoction in Treating Ulcerative Colitis on Intestinal Mucosal Barrier Repair

目的:探讨健脾清热活血方治疗溃疡性结肠炎(Ulcerative Colitis,UC)的临床疗效及对肠黏膜屏障的修复效果。方法:将86例UC患者随机分为治疗组(n=43)和对照组(n=43),对照组采用常规西药进行治疗,治疗组在此基础上增加中药健脾清热活血方进行治疗,2组均治疗12周。比较治疗前后2组肠黏膜功能、血清相关指标水平及中医症状积分变化,统计2组临床有效率及复发情况。结果:治疗后2组乳果糖(Lactulose,LAC)水平、乳果糖/甘露醇(Lactulose/Mannitol,L/M)比值、血清内毒素(Endotoxin,ET)、二胺氧化酶(Diamine Oxidase,DAO)、降钙素原(Procalcitonin,PCT)水平均较治疗前降低(P<0.05或P<0.01),且治疗组明显低于对照组(P<0.01)。治疗后2组临床各项症状积分均较治疗前明显降低(P<0.01),且治疗组溃疡、充血水肿、糜烂、腹泻症状积分及总积分明显低于对照组(P<0.01)。治疗后治疗组总有效率(93.02%)显著高于对照组(76.74%)(P<0.05)。随访期间治疗组复发3例(6.70%),对照组复发8例(18.60%),2组复发率比较,差异有统计学意义(P<0.05)。结论:健脾清热活血方治疗UC可提高患者肠黏膜愈合质量,缓解其临床症状,且复发率低,值得临床推广应用。

Objective： To investigate the curative effect of Jianpiqingre Huoxue Decoction on ulcerative colitis （UC） and its effect on intestinal mucosal barrier repair. Methods ： A total of 86 UC patients were randomly divided into observation group （ n = 43 ） and control group （n = 43） by randomized controlled design. The control group was treated with conventional western medicine, the observation group combined with the traditional Chinese medicine Jianpiqingrehuoxue Decoction treatment, 2 groups were trea- ted for 12 weeks. Before and after treatment, the changes of intestinal mucosa function, serum related indexes and symptoms of TCM were compared. The clinical effective rate and relapse rate of the 2 groups were statistically analyzed. Results ： The levels of lactulose （ LAC）, lactulose/mannitol （ L/M）, serum endotoxin （ ET）, diamine oxidase （DAO） and procalcitonin （PCT） were lower than before treatment （P 〈 0. 05 or P 〈 0. 01 ）, and the observation group was significantly lower than the control group （P 〈 0. 01 ）. The score of ulcer, congestion, edema, erosion and diarrhea in the observation group were significantly lower than those in the control group （P 〈 0. 01 ）. After treatment, the total effective rate of the observation group （93.02%） was significantly higher than the control group （76.74%） （ P 〈 0. 05 ）. During Follow-up period, 3 cases （6.70%） in the observation group and 8 cases （ 18.60% ） relapsed in the control group, there was significant difference in recurrence rate between the 2 groups （ P 〈 0.05 ）. Conclusion：Jianpi qingrehuoxue Decoction can improve the healing quality of intestinal mucosa, relieve the clinical symptoms, and relapse rate is low, it is worthy of clinical application.