“健脾益气、解毒通络”方保留灌肠对溃疡性结肠炎患者血清IL-8、TNF-α含量变化及生存质量的影响

Effects on serum IL-8 and TNF-α and the quality of life in the patients of ulcerative colitis treated with the retention enema with jianpiyiqi and jiedutongluo formula

目的探讨"健脾益气、解毒通络"方保留灌肠对溃疡性结肠炎患者血清IL-8、TNF-α含量变化及生存质量的影响。方法将符合入选标准的140例溃疡性结肠炎患者采用随机数字表法分为两组,每组70例。对照组给予枯草杆菌二联活菌肠溶胶囊配合美沙拉嗪肠溶片;治疗组在对照组基础上给予"健脾益气、解毒通络"方,两组均1个月为1个疗程;分别对治疗前后血清IL-8、TNF-α、IBDQ生存质量、中医症状评分进行对比分析;并对综合疗效进行评价。结果两组治疗后TNF-α、IL-8均较本组治疗前明显降低,且治疗后两组间比较差异有统计学意义(P<0.05)。两组病例治疗后肠道症状、全身症状、情感功能、社会功能和总评分均较本组治疗前明显升高(P<0.05)。治疗组治疗后肠道症状、全身症状、情感功能和总评分均较对照组治疗后明显升高(P<0.05),而社会功能有升高趋势(P>0.05),但差异无统计学意义。两组病例治疗后腹痛腹泻、里急后重、脓血便、肛门灼热、发热评分均较本组治疗前明显降低(P<0.05)。治疗组治疗后腹痛腹泻、里急后重、脓血便、肛门灼热均较对照组治疗后明显降低(P<0.05),而发热评分有降低趋势(P>0.05),但差异无统计学意义。治疗组治疗后总有效率明显高于对照组(P<0.05)。结论 "健脾益气、解毒通络"方保留灌肠可改善患者的生存质量、中医临床症状评分,提高临床疗效,主要的作用机制可能与降低血清TNF-α、IL-8水平相关。

Objective To explore the effects on serum IL-8 and TNF-α and the quality of life in the patients of ulcerative colitis treated with the retention enema with jianpiyiqi and jiedutongluo formula. Methods A total of 140 patients of ulcerative colitis were collected according to the inclusive criteria. They were divided into two groups according to the random number table,70 cases in each one. In the control group,the medication of live combined bacillus subtilis and enterococcus faecium enteric-coated？ capsules and mesalazine enteric-coated tablets. In the treatment group,the jianpiyiqi and jiedutongluo formula was used on the base of the treatment as the control group. The duration of treatment was 1 month in the two groups. Before and after treatment,serum IL-8 and TNF-α,IBDQ quality of life and TCM symptom scores were compared before and after treatment. The comprehensive effects were evaluated. Results After treatment,serum IL-8 and TNF-α were reduced obviously as compared with those before treatment in the two groups,indicating the significant differences（P〈0.05）. After treatment,the scores of intestinal symptom,general symptoms,emotional function,social function and the total score were all increased obviously as compared with those before treatment in the two groups,indicating the significant differences（P〈0.05）. In the treatment group,the scores of intestinal symptom,general symptoms,emotional function and the total score all increased obviously as compared with the control group（P〈0.05）. The score of social function was increased in tendency,without significant difference（P〉0.05）. After treatment,the scores of abdominal pain,diarrhea,tenesmus,bloody purulent stool,anal burning and fever were reduced remarkably as compared with those before treatment in each group,indicating the significant differences（P〈0.05）. After treatment,in the observation group,the scores of abdominal pain,diarrhea,tenesmus,bloody purulent stool and anal burning were remarkably reduced as compared with the control group,indicating the significant differences（P〈0.05）. The score of fever was reducedpotentially,without significant difference（P〉0.05）. The total effective rate in the treatment group was higher remarkably than the control group（P〈0.05）. Conclusion The retention enema with jianpiyiqi and jiedutongluo formula improves in the quality of life,TCM symptom score and the clinical efficacy. Its mechanism is possibly related to the reducing of serum IL-8 and TNF-α and in the patients of ulcerative colitis