白头翁汤加减对溃疡性结肠炎的疗效及部分机制研究

Study on the Therapeutic Effect and Partial Mechanism of Baitouweng Decoction on Ulcerative Colitis

目的:探讨白头翁汤加减对溃疡性结肠炎(UC)疗效及部分作用机制。方法:选取2018年2月至2019年1月唐山市中医医院收治的大肠湿热型UC患者130例作为研究对象,按照住院号单双分为对照组和观察组,每组65例,对照组美沙拉嗪肠溶片治疗,观察组加用中药汤剂白头翁汤加减,均治疗4周。比较2组患者临床疗效及炎性反应因子等指标变化情况。结果:1)2组治疗后腹泻、腹痛、黏液脓血、里急后重、五心烦热、总分较治疗前均显著下降(P<0.01),且观察组下降幅度均高于对照组(P<0.05)。2)2组患者治疗后白细胞介素-23(IL-23)、IL-17、肿瘤坏死因子-α(TNF-α)、CD8^+、肠镜评分、DAI、改良Mayo评分较治疗前均下降(P<0.05),NK细胞、CD4^+/CD8^+较治疗前均升高,且观察组改善幅度均优于对照组(P<0.05)。3)对照组显效率44.62%、总有效率83.08%,观察组显效率60%、总有效率92.31%,观察组显著优于对照组(P<0.05)。结论:白头翁汤加减能通过调节UC的IL-23/IL-17轴平衡,从而发挥改善机体免疫功能,抑制肠道炎性反应,最终提高疗效和改善生命质量。

Objective:To explore the curative effect and partial mechanism of modified Baitouweng Decoction in the treatment of ulcerative colitis(Ulcerative Colitis,UC).Methods:A total of 130 patients with UC of damp-heat type of large intestine were randomly divided into a control group(n=65)and an observation group(n=65).The patients in the control group were treated with mesalazine enteric-coated tablets,and those in the observation group were treated with Baitou Weng Decoction for 4 weeks.The changes of clinical efficacy and inflammatory factors and other indexes were compared between the 2 groups.Results:1)After treatment,diarrhea,abdominal pain,mucus and purulent blood,acute post-acute weight,five-heart fever and total score in the 2 groups were significantly lower than those before treatment(P<0.01),and the decrease in the observation group was higher than that in the control group(P<0.05).2)Interleukin-23(IL-23),IL-17,tumor necrosis factor-α(TNF-α),CD8^+,enteroscopy score,DAI and modified Mayo score in the 2 groups after treatment were significantly lower than those before treatment(P<0.05).NK cells and CD4^+/CD8^+were higher than those before treatment,and the improvement in the observation group was better than that in the control group(P<0.05).3 The markedly effective rate of the control group was 44.62%,and the total effective rate was 83.08%.The markedly effective rate of the observation group was 60%,a nd the total effective rate was 92.31%.The observation group was significantly better than the control group(P<0.05).Conclusion:Modified Baitouweng Decoction can improve the immune function,inhibit intestinal inflammation,and finally improve the curative effect and quality of life by regulating the balance of IL-23/IL-17 axis of UC.