消溃方灌肠治疗溃疡性结肠炎临床研究及对肠道菌群的影响
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R574.62

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全国中医临床特色技术传承骨干人才培训项目(国中医药人教函[2019]36号);河南省科技攻关(202102310500,162102310109); 河南省教育厅高等学校重点科研项目(20A360015);河南省中医药科学研究专项课题项目(2018ZY2055)


Clinical Study on Enema with Xiaokui Prescription for Ulcerative Colitis and Its Effect on Intestinal Flora
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    摘要:

    目的:观察消溃方灌肠治疗溃疡性结肠炎的临床疗效及对外周血C-反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、白细胞介素-17(IL-17) 及肠道菌群的影响。方法:选取72 例中医辨证为湿热内蕴证的溃疡性结肠炎患者,按随机数字表法分为治疗组及对照组各36 例。治疗组给予消溃方灌肠治疗,对照组给予美沙拉嗪栓塞肛治疗。2 组疗程均为1 个月。治疗1 个月后比较2 组临床疗效,观察2 组治疗前后中医证候评分、疾病活动指数(DAI)、炎症性肠病问卷(IBDQ) 评分变化,观察2 组治疗前后Baron 内镜评分、Geboes 评分以及外周血IL-6、IL-10、IL-17、CRP 水平变化,观察2 组治疗前后肠道大肠杆菌、乳酸杆菌、双歧杆菌的变化。结果:治疗后,2 组中医证候、DAI 评分均较治疗前下降,IBDQ 评分均较治疗前上升,治疗组中医证候、DAI 评分均低于对照组,IBDQ 评分高于对照组,差异均有统计学意义(P<0.05)。治疗后,2 组Baron 内镜评分、Geboes 评分均较治疗前降低,治疗组低于对照组,差异均有统计学意义(P<0.05)。治疗后,2 组外周血CRP、IL-6、IL-17 水平均较治疗前降低,IL-10 水平较治疗前升高,治疗组外周血CRP、IL-6、IL-17 水平均低于对照组,IL-10 水平高于对照组,差异均有统计学意义(P<0.05)。治疗后,2 组大肠杆菌水平均较治疗前降低,乳酸杆菌及双歧杆菌水平均较治疗前升高;治疗组大肠杆菌水平低于对照组,乳酸杆菌及双歧杆菌水平均高于对照组,差异均有统计学意义(P<0.05)。治疗组总有效率为94.4%,高于对照组77.8%,2 组比较,差异有统计学意义(P<0.05)。结论:消溃方灌肠治疗溃疡性结肠炎,可调节炎症因子以及肠道菌群的平衡,减轻肠道黏膜炎症反应,缓解临床症状。

    Abstract:

    Abstract:Objective:To observe the clinical effect of enema with Xiaokui prescription for ulcerative colitis and its effect on C-reactive protein(CRP),interleukin-6(IL-6),interleukin-10(IL-10) and interleukin-17(IL-17) in peripheral blood as well as intestinal flora. Methods: A total of 72 cases of patients with ulcerative colitis with dampness- heat accumulation syndrome were selected and divided into the treatment group and the control group according to the random number table method, with 36 cases in each group. The treatment group was treated with enema with Xiaokui prescription, and the control group was given mesalazine for anal treatment. Both groups were treated for one month. After one month of treatment, the clinical effects in the two groups were compared. Before and after treatment, the changes in Chinese medicine syndrome scores, Disease Activity Index(DAI), Inflammatory Bowel Disease Questionnaire(IBDQ), Baron endoscopic scores,Geboes scores,the levels of IL- 6,IL- 10,IL- 17 and CRP in peripheral blood,as well as intestinal escherichia coli,lactobacillus and bifidobacteria in the two groups were observed. Results:After treatment,the scores of Chinese medicine syndromes and DAI in the two groups were decreased when compared with those before treatment,and IBDQ scores were increased;the scores of Chinese medicine syndromes and DAI in the treatment group were lower than those in the control group, and IBDQ score was higher, differences being significant(P<0.05). After treatment, Baron endoscopic scores and Geboes scores in the two groups were decreased when compared with those before treatment,and the scores in the treatment group were lower than those in the control group,differences being significant(P<0.05). After treatment,the levels of CRP,IL- 6 and IL- 17 in peripheral blood in the two groups were decreased when compared with those before treatment,and the levels of IL-10 were increased;the levels of CRP,IL-6 and IL-17 in peripheral blood in the treatment group were lower than those in the control group,and the level of IL-10 was higher,differences being significant (P<0.05). After treatment,the levels of escherichia coli in the two groups were decreased when compared with those before treatment, and the levels of lactobacillus and bifidobacteria were increased; the level of escherichia coli in the treatment group was lower than that in the control group, and the levels of lactobacillus and bifidobacteria were higher, differences being significant(P<0.05). The total effective rate was 94.4% in the treatment group,higher than that of 77.8% in the control group, the difference being significant(P<0.05). Conclusion: The application of enema with Xiaokui prescription for ulcerative colitis can regulate the balance of inflammatory factors and intestinal flora,reduce the inflammatory responses of intestinal mucosa and relieve clinical symptoms.

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常为伟,姚宏健,潘慧,陈淑君,张慧俭,刘佃温,刘世举.消溃方灌肠治疗溃疡性结肠炎临床研究及对肠道菌群的影响[J].新中医,2021,53(23):111-116

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  • 在线发布日期: 2021-12-10
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