经方芍药汤联合美沙拉嗪治疗溃疡性结肠炎的临床观察

Clinical observation on classic prescription Shaoyao decoction combined with Mesalazine in the treatment of ulcerative colitis

目的:观察芍药汤加减联合美沙拉嗪治疗湿热型溃疡性结肠炎(Ulcerative Colitis,UC)的临床疗效。方法:选取2021年8月―2022年8月就诊于黑龙江省中医药科学院南岗分院脾胃科湿热型UC患者60例,按照随机数字表法分为治疗组和对照组,每组30例,对照组口服美沙拉嗪缓释片,治疗组口服美沙拉嗪缓释片联合芍药汤加减。疗程为8周,之后观察两组患者治疗前后及两组治疗后腹痛、腹泻、里急后重、脓血便等症状,内镜下黏膜病变情况,红细胞沉降率变化,以及血清白细胞介素(Interleukin,IL)-10、肿瘤坏死因子(Tumor Necrosis Factor,TNF)-α含量情况。结果:经治疗,两组患者腹痛、腹泻、里急后重、脓血便等症状积分较治疗前均明显下降,治疗前后差异有统计学意义(P<0.05);治疗组总有效率为90.0%(27/30),对照组总有效率为73.3%(22/30),差异有统计学意义(P<0.05)。两组患者肠镜下黏膜病变评分较治疗前明显下降,差异有统计学意义(P<0.05);治疗后,治疗组总有效率为86.7%(26/30),对照组总有效率为70.0%(21/30),差异有统计学意义(P<0.05)。两组患者治疗后红细胞沉降率均较治疗前明显下降,差异有统计学意义(P<0.05)。两组患者治疗后血清IL-10上升,TNF-α下降,与治疗前的差异均有统计学意义(P<0.05);治疗组治疗后IL-10、TNF-α较对照组改善明显,差异均有统计学意义(P<0.05)。结论:经方芍药汤加减联合美沙拉嗪治疗湿热型UC疗效显著,值得推广。

Objective:To observe the clinical efficacy of Modified Shaoyao decoction(芍药汤)combined with Mesalazine in the treatment of damp-heat type of ulcerative colitis(UC).Methods:Sixty patients with damp-heat type of ulcerative colitis admitted to the Spleen and Stomach Department of Nangang Branch of Heilongjiang Academy of Chinese Medicine from August 2021 to August 2022 were selected and divided into the treatment group and the control group according to random number table method,with 30 cases in each group.The control group received oral administration of Mesalazine sustained-release tablets,and the treatment group received Mesalazine sustained-release tablets combined with Modified Shaoyao decoction.The course of treatment was 8 weeks.The symptoms of abdominal pain,diarrhea,posterior tenesia,pus and blood stools,mucosal lesions under endoscope,changes in erythrocyte precipitation,and serum IL-10 and TNF-αcontents were observed in the two groups before and after treatment.Results:After treatment,the scores of symptoms such as abdominal pain,diarrhea,acute diarrhea and bloody stools in two groups were significantly decreased compared with those before treatment,and there were significant differences before and after treatment(P<0.05).The effective rate was 90.0%(27/30)in the treatment group and 73.3%(22/30)in the control group.There was a significant difference between the treatment group and the control group(P<0.05).Mucosal lesion score under colonoscopy in the two groups was significantly decreased compared with that before treatment,there was a significant difference(P<0.05).After treatment,the effective rate in the treatment group was 86.7%(26/30),and that in the control group was 70.0%(21/30).There was a significant difference between the treatment group and the control group(P<0.05).Erythrocyte sedimentation rate in the two groups after treatment was significantly decreased compared with that before treatment,and there was a significant difference between the treatment group and the control group(P<0.05).After treatment,serum IL-10 was increased,and TNF-αwas decreased in the two groups,which was with a statistical significance compared with that before treatment(P<0.05).IL-10 and TNF-αin the treatment group were significantly ameliorated after treatment compared with the control group,the differences were significant(P<0.05).Conclusion:Classic prescription Shaoyao decoction combined with Mesalazine has a significant curative effect in the treatment of damp-heat ulcerative colitis,and it is worthy of promotion.