青柏溃结汤灌肠治疗溃疡性结肠炎的优势研究

Study on the advantages of Qingbai Kuijie Decoction by enema in the treatment of ulcerative colitis

目的研究青柏溃结汤灌肠治疗溃疡性结肠炎的效果及对患者疾病相关因子的影响。方法选取本院2020年12月-2022年12月收治的78例溃疡性结肠炎患者,依据随机数字表法划分为对照组与试验组,各39例。对照组给予美沙拉嗪缓释颗粒治疗,试验组在对照组基础上给予青柏溃结汤灌肠治疗。14 d为1个疗程,2组均持续治疗2个疗程。比较2组治疗2个疗程后的临床疗效及不同时间点(治疗前、治疗2个疗程后)中医证候积分、肠道菌群、免疫功能及血清白细胞介素(IL-6)、肠型脂肪酸结合蛋白(I-FABP)、核周型抗中性粒细胞抗体(p-ANCA)、C反应蛋白(CRP)水平。结果试验组总有效率(92.31%)高于对照组(71.79%)(P<0.05);治疗2个疗程后2组各项中医证候积分、Th17细胞比例、血清IL-6、CRP、I-FABP、p-ANCA水平均呈现降低的趋势(P<0.05),且试验组低于对照组(P<0.05);治疗2个疗程后2组乳酸杆菌、双歧杆菌的数量与治疗前相比均增加,且试验组多于对照组(P<0.05);治疗2个疗程后2组大肠埃希菌的数量与治疗前相比均减少,且试验组少于对照组(P<0.05);2组Treg细胞比例、血清CD3^(+)、CD4^(+)与治疗前相比,均呈现升高的趋势,且试验组高于对照组(P<0.05)。结论青柏溃结汤灌肠可调节溃疡性结肠炎患者肠道菌群变化,可辅助减轻机体炎性损伤、改善免疫功能。

Objective To study the effect of Qingbai Kuijie Decoction by enema in the treatment of ulcerative colitis and its influence on disease-related factors.Methods A total of 78 patients with ulcerative colitis admitted to our hospital from December 2020 to December 2022 were divided into the control group(n=39)and the experimental group(n=39),based on the random number table method.The control group was treated with mesalazine sustained-release granules,while the experimental group was treated with Qingbai Kuijie Decoction by enema on the basis of that.Fourteen days constituted a course of treatment,and both groups received continuously two courses.The clinical efficacy after 2 courses of treatment,TCM syndrome scores,levels of intestinal flora,immune function,serum interleukin(IL-6),intestinal fatty acid binding protein(I-FABP),perinuclear anti-neutrophil antibody(p-ANCA)and C-reactive protein(CRP)at different time points(before and after 2 courses of treatment)of the two groups were compared.Results The total effective rate of the experimental group(92.31%)was significantly higher than that of the control group(71.79%)(P<0.05).After 2 courses of treatment,the TCM syndrome scores,Th17 cell proportions,levels of serum IL-6,CRP,I-FABP and p-ANCA showed a decreasing trend in both groups(P<0.05),and the experimental group was lower than the control group(P<0.05).After two courses of treatment,the numbers of lactobacillus and bifidobacterium increased in both groups,and the numbers were significantly bigger in the experimental group than those in the control group(P<0.05).After two courses of treatment,the number of escherichia coli decreased in both groups,and the number was significantly smaller in the experimental group than that in the control group(P<0.05).The proportions of Treg cells,the levels of serum CD3^(+)and CD4^(+)showed an increasing trend in both groups compared with before treatment,and the experimental group was significantly higher than the control group(P<0.05).Conclusion Qingbai Kuijie Decoction by enema can regulate the changes of intestinal flora in patients with ulcerative colitis,and can auxiliarly alleviate inflammatory injury and improve immune function.