扶正活血汤联合英夫利昔单抗治疗克罗恩病

Fuzheng Huoxue Decoction Combined with Infliximab in the Treatment of Crohn′s Disease

目的:观察扶正活血汤联合英夫利昔单抗治疗克罗恩病的临床疗效。方法:96例中重度克罗恩病患者随机分为治疗组与对照组,每组48例。对照组给予静脉滴注英夫利昔单抗,治疗组在对照组治疗基础上给予扶正活血汤保留灌肠,两组均治疗6个月。比较两组患者治疗前后的主要临床症状、生化指标、克罗恩病简化内镜评分(simplified endoscopic score of Crohn disease,SES-CD)、克罗恩病活动指数(Crohn disease activity index,CDAI)、炎性因子水平、Th1/Th2细胞比例、临床疗效。结果:治疗前,治疗组与对照组发热、腹痛腹泻、食欲不振、营养不良症状,血红蛋白、C反应蛋白、血沉水平,SES-CD评分,CDAI,IL-10、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平及Th1/Th2细胞比例比较,差异均无统计学意义(P>0.05)。治疗后,两组患者发热、腹痛腹泻、食欲不振、营养不良症状,血红蛋白、C反应蛋白、血沉水平,SES-CD、CDAI评分分布,白细胞介素-10(interleukin-10,IL-10)、TNF-α水平及Th1/Th2细胞比例比较,差异均有统计学意义(P<0.05);治疗组治疗后以上指标与对照组比较,差异均有统计学意义(P<0.05)。治疗组有效率为81.25%,对照组有效率为64.58%,治疗组显著高于对照组(P<0.01)。结论:扶正活血汤联合英夫利昔单抗治疗克罗恩病患者疗效显著,可缓解病情,其原因可能与二药联用可以显著降低炎性细胞因子水平及Th1/Th2细胞比例有关。

Objective:To observe the clinical treatment of Fuzheng Huoxue Decoction combined with infliximab in the treatment of Crohn′s disease.Methods:96 patients with moderate and severe Crohn′s disease were randomly divided into treatment group and control group,with 48 cases in each group.The control group was given intravenous infusion of infliximab,and the treatment group was given retention enema of Fuzheng Huoxue Decoction on the basis of the treatment of the control group.Both groups were treated for 6 months.The main clinical symptoms,biochemical indexes,simplified endoscopic score of Crohn′s disease(SES-CD),Crohns disease activity index(CDAI),inflammatory factor level,Th1/Th2 cell ratio and clinical efficacy were compared between the two groups before and after treatment.Results:Before treatment,fever,abdominal pain,diarrhea,loss of appetite,malnutrition,hemoglobin,C-reactive protein,erythrocyte sedimentation rate,SES-CD score,CDAI,IL-10,the level of tumor necrosis factor-α(TNF-α)and the ratio of Th1/Th2 cells in the treatment group and the control group were compared.The difference was not statistically significant(P>0.05).After treatment,fever,abdominal pain,diarrhea,loss of appetite,malnutrition,hemoglobin,C-reactive protein,erythrocyte sedimentation rate,SES-CD score,CDAI,IL-10,the level of tumor necrosis factor-α(TNF-α)and the ratio of Th1/Th2 cells in the treatment group and the control group were compared.The differences were statistically significant(P<0.05).The effective rate of the treatment group was 81.25%and that of the control group was 64.58%,which was significantly higher than that of the control group(P<0.01).Conclusion:Fuzheng Huoxue Decoction combined with infliximab can significantly improve the clinical efficacy and alleviate the condition of patients with Crohn′s disease.The reason may be that the combination of two drugs can significantly reduce the level of inflammatory cytokines and the ratio of Th1/Th2 cells.