清肠祛湿汤对溃疡性结肠炎(大肠湿热证)患者临床症状的改善作用及免疫机制调节研究

Effect of Improvement of Clinical Symptoms of Using Qingchang Qushi Decoction in the Treatment of Ulcerative Colitis (Damp-heat Syndrome) and the Study on the Regulation of Immune Mechanism

目的:观察清肠祛湿汤治疗大肠湿热证溃疡性结肠炎的临床症状改善情况,并对免疫机制的调节作用进行研究。方法:选取75例溃疡性结肠炎患者,随机分为对照组和观察组,对照组患者给予口服柳氮磺吡啶肠溶片治疗,4周为1个疗程,治疗3个疗程;观察组患者给予自拟清肠祛湿汤治疗,每日1剂,分早晚2次温服,4周为1个疗程,治疗3个疗程。比较2组治疗前后Baron评分及DAI评分,测定治疗前后2组患者血清中IFN-γ、IL-2、IL-4及IL-10的含量,比较2组临床症状评分及临床疗效。结果:观察组治疗后IL-2、IFN-γ水平显著高于对照组(P <0. 05),IL-4及IL-10水平明显低于对照组(P<0. 05);治疗后观察组患者的Baron评分及DAI评分明显较对照组低(P<0. 05); 2组患者治疗后临床症状评分均显著降低(P<0. 05),并且观察组治疗后的各项评分较对照组低(P<0. 05)。结论:清热去湿汤治疗大肠湿热证溃疡性结肠炎临床症状改善明显,其作用机制与调节免疫相关。

Objective： To observe the effect of improvement of clinical symptoms of using Qingchang Qushi Decoction in the treatment of damp-heat syndrome of ulcerative colitis and to study the regulation of immune mechanism. Methods： Seventy-five patients with ulcerative colitis were randomly divided into controlled group and observation group. The patients in the controlled group were given oral Sulfasalazine Enteric-Coated Tablets for 4 weeks for 1 course of treatment for 3 courses. The patients in the observation group were given Self-made Qingchang Qushi Decoction,a daily dose of sub-morning and evening 2 times warm clothes,4 weeks for a course of treatment for 3 courses. The Baron score and DAI score of the two groups before and after treatment were compared. The levels of IFN-γ,IL-2,IL-4 and IL-10 in the two groups before and after treatment were measured.The clinical symptom scores and clinical efficacy were compared between the two groups. Results： The levels of IL-2 and IFN-γin the observation group were significantly higher than those in the controlled group（ P〈0. 05）,and the levels of IL-4 and IL-10 in the observation group were significantly lower than those in the controlled group. The Baron score and DAI score in the observation group after treatmenwere were significantly lower than those in the controlled group（ P〈0. 05）. After treatment,the scores of clinical symptoms in both groups were significantly lower（ P〈0. 05）,and the various scores in the observation group were lower than those in the controlled group（ P〈0. 05）. Conclusion： Qingchang Qushi Decoction can significantly improve the clinical symptoms of damp-heat syndrome of ulcerative colitis and its mechanism of action is related to immune regulation.