白头翁汤内服与灌肠对溃疡性结肠炎肠黏膜愈合的影响

Influence of Oral Administration of Baitouweng Tang and Enema with it on the Intestinal Mucosa Healing of Ulcerative Colitis

为了探讨白头翁汤内服与灌肠对溃疡性结肠炎(UC)肠黏膜愈合的影响,将2014年1月至2016年1月甘肃省会宁县人民医院收治的溃疡性结肠炎患者60例,随机分为对照组和观察组,每组各30例。对照组给予美沙拉秦缓释颗粒口服治疗,观察组给予白头翁汤加减内服与保留灌肠治疗,连续治疗4周。使用Mayo评分系统和Baron内镜评分法,以及酶联免疫吸附法(ELISA),比较2组患者治疗前后的肿瘤坏死因子-α(TNF-α)水平、血清白细胞介素-10(IL-10)水平,以及肠黏膜愈合程度、内镜检查溃疡处存在炎症程度、临床疗效及不良反应。结果显示,治疗前,2组患者Mayo评分、Baron评分比较差异无统计学意义(P>0.05);治疗后,2组患者Mayo评分、Baron评分均有所下降,但观察组下降程度更为明显,差异有统计学意义(P<0.05)。治疗前.2组患者TNF-α水平、IL-10水平比较,差异无统计学意义(P>0.05);治疗后,2组患者TNF-α水平、IL-10水平比较,差异有统计学意义(P<0.05)。观察组临床治疗总有效率为96.67%(29/30),对照组临床治疗总有效率为80.00%(24/30),观察组治疗总有效率明显高于对照组,P<0.05。2组患者均无明显肝、肾功能损害,无严重不良反应发生,仅对照组有1例出现便秘.2组患者不良反应发生率对比,P>0.05。结果表明,溃疡性结肠炎采用白头翁汤内服与灌肠治疗效果显著,可使肿瘤坏死因子-α水平下降,使血清白细胞介素-10水平升高,改善促炎因子与抗炎因子之间的失衡,有效降低肠道炎症反应,促进肠黏膜愈合,值得临床推广应用。

This study was to investigate the influence of oral administration of Baitouweng TaNg （Pulsatilla Decoction, a TCM formula） and enema with it on the healing of UC patient＇s intestinal mucosa,recuired 60 cases of UC admitted and treated in the leader author＇s hospital from Jan. 2014 to Jan. 2016 yr. and ran- domly divided them into treatment group and observation one, 30 cases for each, which the former was treated with oral administration of mesalazine delayed-release granules,while the latter received than Tang orally or in enema,for the two groups medical course was all for 4 W,then by using Mayo scale system and Baron endoscopic score method, as well ELISA compared both group＇s follwing indexes such as TNF-α level,IL-10 level,and the degree of intstinal mucosa healing,of the inflammatory response at ulcer showed by endoscope exam. ,and clinical effect as well adverse reaction.As results,before treatment there was no sta- tistical difference in Mayo score and Baron score between the two groups（ P 〉0.05） ,after treatment above two scores of both groups was all declined,but in the latter this decline degree was more significant（ P 〈 0.05）;before treatment in the level of TNF-α, IL-10 there was no statistical difference between the two groups（ P 〉0.05） ,but after treatment this difference just was significant（ P 〈0.05） ;in total effective rate the latter was significantly higher than the former[96.67% （29/30） vs 80.00% （24/30）, P 〈0.051 ;in the two groups no liver and kidney injury was all found,also no severe adverse reaction did,except for one case in the former being suffering from constipation, thus the adverse reaction incidence had no statistical differ- ence between both（ P 〉0.05）.Results show that the therapy used in the latter for UC has significant effect, can make TNF-α level declined,IL-10 level enhanced, so that improve the unbalance between inflam- mation-promoting factors and anti-inflammatory factors,effectively reducing the inflammatory response of intestinal tract, and promoting its mucosa healing.