健脾益气、清热化腐生肌方联合美沙拉嗪对溃疡性结肠炎患者肠黏膜屏障功能的影响

Effect of Jianpi Yiqi,Qingre Huafu Shengji Recipe combined with Mesalazine on the intestinal mucosal barrier function of patients with ulcerative colitis

目的:探讨健脾益气、清热化腐生肌方联合美沙拉嗪对溃疡性结肠炎患者肠道菌群、肠黏膜改善和肠道炎症损伤修复的作用。方法:选择2019年1月—2020年6月治疗的141例溃疡性结肠炎患者进行前瞻性研究,根据随机数字表法将纳入研究的患者分为西药组、中药组和中西药组,3组患者行不同的治疗方案。西药组患者服用美沙拉嗪肠溶片,中药组采用中医灌肠疗法进行治疗,中西医药组采用美沙拉嗪肠溶片联合中医灌肠疗法进行治疗。疗程均为8周,疗程结束后对比中医症状疗效情况、肠黏膜改善疗效情况、肠道菌群含量以及肠道炎症因子含量。结果:治疗后3组患者腹泻、黏液脓血便、腹痛、里急后重、肛门灼热、发热、口干口苦、大便臭秽等症状评分均明显低于治疗前(P<0.05),且中西药组明显低于西药组和中药组(P<0.05);中西药组中医疗效分级情况明显优于西药组和中药组(P<0.05);中西药组肠黏膜改善总有效率明显高于西药组和中药组,差异有统计学意义(P<0.05);治疗后3组患者乳酸杆菌、双歧杆菌、肠球菌各菌群含量均明显高于治疗前(P<0.05),且中西药组明显高于西药组和中药组(P<0.05);治疗后3组患者IL-6、IL-8、TNF-α含量均明显低于治疗前(P<0.05),且中西药组明显低于西药组和中药组(P<0.05)。结论:健脾益气、清热化腐生肌方联合美沙拉嗪对溃疡性结肠炎患者疗效较好,可有效减轻患者肠黏膜病变程度,调节肠道菌群平衡并减轻肠道炎症损伤,促进康复。

Objective:To explore the effects of Jianpi Yiqi,Qingre Huafu Shengji Recipe combined with mesalazine on the intestinal flora,improvement of intestinal mucosa and repair of intestinal inflammation damage in patients with ulcerative colitis.Methods:One hundred and forty one patients with ulcerative colitis who were treated in our hospital from January 2019 to June 2020 were selected for prospective research.According to the random number table method,the included cases were divided into western medicine group,Chinese medicine group,Chinese and western medicine group,each group patients received different treatment plans.Patients in the western medicine group took western medicine mesalazine enteric-coated tablets,the Chinese medicine group was treated with traditional Chinese medicine enema therapy,and the Chinese and western medicine group was treated with mesalazine enteric-coated tablets combined with traditional Chinese medicine enema therapy.The course of treatment is 8 weeks.After the course of treatment,the effect of Traditional Chinese Medicine symptoms,the effect of improving the intestinal mucosa,the content of intestinal flora and the content of intestinal inflammatory factors are compared.Results:After treatment,the three groups of patients with diarrhea,mucus pus and blood in the stool,abdominal pain,tenesmus,anal burning,fever,dry mouth,bitter mouth,foul stool and other symptoms were significantly lower than before treatment(P<0.05),and the Chinese and western medicine group was significantly lower than the western medicine group and the Chinese medicine group(P<0.05);the efficacy classification of the Chinese and western medicine group was significantly better than that of the western medicine group and Chinese medicine group(P<0.05);the total effective rate of intestinal mucosal improvement in the Chinese and western medicine group was significantly higher than that of the western medicine group and the Chinese medicine group(P<0.05);after treatment,the contents of Lactobacillus,Bifidobacterium,Enterococcus bacterial group in the three groups were significantly higher than before treatment(P<0.05)),and the Chinese and western medicine group was significantly higher than the western medicine group and the Chinese medicine group(P<0.05);the levels of IL-6,IL-8 and TNF-αin the three groups after treatment were significantly lower than those before treatment(P<0.05),and The Chinese and western medicine group was significantly lower than the western medicine group and the Chinese medicine group(P<0.05).Conclusion:Invigorating Jianpi Yiqi,Qingre Huafu Shengji Decoction combined with mesalazine has a good effect on patients with ulcerative colitis.It can effectively reduce the degree of intestinal mucosal lesions,regulate the balance of intestinal flora and reduce intestinal inflammation damage,and promote Recovery.