益脾祛湿理肠汤治疗溃疡性结肠炎疗效及对患者肠黏膜屏障功能的影响

Yipi Qushi Lichang decoction on ulcerative colitis and its influence on intestinal mucosal barrier function

目的:探讨益脾祛湿理肠汤治疗大肠湿热证溃疡性结肠炎效果及对肠黏膜屏障功能、白细胞介素-17(IL-17)、白细胞介素-23(IL-23)的影响。方法:选取110例大肠湿热证溃疡性结肠炎患者为研究对象,按随机数字表法,分为两组。对照组采用常规西药治疗,观察组增加益脾祛湿理肠汤治疗,两组均治疗3个月。对比大肠湿热证中医证状评分,腹泻消失时间,血便消失时间,疾病活动指数评分,临床疗效,肠黏膜屏障功能,血清IL-17、IL-23水平及不良反应。结果:两组患者治疗后大肠湿热证症状评分均降低(P<0.05),且观察组更低(P<0.05);观察组腹泻消失时间、血便消失时间均短于对照组(P<0.05);两组治疗后疾病活动指数评分均降低(P<0.05),且观察组低于对照组(P<0.05);两组治疗后疗效等级分布比较,差异具有统计学意义(P<0.05),且观察组的总有效率高于对照组(P<0.05);两组治疗后血清D-乳酸(D-LA)、内毒素(BT)、二胺氧化酶(DAO)、IL-17、IL-23水平均降低(P<0.05),且观察组均低于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:益脾祛湿理肠汤用于治疗大肠湿热证溃疡性结肠炎能够改善临床症状,疗效显著,且能够改善肠黏膜屏障功能及血清细胞因子水平。

Objective:To explore the effect of Yipi Qushi Lichang decoction in treating ulcerative colitis of large intestine damp-heat syndrome and its influence on intestinal mucosal barrier function,interleukin-17(IL-17),interleukin-23(IL-23).Methods:110 patients with ulcerative colitis with large intestine damp-heat syndrome were selected as the research objects,and they were divided into two groups according to the random number table.The control group was treated with conventional western medicine,and the observation group was treated with Yipi Qushi Lichang decoction,both groups were treated for 3 months.Two groups of patients with large intestine damp-heat syndrome traditional Chinese medicine syndrome scores,diarrhea disappearance time,bloody stool disappearance time,disease activity index,clinical efficacy,intestinal mucosal barrier function,serum IL-17,IL-23 levels and adverse reactions were compared.Results:After treatment,the symptom scores of large intestine damp-heat syndrome of the two groups were decreased(P<0.05),and the observation group were lower(P<0.05).The disappearance time of diarrhea and bloody stool in the observation group were shorter than those in the control group(P<0.05),after treatment,the disease activity index of the two groups were decreased(P<0.05),and the observation group was lower than the control group(P<0.05).After treatment,there was a significant difference in the distribution of curative effects between the two groups(P<0.05),and the total effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the levels of serum D-lactic acid(D-LA),endotoxin(BT),diamine oxidase(DAO),IL-17,and IL-23 in the two groups were decreased(P<0.05),and the observation group were lower than control group(P<0.05).There were no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Yipi Qushi Lichang decoction for the treatment of ulcerative colitis with large intestine damp-heat syndrome can improve the clinical symptoms and has significant curative effect,and it can improve the intestinal mucosal barrier function and serum cytokine levels.