溃疡性结肠炎患者不同中医证型Mayo评分、血清pANCA水平的研究

RELATIONSHIP BETWEEN MAYO SCORES AND SERUM P-ANCA LEVEL IN PATIENTS WITH ULCERATIVE COLITIS OF DIFFERENT TCM SYNDROMES

目的探讨不同中医证型溃疡性结肠炎患者的Mayo评分及血清pANCA水平之间的关系。方法收集符合标准的溃疡性结肠炎患者150例,分为大肠湿热证组、脾气虚弱证组、寒热错杂证组,每组患者50例,所有患者均进行Mayo评分并检测血清pANCA水平,进行统计分析。结果溃疡性结肠炎活动性Mayo评分,轻度活动以脾气虚弱证组、寒热错杂证组多见,明显高于大肠湿热证组(P<0.05);重度活动以大肠湿热证组多见,明显高于脾气虚弱证组和寒热错杂证组(P<0.05);中度活动三组发生概率相当。血清pANCA阳性率比较,大肠湿热证组血清pANCA阳性率明显高于脾气虚弱证组、寒热错杂证组(P<0.05),寒热错杂证组血清pANCA阳性率略高于脾气虚弱证组,差异无统计学意义(P>0.05)。结论溃疡性结肠炎患者的Mayo评分高低、血清pANCA水平高低与中医辨证分型有关,不同中医证型的溃疡性结肠炎活动性严重程度不同,通过Mayo评分和测量血清pANCA水平,可以协助中医辨证分型,判断病情程度,提高临床疗效。

Objective To explore the relationship between Mayo scores and serum p-ANCA level in patients with ulcerative colitis（UC）of different TCM syndromes.Methods 150 cases of UC were collected and divided into the damp-heat syndrome group,the spleen-deficiency syndrome group and the group of syndromes of intermingled heat and cold,with 50 cases in each group.The Mayo scores and serum p-ANCA levels were statistically analyzed.Results The Mayo scores indicated that the mild activity of UC occurred more frequently in the spleen-deficiency syndrome group and the group of syndromes of intermingled heat and cold than in the damp-heat syndrome group（P 0.05）.The severe activity of UC occurred more frequently in the damp-heat syndrome group than in the spleen-deficiency syndrome group and the group of syndromes of intermingled heat and cold（P 0.05）.The occurrence probability of moderate activity of UC was about the same in all the three groups.The positive rate of serum p-ANCA was obviously higher in the damp-heat syndrome group than that in the spleendeficiency syndrome group and the group of syndromesof intermingled heat and cold（P 0.05）,but no significant difference was found between the spleen-deficiency syndrome group and the group of syndromes of intermingled heat and cold（P 0.05）.Conclusion The Mayo scores and the level of serum p-ANCA in patients with ulcerative colitis are related to TCM syndromes and UC of different TCM syndromes has different degrees of activity.Measuring Mayo scores and the level of serum p-ANCA can contribute to syndrome differentiation and disease diagnosis.