加味白头翁汤治疗热毒炽盛型溃疡性结肠炎的疗效

Efficacy of Jiawei Baitouweng Decoction in the treatment of noxious heat type ulcerative colitis

目的探讨加味白头翁汤对热毒炽盛型溃疡性结肠炎(UC)患者的治疗效果及对辅助T细胞1(Th1)/辅助T细胞2(Th2)平衡的影响。方法选取68例热毒炽盛型UC患者,按照随机数字表法分为治疗组与对照组,每组34例。对照组给予氢化可的松琥珀酸钠保留灌肠联合美沙拉嗪肠溶片治疗,治疗组在对照组治疗的基础上加用加味白头翁汤治疗,疗程均为4周。对比2组用药前后中医症候积分变化、中医症候疗效、Th1/Th2免疫平衡[白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、白细胞介素-10(IL-10)、γ干扰素(IFN-γ)]、肠黏膜屏障功能指标[二胺氧化酶(DAO)和低氧诱导因子-1α(HIF-1α)]以及免疫功能指标[CD4+、CD8+、CD4+/CD8+及自然杀伤细胞(NK)],并记录不良反应发生情况。结果治疗组与对照组的中医症候总有效率(94.12%vs.79.41%)和不良反应发生率(8.82%vs.26.47%)比较差异有统计学意义(P<0.05)。治疗组治疗后的便血、腹痛、发热、里急后重、口渴、腹胀以及烦躁不安评分均显著低于对照组(P<0.05)。与对照组相比,治疗组治疗后的血清IL-2、IFN-γ、DAO、HIF-1α以及CD8+水平显著降低(P<0.05),IL-4、IL-10、CD4+以及CD4+/CD8+水平显著提高(P<0.05)。结论加味白头翁汤治疗热毒炽盛型UC疗效确切,其作用机制可能与调节Th1/Th2细胞平衡和激活免疫功能有关。

Objective To explore the therapeutic effect of Jiawei Baitouweng Decoction in patients with noxious heat type ulcerative colitis(UC)and its influence on helper T cell 1(Th1 cell,Th1)/helper T cell 2(Th2 cell,Th2)balance.Methods 68 patients with noxious heat type UC were divided into treatment group and control group according to a random number table,with 34 cases in each group.The control group were treated with hydrocortisone sodium succinate retention enema+Mesalazine Enteric-coated Tablets,and the treatment group were treated with the control group regimen+Jiawei Baitouweng Decoction for 4 weeks.The changes of Traditional Chinese Medicine(TCM)syndrome scores,TCM syndrome curative effect,Th1/Th2 immune balance[interleukin-2(IL-2),interleukin-4(IL-4),interleukin-10(IL-10),interferon-γ(IFN-γ)]were compared between the 2 groups before and after treatment.The intestinal mucosal barrier function indexes[diamine oxidase(DAO)and hypoxia-inducible factor-1α(HIF-1α)]and immune function indexes[CD4+,CD8+,CD4+/CD8+,natural killer cell(NK)]were also compared.The occurrence of adverse reactions was recorded.Results There were significant differences between the treatment group and the control group in the total effective rate of TCM symptoms(94.12%vs.79.41%)and the incidence of adverse reactions(8.82%vs.26.47%)(P<0.05).The scores of blood in stool,abdominal pain,fever,tenesmus,thirst,abdominal distension and restlessness after treatment in the treatment group were significantly lower than those in the control group(P<0.05).Compared with the control group,the serum IL-2,IFN-γ,DAO,HIF-1αand CD8+levels in the treatment group after treatment were significantly reduced(P<0.05),and the levels of IL-4,IL-10,CD4+and CD4+/CD8+were significantly improved(P<0.05).Conclusion Jiawei Baitouweng Decoction has a definite therapeutic effect in the treatment of noxious heat type UC,and its mechanism of action may be related to regulating Th1/Th2 cell balance and activating immune function.