化瘀清肠法对左半结肠型活动期溃疡性结肠炎的临床疗效

Effect of removing blood stasis and clearing intestine method on active ulcerative colitis of left colon type

目的:观察化瘀清肠法用于左半结肠型活动期溃疡性结肠炎患者的治疗效果。方法:选取我院2022年1月—2022年12月收治的活动期左半结肠型溃疡性结肠炎患者100例为研究对象,按计算机随机数字分组法将其分为试验组(50例)和对照组(50例)。对照组口服美沙拉嗪肠溶片治疗,试验组在对照组基础上加用化瘀清肠中药口服+保留灌肠治疗,于治疗8周后评价2组临床有效率和诱导缓解率,对比2组治疗前后中医症状评分、炎症性肠病生存质量问卷(IBDQ量表)评分变化,通过检测凝血相关参数[凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、纤维蛋白原(FIB)、血小板平均体积(MPV)]及血清炎性细胞因子含量[肿瘤坏死因子α(TNF-α)、白介素-6(IL-6)、白介素-8(IL-8)、白介素-10(IL-10)]观察患者炎症及血液高凝情况的变化;观察2组治疗前后常规血清学指标[白细胞(WBC)、血红蛋白(HGB)、血浆白蛋白(ALB)]水平的变化。结果:与治疗前比较,试验组、对照组治疗后中医症状各项评分明显降低,IBDQ量表评分明显提升(P<0.05),PT与APTT明显延长,MPV明显增大,FIB明显减少(P<0.05),血清中TNF-α、IL-6、IL-8的含量明显减少,IL-10的含量明显增高(P<0.05),WBC水平明显降低(P<0.05),HGB、ALB水平与治疗前比较差异无统计学意义(P>0.05);治疗后,试验组临床总有效率、诱导缓解率均明显优于对照组(P<0.05),试验组中医症状、生存质量评分及凝血相关参数、炎性因子、常规血清学指标的改善均优于对照组(P<0.05)。结论:化瘀清肠法治疗左半结肠型活动期溃疡性结肠炎疗效和安全性良好,能够缓解患者临床症状,提高生活质量,其机制可能与调节血液高凝状态、降低炎性因子的表达相关。

Objective To observe the therapeutic effect of removing blood stasis and clearing intestines method on left colon type active ulcerative colitis.Methods One hundred patients with active ulcerative colitis of left colon type admitted to our hospital from January 2022 to December 2022 were selected as study cases.They were divided into an experimental group and a control group according to the computer random number grouping method.The control group was treated with Mesalazine enteric-coated tablets,and the experimental group was treated with removing blood stasis and clearing intestines method+retention enema based on the control group.After 8 weeks of treatment,the clinical efficiency and induced remission rate of the two groups were evaluated.The changes in TCM symptom scores and inflammatory bowel disease quality of life questionnaire(IBDQ)scores of the two groups before and after treatment were compared.Blood coagulation parameters[prothrombin time(PT),activated partial thrombin time(APTT),fibrinogen(FIB),mean platelet volume(MPV)and serum inflammatory cytokines tumor necrosis factorα(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8)and interleukin-10(IL-10)]were measured to observe the changes of inflammation and blood hypercoagulability.Observe the changes in routine serological indicators[white blood cell(WBC),hemoglobin(HGB)and plasma albumin(ALB)]levels before and after treatment in two groups.Results Compared with before treatment,the scores of traditional Chinese medicine symptoms in the experimental group and control group were significantly reduced,and the IBDQ scale score was significantly improved(P<0.05).PT and APTT were significantly prolonged,MPV was significantly increased,and FIB was significantly reduced(P<0.05).The content of TNF-α,IL-6 and IL-8 significantly decreased,while the content of IL-10 significantly increased(P<0.05).The WBC level significantly decreased(P<0.05)and there was no statistically significant difference in HGB and ALB levels compared to before treatment(P>0.05).After treatment,the total clinical effective rate and induced remission rate of the experimental group were significantly better than those of the control group(P<0.05).The experimental group showed better improvement in traditional Chinese medicine symptoms,quality of life scores,coagulation-related parameters,inflammatory factors,and routine serological indicators than the control group(P<0.05).Conclusion The method of removing blood stasis and clearing intestines has a good effect and safety on left colon-type active ulcerative colitis,which can alleviate the clinical symptoms of patients and improve the quality of life.Its mechanism may be related to regulating the hypercoagulability of blood and reducing the expression of inflammatory factors.