清肠化湿灌肠方直肠滴入治疗激素抵抗型重症溃疡性结肠炎的疗效观察

Effect of qingchang huashi prescription for coloclyster by rectal dripping on the treatment of patients with hormone-resistant severe ulcerative colitis

目的探讨清肠化湿灌肠方直肠滴入治疗激素抵抗型重症溃疡性结肠炎(HRUC)疗效。方法 70例HRUC患者分成实验组与对照组各35例,对照组服用美沙拉嗪肠溶片治疗,实验组在对照组基础上给予清肠化湿灌肠方中药直肠滴入治疗。观察2组临床疗效、肠道菌群(双歧杆菌、肠球菌及乳酸杆菌)、血清炎症因子[白介素-6(IL-6)、白介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)]及不良反应发生情况。结果实验组治疗总有效率97.14%,显著高于对照组的68.57%(P<0.05)。治疗后,2组双歧杆菌、乳酸杆菌含量均显著高于治疗前(P<0.05),且实验组双歧杆菌、乳酸杆菌含量显著高于对照组(P<0.05)。治疗后,实验组肠球菌含量显著高于治疗前与对照组(P<0.05)。治疗后,2组IL-6、IL-8及TNF-α水平均显著低于治疗前(P<0.05),且实验组IL-6、IL-8及TNF-α水平显著低于对照组(P<0.05)。2组患者不良反应的发生率无显著差异(P>0.05)。结论清肠化湿灌肠方中药直肠滴入治疗HRUC疗效确切,可显著提升肠道内双歧杆菌、肠球菌及乳酸杆菌含量,降低IL-6、IL-8及TNF-α水平。

Objective To investigate the effect of qingchang huashi prescription for coloclyster by rectal dripping on the treatment of patients with hormone-resistant severe ulcerative colitis（ HRUC）. Methods Totally 70 patients with HRUC were divided into experimental group and control group,35 cases in each group. The patients in the control group were treated with mesalazine enteric-coated tablets,while the experimental group was given rectal infusion of qingchang huashi prescription for coloclyster on the basis of the control group. The clinical efficacy,intestinal flora（ bifidobacterium,enterococcus and lactobacillus）,serum inflammatory factors such as IL-6,IL-8,TNF-α and adverse reactions were observed in both groups. Results The total effective rate was97. 14% in the experimental group,which was significantly higher than 68. 57% in the control group（ P 〈 0. 05）. After treatment,the contents of bifidobacteria and lactobacilli in both groups were significantly higher than those before treatment（ P 〈 0. 05）,and the experimental group had higher bifidobacterium,lactobacillus contents than the control group（ P 〈 0. 05）. After treatment,the content of enterococci in the experimental group was significantly higher than that before treatment and in the control group（ P 〈 0. 05）. The levels of IL-6,IL-8 and TNF-α in both groups were significantly lower than those before treatment（ P 〈 0. 05）. The levels of IL-6,IL-8 and TNF-α in the experimental group were significantly lower than those in the control group（ P 〈 0. 05）. The incidence rate of adverse reactions showed no significant difference between two groups（ P 〉 0. 05）. Conclusion The effect of qingchang huashi prescription for coloclyster by rectal dripping is definite in the treatment of HRUC,which can significantly increase the contents of bifidobacteria,enterococci and lactobacilli in the intestinal tract,and reduce the levels of IL-6,IL-8 and TNF-α.