黄葵敛肠汤保留灌肠治疗溃疡性结肠湿热内蕴证临床研究

Clinical Study of Retention Enema of Huangkui Lianchang Decoction in the Treatment of Ulcerative Colitis with Internal Accumulation of Damp-Heat Syndrome

目的探讨黄葵敛肠汤保留灌肠治疗溃疡性结肠炎(UC)湿热内蕴证的临床疗效,以及对患者脑肠肽及免疫功能指标的影响。方法选取医院2020年7月至2021年6月收治的UC湿热内蕴证患者120例,随机分为观察组和对照组,各60例。对照组患者给予美沙拉嗪肠溶片口服治疗,观察组患者给予黄葵敛肠汤保留灌肠治疗,两组患者均治疗12周。结果观察组总有效率为83.33%,显著高于对照组的73.33%(P<0.05)。治疗后,观察组主要症状腹泻、腹痛、黏液血便、里急后重评分均显著低于对照组(P<0.05);Baron内镜评分及梅奥(Mayo)评分均显著低于对照组(P<0.05);脑肠肽指标血清5-羟色胺(5-HT)和血浆P物质(SP)含量均显著低于对照组,血清生长抑制(SS)水平和血浆血管活性肠肽(VIP)含量均显著高于对照组(P<0.05);血清免疫球蛋白(Ig)A、IgG水平均显著低于对照组(P<0.05)。观察组患者不良反应发生率为6.67%,显著低于对照组的15.00%(P<0.05)。结论黄葵敛肠汤保留灌肠治疗UC湿热内蕴证疗效佳,可抑制患者的肠黏膜炎性反应,减轻黏膜损伤,且安全性好。

Objective To investigate the clinical efficacy of retention enema of Huangkui Lianchang Decoction in the treatment of ulcerative colitis(UC)with internal accumulation of damp-heat syndrome,and its effect on brain-gut peptide and immune function indexes.Methods A total of 120 UC patients with internal accumulation of damp-heat syndrome admitted to the hospital from July 2020 to June 2021 were selected and randomly divided into the observation group and the control group,with 60 cases in each group.The patients in the control group were treated with Mesalazine Enteric-Coated Tablets orally,while the patients in the observation group were treated with retention enema of Huangkui Lianchang Decoction.Both groups were treated for 12 weeks.Results The total effective rate in the observation group was 83.33%,which was significantly higher than 73.33%in the control group(P<0.05).After treatment,the scores of diarrhea,abdominal pain,mucous bloody stool and rectal tenesmus in the observation group were significantly lower than those in the control group(P<0.05);the Baron endoscopic score and Mayo score in the observation group were significantly lower than those in the control group(P<0.05);the contents of brain-gut peptide indexes such as serum 5-hydroxytryptamine(5-HT)and plasma substance P(SP)in the observation group were significantly lower than those in the control group,while the serum growth inhibition(SS)level and plasma vasoactive intestinal peptide(VIP)content in the observation group were significantly higher than those in the control group(P<0.05);the levels of serum immunoglobulin(Ig)A and IgG in the observation group were significantly lower than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was 6.67%,which was significantly lower than 15.00%in the control group(P<0.05).Conclusion Retention enema of Huangkui Lianchang Decoction is effective and safe in the treatment of UC patients with internal accumulation of damp-heat syndrome,which can inhibit the inflammatory response of the patient's intestinal mucosa,and reduce mucosal damage.