甘草泻心汤治疗溃疡性结肠炎的疗效及患者肠道菌群、炎症免疫细胞因子变化研究

Effect of Gancao Xiexin decoction in the treatment of ulcerative colitis and the level changes of intestinal flora and inflammatory immune cytokines

目的研究甘草泻心汤治疗溃疡性结肠炎的疗效及患者肠道菌群、炎症免疫细胞因子变化。方法选取2020年1月-2022年6月我院收治的溃疡性结肠炎患者82例,分为对照组与试验组,各41例,方法为随机数字表法。对照组予以美沙拉嗪治疗,试验组在对照组的基础上予以甘草泻心汤治疗,2组均治疗8周。比较2组治疗前、治疗8周后肠道菌群、炎症免疫细胞因子及中医证候积分水平,治疗8周后疗效,治疗期间不良反应发生情况。结果与对照组治疗8周后的总有效率(75.61%)比较,试验组总有效率更高(95.12%,P<0.05)。与治疗前比较,治疗8周后2组血清肿瘤坏死因子-α(TNF-α)、大肠杆菌、肠球菌数量,血清白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)水平,黏液脓血便、里急后重、肛门灼痛、小便短赤评分降低,且试验组更低(P<0.05);2组双歧杆菌、乳杆菌、血清白细胞介素-10(IL-10)水平升高,且试验组更高(P<0.05)。治疗过程中试验组未见明显不良反应,对照组有2例头痛,1例出现恶心呕吐,1例出现皮疹,但未出现肝功能异常,均未影响继续治疗。结论甘草泻心汤治疗溃疡性结肠炎患者疗效确切,可改善患者中医证候积分,可能与其调节肠道菌群、炎症免疫细胞因子表达有关,且具有较好的安全性。

Objective To study the effect of Gancao Xiexin decoction in the treatment of ulcerative colitis and the level changes of intestinal flora and inflammatory immune cytokines.Methods From January 2020 to June 2022,82 patients with ulcerative colitis admitted to our hospital were randomly divided into a control group and an experimental group,with 41 cases in each group.The control group was treated with mesalazine,while the experimental group was treated with Gancao Xiexin decoction on the basis of the control group,both for 8 weeks.The levels of intestinal flora,inflammatory immune cytokines and TCM syndrome scores before and after treatment,as well as the efficacy after 8 weeks and the occurrence of adverse reactions during treatment were compared between the two groups.Results The total effective rate of the experimental group(95.12%)was higher than that of the control group(75.61%)after 8 weeks of treatment(P<0.05).After 8 weeks of treatment,the serum levels of tumor necrosis factor-α(TNF-α),the number of escoli and enterococcus,the serum levels of interleukin-6(IL-6),interleukin-1β(IL-1β),the syndrome scores of mucous pus and blood stools,posterior tenesmus,anal burning pain,short red urine in the two groups were decreased,and those in the experimental group were much lower(P<0.05).The levels of bifidobacterium,lactobacillus and serum interleukin-10(IL-10)in the two groups were increased,and those in the experimental group were much higher(P<0.05).During treatment,there were no obvious adverse reactions in the experimental group,while in the control group,there were 2 cases of headache,1 case of nausea and vomiting,and 1 case of rash,but no abnormal liver function,which did not affect the continued treatment.Conclusion Gancao Xiexin decoction is effective in the treatment of ulcerative colitis,and can improve the TCM syndrome scores of patients,which may be related to the regulation of intestinal flora and the expression of inflammatory immune cytokines,having a good safety.