丹参酮联合美沙拉嗪治疗溃疡性结肠炎的临床疗效观察及对生活质量的影响

Clinical observation of tanshinone combined with mesalazine in the treatment of ulcerative colitis and its effect on quality of life

目的探讨丹参酮胶囊联合美沙拉嗪肠溶片治疗溃疡性结肠炎对凝血功能、溃疡周围黏膜组织中TF、TFPI表达水平及生活质量的影响。方法将110例溃疡性结肠炎患者应用随机数字法分为对照组和治疗组,每组55例,对照组予美沙拉嗪肠溶片治疗,治疗组在对照组的基础上加用丹参酮胶囊进行治疗,14d为1个疗程,研究周期为2个疗程。疗程结束后,观察两组治疗前后凝血功能指标如血小板计数(PLT)、血小板平均体积(MPV)、活化部分凝血酶原时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)、C-反应蛋白(CRP)的水平变化,以及溃疡周围黏膜组织中TF、TFPI表达水平及阳性表达情况,并观察治疗前后生活质量改善情况。结果两组患者各项凝血指标水平(PLT、MPV、APTT、FIB)、D-D、CRP及治疗前比较,差异均无统计学意义(均P>0.05)。治疗后以上指标两组均较治疗前有所改善,差异均有统计学意义(均P <0.05),且治疗组均优于对照组,差异均有统计学意义(均P <0.05)。治疗前对照组与治疗组TF阳性率分别为59.1%和54.5%,差异无统计学意义(P>0.05)。治疗后对照组与治疗组TF阳性率分别为36.36%和18.18%,差异有统计学意义(χ2=4.41,P=0.036)。治疗前对照组与治疗组TFPI表达阳性率分别为50.0%和54.5%,差异无统计学意义(P>0.05)。治疗后对照组与治疗组TFPI表达阳性率分别为34.09%和13.63%,差异有统计学意义(χ2=5.07,P=0.022)。两组患者溃疡周围黏膜组织中TF、TFPI在治疗前比较,差异均无统计学意义(均P>0.05)。治疗后两组TF、TFPI均较治疗前有所改善,差异均有统计学意义(均P <0.05),且治疗组TF、TFPI均优于对照组,差异均有统计学意义(均P <0.05)。两组患者IBDQ量表评分(肠道症状、全身症状、情感能力、社会能力)治疗前比较,差异均无统计学意义(均P>0.05)。治疗后两组IBDQ量表评分均较治疗前有所改善,差异均有统计学意义(均P <0.05),且治疗组IBDQ量表评分均优于对照组,差异均有统计学意义(均P <0.05)。结论丹参酮胶囊联合美沙拉嗪肠溶片能够显著改善溃疡性结肠炎患者的高凝状态,降低微血栓形成的风险,有效改善生活质量,值得临床推广。

Objective To investigate the effect of tanshinone capsule combined with mesalazine enteric-coated tablets on coagulation function,TF and TFPI expression level and quality of life in ulcerative colitis.Methods 110 patients with ulcerative colitis were randomly divided into control group and treatment group,55 cases in each group.The control group was treated with mesalazine enteric-coated tablets.The treatment group was treated with tanshinone Capsule on the basis of the control group.The 14-day treatment course was one course,and the study period was two courses.After the treatment,the changes of coagulation function indexes such as platelet count(PLT),mean platelet volume(MPV),activated partial thrombin time(APTT),fibrinogen(FIB),D-dimer(D-D),C-reactive protein(CRP)and the expression of TF and TFPI in mucosa around ulcer were observed,and the quality of life was observed before and after treatment.Good situation.Results There was no significant difference in coagulation index and TF and TFPI expression between the two groups before treatment(P>0.05).After treatment,PLT,MPV,APTT,FIB,D-D and CRP were improved in both groups(P<0.05),and the treatment group was better than the control group(P<0.05).After treatment,TF and TFPI expression levels in mucosa around ulcer in the two groups were significantly decreased,and there were differences within and between groups.After treatment,the positive rates of TF in the two groups were 40.00%and 23.63%,respectively,with statistical significance(P<0.05);before treatment,the positive rates of TF in the two groups had no statistical significance(P>0.05);after treatment,the positive rates of TFPI in the two groups were 38.18%and 20.00%,respectively,with statistical significance(P<0.05).Compared with before treatment,the scores of IBDQ scale in the two groups after treatment were significantly improved(P<0.05),and the differences between the two groups were significant(P<0.05).Conclusion Tanshinone capsule combined with mesalazine enteric-coated tablets can significantly improve the hypercoagulability of patients with ulcerative colitis,reduce the risk of microthrombosis,and effectively improve the quality of life,which is worthy of clinical promotion.