益气愈溃汤联合美沙拉嗪治疗溃疡性结肠炎患者的临床疗效分析

Clinical efficacy analysis of Yiqi Yukui Decoction combined with mesalazine in the treatment of ulcerative colitis

目的:分析益气愈溃汤联合美沙拉嗪治疗溃疡性结肠炎(ulcerative colitis, UC)患者的临床效果,为UC的临床治疗提供经验指导。方法:采用随机对照方法,纳入2018年1月—2022年1月期间本院接收的100例UC患者为研究对象,采用区组随机分组法分为两组,每组各50例。两组患者均进行常规治疗,对照组给予美沙拉嗪治疗,观察组给予益气愈溃汤联合美沙拉嗪治疗,均连续治疗4周。比较两组患者治疗前及治疗4周后的临床疗效、肠黏膜屏障功能[D-乳酸(D-lactic acid, D-LA)、二胺氧化酶(diamine oxidase, DAO)、内毒素(endotoxin, ET)]、辅助性T细胞17(helper T cell 17,Th17)/调节性T细胞(regulatory T cell, Treg)免疫平衡情况(Th17水平、Treg水平、Th17/Treg值)及不良反应发生情况。结果:观察组的治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗4周后,两组患者的D-LA、DAO、ET水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗4周后,两组患者的Th17、Th17/Treg低于治疗前,Treg高于治疗前,且观察组患者的Th17、Th17/Treg低于对照组,Treg高于对照组,均差异有统计学意义(均P<0.05);两组患者的不良反应发生情况比较,差异无统计学意义(P>0.05)。结论:益气愈溃汤联合美沙拉嗪可显著改善UC患者的肠黏膜屏障功能,维持Th17/Treg细胞免疫平衡,提高临床治疗效果,且不会增加不良反应发生风险。

Objective:To analyze the clinical effect of Yiqi Yukui Decoction combined with mesalazine in the treatment of ulcerative colitis(UC),and provide experience guidance for the clinical treatment of UC.Methods:A randomized controlled trial was used to include 1oo patients with UC who were admitted to our hospital from January 2018 to January 2022.They were divided into two groups with 50 patients in each group.Both groups were treated with greedy ghosts,the control group was treated with mesalazine,and the observation group was treated with Yiqi Yukui Decoction combined with mesalazine for four weeks.The clinical efficacy,intestinal mucosal barrier functionserum D-lactic acid(D-LA),diamine oxidase(DAO),endotoxin(ET)J,helper T cell 17(Th17)/regulatory T(Treg)cell immune balance(Th17 level,Treg level,Th17/Treg value)and adverse reactions were compared between the two groups before and after four weeks of treatment.Results:The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).After four weeks of treatment,the levels of D-LA,DAO and ET in the two groups were lower than those before treatment,and the levels in the observation group were lower than those in the control group(P<0.05).After four weeks of treatment,Th17,Th17/Treg in the two groups were lower than those before treatment,and Treg was higher than those before treatment,and Th17,Th17/Treg in the observation group was lower than that in the control group,and Treg was higher than that in the control group(P<o.05).There was no statistical significant difference in the occurrence of adverse reactions between the two groups(P>0.05).Conclusion:Yiqi Yukui Decoction combined with mesalazine can significantly improve the intestinal mucosal barrier function of UC patients,maintain the Th17/Treg cell immune balance,improve the clinical treatment effect,and will not increase the risk of adverse reactions.