溃结灵口服、青蒲方保留灌肠联合美沙拉秦缓释颗粒治疗溃疡性结肠炎临床观察

Clinical observation of Kuijieling oral and Qingpu formula retention enema combined with Mesalazine SR Granules in the treatment of ulcerative colitis

目的观察溃结灵口服、青蒲方保留灌肠联合美沙拉秦缓释颗粒治疗溃疡性结肠炎(UC)的临床疗效。方法将80例UC患者按照随机数字表法分为2组。对照组40例予美沙拉秦缓释颗粒治疗,治疗组40例在对照组治疗基础上予溃结灵口服联合青蒲方保留灌肠。2组均治疗4周。比较2组治疗前后症状评分、C反应蛋白(CRP)、红细胞沉降率(ESR)、粪钙卫蛋白,以及肠黏膜和血清白细胞介素6(IL-6)表达和其基因甲基化的变化,并统计疗效。结果治疗组总有效率92.5%(37/40),对照组总有效率75.0%(30/40),治疗组疗效优于对照组(P<0.05)。治疗后治疗组各项症状评分均较本组治疗前降低(P<0.05),对照组腹泻、脓血便、腹胀、肛门灼热及里急后重评分均降低(P<0.05),且治疗后治疗组腹泻、脓血便、腹痛、里急后重评分均低于对照组(P<0.05)。治疗后2组CRP、ESR及粪钙卫蛋白均较本组治疗前降低(P<0.05),且治疗后治疗组均低于对照组(P<0.05)。治疗后2组肠黏膜组织及血清IL-6表达均较本组治疗前降低(P<0.05),且治疗后治疗组均低于对照组(P<0.05)。治疗后2组肠黏膜组织IL-6启动子区CpG位点甲基化水平均较本组治疗前升高(P<0.05),且治疗组高于对照组(P<0.05)。结论溃结灵口服、青蒲方保留灌肠联合美沙拉秦缓释颗粒治疗UC疗效确切,其作用机制之一为提高肠黏膜IL-6甲基化水平,降低IL-6表达。

Objective To observe the effect of Kuijieling oral and Qingpu formula retention enema combined with Mesalazine SR Granules in the treatment of ulcerative colitis(UC)Methods 80 UC patients were divided into the control group(n=40)and the treatment group(n=40)according to the random number table.Patients in the control group were treated with Mesalazine SR Granules while the treatment group with oral administration of Kuijieling combined with retention enema by Qingpu formula based on the control group.Patients in the two groups were treated for four weeks.The symptom score and the changes of C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),fecal calprotectin,interleukin 6(IL-6)and its gene methylation were compared in the two groups before and after treatment.And the treatment effects were evaluated.Results The total effective rate was 92.5%(37/40)in the treatment group while 75.0%(30/40)in the control group.Obviously,the treatment group was superior to the control group(P<0.05).By comparison with the score before treatment,each symptom score was lower in the treatment group after treatment(P<0.05)and the scores of diarrhea,bloody purulent stool,abdominal distension,burning pain in anus,and tenesmus were lower in the control group(P<0.05).Meanwhile,the scores of diarrhea,bloody purulent stool,abdominal distension,and tenesmus in the treatment group were lower than those of the control group after treatment(P<0.05).The levels of CRP,ESR,fecal calprotectin,and expression of intestinal mucosa and serum IL-6 in the two groups were lower than those before treatment(P<0.05).And those levels in the treatment group were lower than those of the control group(P<0.05).After treatment,the levels of methylation in the IL-6 promoter region CpG site of intestinal mucosa in the two groups were higher than those results before treatment(P<0.05).And the levels of methylation in the treatment group were higher than those of the control group after treatment(P<0.05).Conclusion It has a definite curative effect of Kuijieling oral and Qingpu formula retention enema combined with Mesalazine SR Granules in the treatment of UC.And one of action mechanisms to treat UC is to increase the level of IL-6 methvlation of intestinal mucosa and reduce the expression of IL-6.