虎地肠溶胶囊结合二丙酸倍氯米松灌肠治疗活动期溃疡性结肠炎的疗效及机制分析

Efficacy and mechanism of Hudi enteric-coated capsules combined with beclomethasone dipropionate enema in treatment of active ulcerative colitis

背景溃疡性结肠炎(ulcerative colitis,UC)是临床常见慢性肠道疾病,发病率较高,临床治疗UC主要以糖皮质激素类药物为主,但由于UC病情易反复,治疗效果不佳.虎地肠溶胶囊有清热凉血之功效,可能对治疗UC有一定积极作用.目的探讨虎地肠溶胶囊结合二丙酸倍氯米松灌肠治疗活动期UC的疗效及机制.方法根据随机数表法将2018-01/2019-10期间在我院接受治疗的106例活动期溃疡性结肠炎患者分为对照组(53例)和研究组(53例).对照组采用二丙酸倍氯米松灌肠治疗,研究组采用虎地肠溶胶囊+二丙酸倍氯米松灌肠治疗.对比两组临床疗效、中医证候积分、炎性因子水平、结肠黏膜诱导型一氧化氮合酶(inducible nitric oxide synthase,iNOS)、免疫功能等指标.结果研究组治疗总有效率比对照组高(92.45%vs 77.36%),差异有统计学意义(P<0.05).研究组治疗后症候总积分、CD3+、CD4+、CD4+/CD8+均比对照组高,血清白介素-6、白介素-8、肿瘤坏死因子-α及结肠黏膜iNOS水平均比对照组低,差异均有统计学意义(P<0.05).结论虎地肠溶胶囊结合二丙酸倍氯米松灌肠治疗活动期UC的疗效确切,可明显缓解临床症状,降低机体炎症反应,并可调节结肠黏膜iNOS水平,改善免疫功能.

BACKGROUND Ulcerative colitis(UC)is a clinically common chronic intestinal disease with a high incidence.The clinical treatment of UC is mainly based on glucocorticoid drugs,but due to the recurrence of UC,the treatment effect is not satisfactory.Hudi enteric-coated capsules have the effect of clearing heat and cooling blood,and may have a positive effect in the treatment of UC.AIM To investigate the efficacy and mechanism of Hudi enteric-coated capsules combined with beclomethasone dipropionate enema in the treatment of active UC.METHODS Using the random number table method,106 patients with active UC who were treated at our hospital from January 2018 to October 2019 were divided into a control group(53 cases)and a study group(53 cases).The control group was treated with beclomethasone dipropionate enema alone,and the study group was treated with Hudi enteric-coated capsules plus beclomethasone dipropionate enema.The clinical curative effect,traditional Chinese medicine syndrome score,inflammatory factor levels,inducible nitric oxide synthase(iNOS)expression in the colonic mucosa,and immune function were compared between the two groups.RESULTS The total effective rate in the study group was significantly higher than that in the control group(92.45%vs 77.36%,P<0.05).The total syndrome score,CD3+T lymphocytes,CD4+T lymphocytes,and CD4+/CD8+T lymphocyte ratio in the study group were significantly higher than those in the control group,but the levels of interleukin-6,interleukin-8,tumor necrosis factor-α,and iNOS expression in the colonic mucosa were significantly lower than those of the control group(P<0.05).CONCLUSION Hudi enteric-coated capsules combined with beclomethasone dipropionate enema is effective in the treatment of active UC,which can significantly relieve clinical symptoms,reduce the body’s inflammatory response,adjust the level of iNOS in the colonic mucosa,and improve immune function.