云南白药胶囊联合西药治疗溃疡性结肠炎血瘀肠络证临床研究

Clinical Study on Yunnan Baiyao Capsules Combined with Western Medicine for Ulcerative Colitis with Blood Stasis in the Intestinal Collateral Syndrome

目的:观察云南白药胶囊联合西药治疗溃疡性结肠炎(UC)血瘀肠络证的临床疗效。方法:将60例UC血瘀肠络证患者按随机数字表法分为对照组和治疗组各30例。对照组口服柳氮磺吡啶肠溶片和甲泼尼龙片治疗,治疗组在对照组基础上加服云南白药胶囊,2组均连续治疗8周。比较2组治疗前后中医证候积分、Southerland疾病活动指数、大肠黏膜评分及血浆基质金属蛋白酶(MMP)-3和金属蛋白酶抑制剂(TIMP)-1水平,对比分析临床疗效。结果:治疗后,2组4项中医证候积分均较治疗前降低(P <0.01);治疗组4项中医证候积分均低于对照组(P <0.01)。治疗后,2组Southerland疾病活动指数及大肠黏膜评分均较治疗前降低(P <0.01);治疗组Southerland疾病活动指数及大肠黏膜评分均低于对照组(P <0.01)。治疗组总有效率(93.33%)高于对照组(66.67%),差异有统计学意义(P <0.05)。治疗后,2组血浆MMP-3及TIMP-1水平均较治疗前下降(P <0.01);治疗组血浆MMP-3及TIMP-1水平均低于对照组(P <0.01)。结论:云南白药胶囊联合西药治疗UC血瘀肠络证可提高临床疗效,作用机制可能与下调血浆MMP-3和TIMP-1水平有关。

Objective:To observe the clinical effect of Yunnan Baiyao capsules combined with western medicine for ulcerative colitis(UC)with blood stasis in the intestinal collateral syndrome.Methods:A total of 60 cases of UC patients with blood stasis in the intestinal collateral syndrome were divided into the control group and the treatment group according to the random number table method,30 cases in each group.The control group was treated with the oral administration of sulfasalazine enteric-coated tablets and methylprednisolone tablets,and the treatment group was additionally treated with Yunnan Baiyao capsules based on the treatment of the control group.Both groups were treated for eight weeks.The Chinese medicine syndrome scores,the Southerland Disease Activity Indexes,the scores of the colorectal mucosa as well as the levels of matrix metalloproteinase(MMP)-3 and tissue inhibitor of metalloproteinase(TIMP)-1 in plasma before and after treatment in the two groups were compared.The clinical effect was compared and analyzed.Results:After treatment,the four Chinese medicine syndrome scores in the two groups were decreased when compared with those before treatment(P<0.01),and the four Chinese medicine syndrome scores in the treatment group were lower than those in the control group(P<0.01).After treatment,the Sutherland Disease Activity Indexes and the scores of the colorectal mucosa in the two groups were decreased when compared with those before treatment(P<0.01);the above scores in the treatment group were lower than those in the control group(P<0.01).The total effective rate was 93.33%in the treatment group,higher than that of 66.67%in the control group,the difference being significant(P<0.05).After treatment,the levels of MMP-3 and TIMP-1 in plasma in the two groups were decreased when compared with those before treatment(P<0.01);the above levels in the treatment group were lower than those in the control group(P<0.01).Conclusion:The therapy of Yunnan Baiyao capsules combined with western medicine for UC with blood stasis in the intestinal collateral syndrome can improve the clinical effect,whose mechanism is probably related to the down-regulation of the levels of MMP-3 and TIMP-1 in plasma.