葛根红藤解毒汤联合美沙拉嗪肠溶片治疗溃疡性结肠炎浊毒内蕴证的疗效及对炎症因子的影响

Efficacy of Gegen Hongteng Jiedu Decoction combined with mesalazine enteric-coated tablets for ulcerative colitis of"Zhuoduneiyun"syndrome and how to impact on inflammatory factors

目的观察葛根红藤解毒汤联合美沙拉嗪肠溶片治疗溃疡性结肠炎(UC)浊毒内蕴证的疗效及对炎症因子的影响。方法将80例UC浊毒内蕴证患者按照随机数字表法分为2组,对照组40例予美沙拉嗪肠溶片治疗,治疗组40例在对照组治疗基础上加葛根红藤解毒汤治疗,2组疗程均为8周。比较2组中医证候疗效;比较2组治疗前后中医证候评分变化;比较2组治疗前后Baron内镜评分变化;比较2组治疗前后血清炎症因子肿瘤坏死因子α(TNF-α)、白细胞介素10(IL-10)水平变化;疗程结束后6个月随访比较2组复发情况。结果治疗组中医证候总有效率90.0%(36/40),对照组中医证候总有效率72.5%(29/40),治疗组中医证候疗效优于对照组(P<0.05)。2组治疗后便溏腹泻、脘腹疼痛、黏液脓血便、脘腹胀满、里急后重、口干口苦、肛门灼烧感评分及总评分均较本组治疗前降低(P<0.05),治疗组治疗后便溏腹泻、黏液脓血便、脘腹胀满、里急后重、口干口苦评分及总评分均低于对照组(P<0.05)。2组治疗后Baron内镜评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后TNF-α水平均较本组治疗前降低(P<0.05),IL-10水平均较本组治疗前升高(P<0.05),且治疗组治疗后TNF-α水平低于对照组(P<0.05),IL-10水平高于对照组(P<0.05)。治疗组复发率10.53%(4/38),对照组复发率29.73%(11/37),2组复发率比较差异有统计学意义(P<0.05)。结论葛根红藤解毒汤联合美沙拉嗪肠溶片治疗UC浊毒内蕴证,能改善患者中医临床症状,改善结肠镜检查结果,减轻炎性反应,且复发率低。

Objective To observe the efficacy of Gegen Hongteng Jiedu Decoction combined with mesalazine enteric-coated tablets for ulcerative colitis(UC)of"Zhuoduneiyun"syndrome and how to impact on inflammatory factors.Methods A total of 80 UC patients("Zhuoduneiyun"syndrome)were randomly assigned into the treatment group(n=40)and the control group(n=40).All patients were managed by mesalazine enteric-coated tablets,and those in the treatment group were additionally treated with Gegen Hongteng Jiedu Decoction.Treated for 8 weeks,aiming to compare therapeutic effect of traditional Chinese medicine(TCM)syndrome,TCM syndrome score,Baron endoscopy scores,serum inflammatory factor(tumor necrosis factor-α[TNF-α],Interleukin-10[IL-10]),and recurrence during follow-up;the curative effect was assessed.Results The overall effective rate of TCM syndrome in the treatment group was better than that in the control group[90.0%(36/40)vs 72.5%(29/40),(P<0.05),respectively].After treatment,TCM symptom(diarrhea of loose stools,epigastric pain,mucus pus and bloody stools,epigastric fullness,tenesmus,dry mouth and bitter taste,anal burning sensation)scores in groups were decreased(P<0.05),TCM symptom(diarrhea of loose stools,mucus pus and bloody stools,epigastric fullness,tenesmus,dry mouth and bitter taste)scores were decreased in the treatment group compared with the control group(P<0.05);Baron endoscopy scores in groups were decreased(P<0.05),which in the treatment group were remarkably decreased(P<0.05);decreased TNF-αand increased IL-10 were detected in groups(P<0.05),the treatment group was more prevalent(P<0.05).The recurrence rate in the treatment group and was significantly higher than that in the control group(10.53%[4/38]vs 29.73%[11/37],(P<0.05),respectively).Conclusion For UC patients("Zhuoduneiyun"syndrome),Gegen Hongteng Jiedu Decoction combined with mesalazine enteric-coated tablets has a significant therapeutic effect on improving TCM clinical symptoms,colonoscopy results and inflammatory response,with low recurrence rate.