平肠汤治疗慢性复发型溃疡性结肠炎的临床观察

Clinical Observation of Pingchang Decoction in Treatment of Chronic Recurrent Ulcerative Colitis

目的:观察自拟平肠汤治疗慢性复发型溃疡性结肠炎(UC)的疗效及安全性。方法:选取2017年12月—2019年8月西南医科大学附属医院诊治的120例UC患者,随机分为观察组(口服平肠汤)和对照组(口服美沙拉嗪)各60例。两组患者均连续治疗8周,疗程结束后随访6个月。比较两组的临床疗效、改良Mayo评分、主要临床症状积分、结肠镜评分及生存质量。采用酶联免疫吸附法检测两组患者治疗前后的肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6及IL-10表达水平变化,观察两组复发情况及不良反应。结果:治疗后,观察组临床总有效率(89%)明显优于对照组(73%),复发率(14%)低于对照组(31%),差异有统计学意义(P<0.05)。观察组的改良Mayo评分(1.89±0.79)、主要临床症状积分(1.72±0.56)、Baron评分(1.37±0.49)均较前明显下降,且低于对照组[分别为(2.22±0.71)、(2.02±0.68)、(1.60±0.49)],差异有统计学意义(P<0.05)。治疗后,两组TNF-α、IL-6表达水平均下调,观察组低于对照组;IL-10表达水平上调,且观察组高于对照组,差异有统计学意义(P<0.05)。治疗后,两组生存质量IBDQ评分均较前明显改善,且观察组治疗后的生存质量更优于对照组,差异有统计学意义(P<0.05)。治疗期间观察组无不良反应,对照组出现2例不良反应。结论:自拟平肠汤治疗慢性复发型UC疗效显著且安全性高,其主要通过下调炎症介质表达水平有效抑制炎症反应,促进黏膜愈合,明显改善UC患者临床症状及生存质量,并减少复发。

Objective To observe the efficacy and safety of self-made Pingchang Decoction in the treatment of chronic recurrent ulcerative colitis.Methods In a randomized and parallel-controlled study,120 patients with chronic recurrent ulcerative colitis(UC)who met the inclusion criteria were randomly divided into observation group(n=60)and control group(n=60).The patients in the observation group were treated with oral Pingchang decoction and the patients in the control group were treated with oral mesalazine enteric-coated tablets.The patients in both groups were treated continuously for 8 weeks and followed up for 6 months at the end of the course of treatment.The clinical efficacy,modified Mayo score,main clinical symptom score,colonoscopy score and quality of life of the two groups were compared,and the comprehensive curative effect was evaluated.The expression levels of serum tumor necrosis factor-alpha(TNF-α),interleukin-6(IL-6)and interleukin-10(IL-10)in the two groups were detected by enzyme-linked immunosorbent assay(ELISA).The recurrence and adverse reactions of the two groups were recorded.Results After treatment,the total clinical effective rate of the observation group(89%)was significantly better than that of the control group(73%),and the recurrence rate(14%)was lower than that of the control group(31%)(P<0.05).The modified Mayo score,main clinical symptom score and Baron endoscopic score of the observation group[(1.89±0.79),(1.72±0.56),(1.37±0.49)]were significantly lower than those before treatment,and lower than those of the control group[(2.22±0.71),(2.02±0.68),(1.60±0.49)](P<0.05).After treatment,the expression levels of serum TNF-αand IL-6 in the two groups were lower than those before treatment,and lower than those in the control group(P<0.05).The level of IL-10 expression and IBDQ score in the observation group were higher than those before treatment and those in the control group(P<0.05).During the treatment,there were no adverse reaction cases in the observation group but 2 cases in the control group.Conclusion Self-made Pingchang decoction is effective and safe in the treatment of chronic recurrent UC.It can down-regulate the expression of inflammatory mediators,effectively inhibit inflammatory reaction,promote mucosal healing,significantly improve clinical symptoms and quality of life in patients with UC as well as reduce its recurrence.