安肠汤对活动期中重度溃疡性结肠炎脾肾阳虚证患者免疫功能及炎症因子影响的回顾性研究

Retrospective Study on Effect of Immune Function and Inflammatory Factors in Active Stage Moderate to Severe Ulcerative Colitis Patients with Spleen-Kidney Yang Deficiency Treated by Anchang Decoction

目的评价安肠汤对慢性复发型活动期中重度溃疡性结肠炎脾肾阳虚证患者的临床疗效,及对免疫功能和炎症因子的影响。方法利用广西中医药大学第一附属医院信息系统,检索2018年1月-2020年1月慢性复发型活动期中重度溃疡性结肠炎脾肾阳虚证患者病历资料。对照组采用美沙拉嗪肠溶片为主的西医常规疗法,观察组在对照组治疗基础上予安肠汤口服。2组均4周为1个疗程,连续治疗2个疗程。评价近期临床疗效,观察中医症状积分、溃疡性结肠炎活动度指数(UCAI)评分,外周血T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+))水平、免疫球蛋白(Ig)M、IgG、C-反应蛋白(CRP)、红细胞沉降率(ESR)、肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-8、全血细胞计数及不良反应。结果最终纳入80例患者,观察组与对照组各40例。观察组总有效率为92.5%(37/40),对照组为67.5%(27/40),观察组总有效率明显优于对照组(P<0.05)。与本组治疗前比较,2组治疗后中医症状积分、UCAI评分、免疫功能指标、血清炎症因子、全血细胞计数水平均明显改善(P<0.05);2组治疗后比较,观察组上述指标改善水平明显优于对照组(P<0.05)。2组治疗期间未见明显不良反应。结论在西医常规疗法基础上,持续性服用安肠汤能使慢性复发型活动期中重度溃疡性结肠炎脾肾阳虚证患者获得更好的临床疗效,增强免疫功能,减轻外周血清炎症因子水平,改善微循环,提高治疗安全性。

Objective To analyze the clinical efficacy of Anchang Decoction on chronic recurrent active stage moderate to severe ulcerative colitis patients with spleen-kidney yang deficiency and its effects on immune function and inflammatory factors.Methods The First Affiliated Hospital of Guangxi University of Chinese Medicine information retrieval system was used to retrieve medical records of chronic recurrent active stage moderate to severe ulcerative colitis patients with spleen-kidney yang deficiency from January 2018 to January 2020.The control group received Western medicine routine therapy such as mesalazine enteric-coated tablets,while the observation group received Anchang Decoction on the basis of treatment of the control group.In both groups,4 weeks was a course of treatment,with 2 consecutive courses of treatment.Short-term clinical efficacy was evaluated.TCM symptom scores,ulcerative colitis activity score(UCAI),peripheral blood T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+))levels,immunoglobulin(Ig)M,IgG,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-8,complete blood cell count and adverse reactions were observed.Results Finally,80 patients were screened out,40 cases in the observation group and 40 cases in the control group.The total effective rate of the observation group was 92.5%(37/40),and the control group was 67.5%(27/40).The total effective rate of the observation group was significantly better than that of the control group(P<0.05).Compared with before treatment,TCM symptom scores,UCAI scores,immune function indexes,serum inflammatory factors,and complete blood cell count levels in the two groups were significantly improved after treatment(P<0.05);after treatment,the improvement level of the above indicators in the observation group was significantly better than that in the control group(P<0.05).There were no obvious adverse reactions during treatment in both groups.Conclusion On the basis of Western medicine routine therapy,continuous use of Anchang Decoction can make chronic recurrent active stage moderate to severe ulcerative colitis patients with spleen-kidney yang deficiency have better clinical efficacy,enhance immune function,reduce peripheral serum inflammatory factor levels,and improve microcirculation and the safety of treatment.