清热愈疡汤治疗溃疡性结肠炎对患者肠道菌群紊乱和改善炎症效果的组方分析

Analysis of the effects of Qingre Yuyang decoction on intestinal flora disturbance and inflammation improvement in patients with ulcerative colitis

目的探究清热愈疡汤治疗溃疡性结肠炎的效果,分析其组方对患者肠道菌群和炎症因子的影响。方法选取上海中医药大学附属曙光医院肛肠科2021年1月-2022年9月收治的溃疡性结肠炎患者100例,按随机数字表法将患者分成观察组与对照组,各50例。对照组采用常规治疗,观察组在常规治疗的基础上采用清热愈疡汤灌肠治疗。比较2组患者的临床疗效、治疗前后的肠道菌群、炎症因子[肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、单核细胞趋化蛋白-1(monocyte chemotactic protein 1,MCP-1)、白细胞介素-10(interleukin 10,IL-10)]水平、中医证候积分、Baron内镜积分、梅奥(Mayo)评分以及不良反应的发生情况。结果观察组的治疗总有效率(92.00%)较对照组(82.00%)明显提高,差异具有统计学意义(P<0.05)。治疗后较治疗前,2组双歧杆菌水平上升,乳酸杆菌、肠杆菌、肠球菌水平均下降,且观察组较对照组的双歧杆菌水平上升明显,乳酸杆菌、肠杆菌、肠球菌水平下降明显,差异具有统计学意义(P<0.05)。治疗后较治疗前2组TNF-α、MCP-1水平均下降,IL-10水平上升,且观察组较对照组的TNF-α、MCP-1水平下降明显,IL-10水平上升明显,差异具有统计学意义(P<0.05)。治疗后较治疗前2组的中医证候积分、Baron内镜积分及Mayo评分均下降,且观察组较对照组的中医证候积分、Baron内镜积分及Mayo评分下降明显,差异具有统计学意义(P<0.05)。观察组的不良反应总发生率(2.00%)较对照组(14.00%)明显降低,差异具有统计学意义(P<0.05)。结论清热愈疡汤在溃疡性结肠炎中的治疗效果较好,能够调节患者肠道菌群紊乱,减轻炎症反应,且安全性较好,值得临床推广应用。

Objective To explore the effect of Qingre Yuyang decoction in the treatment of ulcerative colitis,and analyze the influences of the prescription on the intestinal microbiota and inflammatory factors of patients.Methods A total of 100 patients with ulcerative colitis admitted to the Department of Anorectal Surgery,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2021 to September 2022 were selected,and divided into an observation group and a control group using a random number table method,with 50 patients in each group.The control group was treated with a conventional therapy,while the observation group was treated with Qingre Yuyang decoction enema on the basis of the conventional treatment.The clinical efficacy,the levels of intestinal microbiota and inflammatory factors[tumor necrosis factor-α(TNF-α),monocyte chemotactic protein-1(MCP-1),interleukin-10(IL-10)],the TCM syndrome scores,Baron endoscopy scores,Mayo scores before and after treatment,and the incidence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group(46 cases/50 cases,92.00%)was significantly improved compared to that of the control group(41 cases/50 cases,82.00%),and the difference was statistically significant(P<0.05).Compared with before treatment,the levels of bifi dobacterium in the two groups were increased,while the levels of lactobacillus,enterobacteriaceae,and enterococcus were decreased.The level of bifi dobacterium was increased significantly in the observation group compared with that in the control group,while the levels of lactobacillus,enterobacteriaceae,and enterococcus were decreased significantly,all with a statistically significant difference(P<0.05).Compared with before treatment,the levels of TNF-αand MCP-1 were decreased in both groups while the level of IL-10 was increased,and the decrease and increase in the observation group were significantly higher than those in the control group(P<0.05).After treatment,the TCM syndrome scores,Baron endoscopy scores,and Mayo scores were all decreased in the two groups compared with before treatment,and the observation group showed a significant decrease,with a statistically significant difference(P<0.05).The total incidence of adverse reactions in the observation group(1 case/50 cases,2.00%)was significantly reduced compared to that of the control group(7 cases/50 cases,14.00%),and the difference was statistically significant(P<0.05).Conclusion Qingre Yuyang decoction has a good effect in the treatment of ulcerative colitis,which can regulate the intestinal flora disorder of patients,reduce inflammatory responses,and has a better safety,worthy of a clinical promotion and application.