黄芪建中汤结合艾灸对脾虚湿蕴型溃疡性结肠炎患者的治疗作用及对T细胞亚群的影响

Effects of Huangqi Jianzhong Decoction combined with moxibustion on ulcerative colitis of spleen deficiency and dampness accumulation type and on T cell population

目的:探讨黄芪建中汤结合艾灸疗法对溃疡性结肠炎(UC)脾虚湿蕴证患者的治疗效果,为UC的临床治疗提供参考。方法:选取脾虚湿蕴型UC患者80例,随机分为治疗组与对照组各40例。对照组口服美沙拉嗪肠溶片,治疗组口服中药黄芪建中汤联合艾灸治疗。治疗30 d后,对2组患者治疗前后的临床疗效进行评价,中医证候评分评价患者中医相关症状的改善情况,肠镜Baron评分、Mayo评分评价患者肠黏膜病变及疾病活动情况,观察患者外周血中肿瘤坏死因子-α(TNF-α)、白细胞介素-2(IL-2)、IL-4、IL-10及T淋巴细胞亚群水平变化,记录2组患者不良反应发生率。结果:2组患者治疗前各项指标差异无统计学意义(P>0.05),治疗30 d后,治疗组临床有效率高于对照组,中医证侯评分、Baron评分及Mayo评分较对照组均明显降低,TNF-α、IL-2水平及CD3^(+)CD4^(+)T淋巴细胞、CD3^(+)CD4^(+)/CD3^(+)CD8^(+)比值低于对照组,IL-4、IL-10水平及CD3^(+)CD8^(+)T淋巴细胞较对照组升高,差异有统计学意义(P<0.05)。结论:黄芪建中汤结合艾灸治疗可缓解脾虚湿蕴型UC患者临床症状,降低UC活动度,促进肠黏膜愈合并降低不良反应,临床疗效明显优于常规西药治疗,其机制可能与改善免疫功能,调节炎性因子表达相关。

Objective: To explore the therapeutic effect of Huangqi Jianzhong Decoction combined with Moxibustion on ulcerative colitis(UC) patients with spleen deficiency and dampness accumulation syndrome, so as to provide reference for the clinical treatment of UC. Methods: Eighty patients with UC of spleen deficiency and dampness accumulation type were randomly divided into treatment group and control group, fourty cases in each group. The control group was treated with mesalazine enteric coated tablets, and the treatment group was treated with Huangqi Jianzhong Decoction Combined with moxibustion. After 30 days of treatment, the clinical efficacy of the two groups before and after treatment was evaluated, the improvement of TCM related symptoms was evaluated by TCM syndrome score, the intestinal mucosal lesions and disease activity were evaluated by colonoscopy Baron score and Mayo score, and the tumor necrosis factor in peripheral blood was observed-α(TNF-α), The levels of interleukin-2(IL-2), interleukin-4(IL-4), interleukin-10(IL-10) and T lymphocyte subsets were measured. Results: There was no significant difference in the indexes of the two groups before treatment(P>0.05). After 30 days of treatment, the clinical effective rate of the treatment group was higher than that of the control group, and the TCM syndrome score, Baron score and Mayo score of the treatment group were significantly lower than those of the control group. The levels of TNF-α、IL-2 and CD3^(+)CD4^(+), CD3^(+)CD4^(+)/CD3^(+)CD8^(+)in the treatment group were lower than those in the control group, and the levels of IL-4, IL-10, CD3^(+)CD8^(+)in the treatment group were higher than those in the control group(P<0.05). Conclusion: Huangqi Jianzhong Decoction Combined with moxibustion can relieve the clinical symptoms of UC patients with spleen deficiency and dampness accumulation type, reduce the activity of UC, promote the healing of intestinal mucosa and reduce adverse reactions. The clinical effect is significantly better than that of conventional western medicine treatment, and its mechanism may be related to activating immune function and regulating the expression of inflammatory factors.