理气健脾化瘀清肠法联合美沙拉嗪治疗活动期溃疡性结肠炎疗效观察

Observation on therapeutic effect of Liqi Jianpi Huayu Qingchang method combined with mesalazine on active ulcerative colitis

目的观察理气健脾化瘀清肠法联合美沙拉嗪治疗活动期溃疡性结肠炎(UC)的临床疗效。方法将61例活动期UC患者按照随机数字表法分为2组。对照组30例予美沙拉嗪肠溶片口服;治疗组31例在对照组治疗基础上予理气健脾化瘀清肠法为治则的中药汤剂口服及保留灌肠。2组均治疗8周。比较2组症状改善情况、诱导缓解率,以及治疗前后凝血指标[凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、纤维蛋白原(FIB)]、血小板计数(PLT)、平均血小板体积(MPV)、炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、IL-8、IL-10]的变化。结果治疗组诱导缓解率90.3%,对照组诱导缓解率76.7%,治疗组诱导缓解率高于对照组(P<0.05)。治疗后2组各中医症状评分均降低(P<0.05),治疗组治疗后各中医症状评分均低于对照组(P<0.05)。治疗后2组PT、APTT均延长,MPV均增大,FIB、PLT均降低(P<0.05);治疗组治疗后PT、APTT长于对照组,MPV大于对照组,FIB、PLT低于对照组(P<0.05)。治疗后2组TNF-α、IL-6、IL-8均降低,IL-10均升高(P<0.05),且治疗组治疗后TNF-α、IL-6、IL-8均低于对照组,IL-10高于对照组(P<0.05)。结论理气健脾化瘀清肠法联合美沙拉嗪口服治疗活动期UC疗效确切,能有效缓解临床症状,降低体内炎症水平及血液高凝状态。

Objective To observe the effect of Liqi Jianpi Huayu Qingchang method combined with mesalazine on active ulcerative colitis(UC). Methods 61 active UC patients were divided into two groups according to the random number table method. 30 cases in control group were treated by mesalazine enteric coated tablets. 31 cases in treatment group were treated by traditional Chinese medicine decoction and retention enema on the basis of the control group. Both groups were treated for 8 weeks. The improvement of symptoms and remission rate were compared between the two groups, and the changes of coagulation indexes [prothrombin time(PT), activated partial thrombin time(APTT), fibrinogen(FIB)], platelet count(PLT), mean platelet volume(MPV), inflammatory cytokines [tumor necrosis factor α(TNF-α), interleukin-6(IL-6), IL-8, IL-10] before and after treatment were compared. Results The induced remission rate was 90.3% in the treatment group and 76.7% in the control group, and the treatment group was higher than the control group(P<0.05). After treatment, the scores of TCM symptoms in the two groups were decreased(P<0.05), and the treatment group were lower than the control group(P<0.05). After treatment, PT and APTT were prolonged, MPV was increased, FIB and PLT were decreased in both groups(P<0.05);PT and APTT in the treatment group were longer than those in the control group, MPV was larger than those in the control group, FIB and PLT were lower than those in the control group(P<0.05). After treatment, TNF-α, IL-6 and IL-8 were all decreased and IL-10 was increased in the two groups(P<0.05), and TNF-α, IL-6 and IL-8 in the treatment group were lower than those in the control group, and IL-10 was higher than those in the control group(P<0.05). Conclusion Liqi Jianpi Huayu Qingchang method combined with mesalazine is effective in the treatment of active UC, which can effectively relieve the clinical symptoms, reduce the level of inflammation and hypercoagulability of blood.