健脾化滞丸治疗不同证型溃疡性结肠炎的临床疗效及对血清白细胞介素8、单核细胞趋化因子1和巨噬细胞迁移抑制因子水平的影响

Clinical efficacy of Jianpi Huazhi Pill in the treatment of different syndromes of ulcerative colitis and its effect on serum iterleukin-8,monocyte chemokine-1 and macrophagic migration inhibitor levels

目的观察健脾化滞丸治疗不同证型溃疡性结肠炎(UC)的临床疗效及对血清白细胞介素8(IL-8)、单核细胞趋化因子1(MCP-1)和巨噬细胞迁移抑制因子(MIF)水平的影响。方法将126例UC患者按辨证分为大肠湿热组(34例)、脾虚湿蕴组(32例)、脾肾阳虚组(30例)、寒热错杂组(30例),4组均在UC基础治疗基础上予健脾化滞丸治疗。疗程2个月。比较4组治疗前后改良Mayo评分、临床症状评分及血清IL-8、MCP-1、MIF水平,并统计疗效。结果脾虚湿蕴组总有效率96.88%(31/32),高于大肠湿热组[85.29%(29/34)]、脾肾阳虚组[83.33%(25/30)]及寒热错杂组[86.67%(26/30)](P<0.05)。治疗后4组改良Mayo评分均较本组治疗前降低(P<0.05),且治疗后脾虚湿蕴组均低于大肠湿热组、脾肾阳虚组及寒热错杂组(P<0.05)。治疗后4组各临床症状评分均较本组治疗前降低(P<0.05),治疗后脾虚湿蕴组腹痛、腹泻、纳差、乏力症状评分均低于大肠湿热组、脾肾阳虚组、寒热错杂组(P<0.05)。治疗后4组血清IL-8、MCP-1、MIF水平均较本组治疗前降低(P<0.05),且治疗后脾虚湿蕴组均低于大肠湿热组、脾肾阳虚组、寒热错杂组(P<0.05)。结论不同证型UC患者在基础治疗基础上加用健脾化滞丸后,临床效果均良好,均能改善临床症状,其作用机制与下调血清IL-8、MCP-1、MIF水平有关。其中健脾化滞丸对脾虚湿蕴证UC患者疗效和下调炎性指标作用更为显著。

Objective To analyze the clinical efficacy on Jianpi Huazhi Pill in the treatment of different syndromes of ulcerative colitis(UC)and its effect on serum interleukin-8(IL-8),monocyte chemokine-1(MCP-1)and macrophagic migration inhibitor(MIF).Methods A total of 126 patients with UC diagnosed in our hospital were selected,according to traditonal Chinese medicine(TCM)syndromes,they were divided into large intestine dampness-heat group(n=34),spleen deficiency dampness-yun group(n=32),spleen-kidney yang-deficiency group(n=30)and cold-heat hybrid group(n=30).On the basis of UC treatment,all groups were treated with Jianpi Huazhi Pill,the course of treatment was 2 months.The modified Mayo disease activity index score,symptom score,the lever of serum IL-8,MCP-1 and MIF in all groups were detected before and after treatment,and aslo clinical data of the patients were collected.Results The total response rates in spleen deficiency dampness-yun group,large intestine dampness-heat group,spleen-kidney yang-deficiency group,and cold-heat hybrid group were[96.88%(31/32)]vs[85.30%(29/34)]vs[83.33%(25/30)]vs[86.67%(26/30)](P<0.05),respectively.After treatment,the modified Mayo disease activity index score in all groups were lower than that before treatment(P<0.05),and the syndrome of spleen deficiency dampness-yun group was lower than that of the other three groups(P<0.05).After treatment,the symptom scores in all groups were all lower than those before treatment(P<0.05),and the scores of abdominal pain,diarrhea,appetite difference and fatigue in spleen deficiency dampness-yun group were all lower than those of the other three groups(P<0.05).After treatment,the levels of serum IL-8,MCP-1 and MIF in all groups were all lower than those before treatment(P<0.05),and the syndrome of spleen deficiency dampness-yun group was lower than the other three groups(P<0.05).Conclusion After treatment with Jianpi Huazhi Pill,the clinical effect of UC patients with different syndromes is good,which can improve the clinical symptoms,and down-regulate the levels of serum IL-8,MCP-1 and MIF.Among them,Jianpi Huazhi Pill has a more significant effect on UC patients with dampness syndrome of spleen deficiency.