益气解毒汤结合美沙拉秦缓释颗粒治疗溃疡性结肠炎临床研究

Clinical study of Yiqi-Jiedu decoction combined with mesalazine sustained release granules for the patients with ulcerative colitis

目的评价益气解毒汤结合美沙拉秦缓释颗粒治疗溃疡性结肠炎(ulcerative colitis, UC)的疗效。方法将符合入选标准的93例UC患者按随机数表法分为对照组46例和研究组47例。对照组口服美沙拉秦缓释颗粒治疗,研究组在对照组基础上加用益气解毒汤。2组均连续治疗2个月。采用ELISA法检测血浆血栓烷B2(thromboxaneB2, TXB2)、6-酮-PGF1a(6-keto-prostaglandin F1a, 6-Keto-PGF1a)及血清CRP、IL-1、TNF-a水平,评价临床疗效。结果研究组总有效率为95.7%(45/47)、对照组为78.3%(36/46),2组比较差异有统计学意义(χ2=6.323,P=0.012)。治疗后,研究组血浆TXB2[(601.14± 13.31)pg/ml比(780.33±16.54)pg/ml,t=57.619]水平低于对照组(P<0.01)、6-Keto-PGF1a[(84.04± 11.39)pg/ml比(69.48±10.21)pg/ml,t=6.487]水平高于对照组(P<0.01)。研究组治疗后血清CRP、IL-1、TNF-a水平低于对照组(t值分别为15.457、7.006、17.434,P值均<0.01)。结论益气解毒汤结合美沙拉秦缓释颗粒可有效降低UC患者的血清炎性细胞因子水平,下调血浆TXB2,上调血浆6-Keto-PGF1a,提高临床疗效。

Objective To evaluate the effect of Yiqi-Jiedu decoction combined with mesalazine sustained release granules for the patients with ulcerative colitis (UC). Methods A total of 93 UC patients who met the inclusion criteria were divided into control group (46 cases) and study group (47 cases) according to the random number table method. The control group was treated with mesalazine sustained release granules orally. The treatment group added Yiqi-Jiedu decoction on the basis of the control group. Both groups were treated for 2 months. The level of plasma thromboxane B2 (TXB2), 6-keto-prostaglandin F1a (6-Keto-PGF1a) and serum CRP, IL-1 and TNF-a were measured by ELISA, and the clinical effect was evaluated. Results The total effective rate was 95.7%(45/47) in the treatment group and 78.3%(36/46) in the control group. There was significant difference between the two groups (χ2=6.323, P=0.012). After treatment, the plasma TXB2 level in the treatment group was significantly lower than that in the control group (601.14 ± 13.31 pg/ml vs. 780.33 ± 16.54 pg/ml;t=57.619, P<0.01), and the plasma 6-Keto-PGF1a level was significantly higher than that in the control group (84.04 ± 11.39 pg/ml vs. 69.48 ± 10.21 pg/ml;t=6.487, P<0.01). After treatment, the level of CRP, IL-1 and TNF-a in the treatment group was significantly lower than those in the control group (t=15.457, 7.006 and 17.434, respectively, all Ps<0.01). Conclusions The Yiqi-Jiedu decoction combined with mesalazine sustained release granules can reduce the level of serum inflammatory cytokines in UC patients, reduce the level of plasma TXB2, and increase the level of plasma 6-Keto-PGF1a, so as to improve the clinical effectiveness.