愈肠煎保留灌肠联合美沙拉嗪治疗溃疡性结肠炎60例

发布时间：2019-04-29 19:25

【摘要】：目的:观察愈肠煎保留灌肠配合美沙拉嗪治疗(大肠湿热证)溃疡性结肠炎(UC)的临床疗效及对血清白介素(IL)-17,IL-21的影响。方法:将120例UC患者随机按数字表法分为对照组和综合组各60例。对照组给予美沙拉嗪肠溶片,1 g/次,4次/d,吞服勿咀嚼。综合组在对照组治疗的基础上加用愈肠煎,1次/d,保留灌肠。两组疗程均为4周。进行治疗前后Baron内镜评分法评分;采用肠黏膜病变活动指数(Sutherland DAI)对疾病严重度与活动度进行评价;记录治疗前后主要症状、体征;进行治疗前后炎症性肠病问卷(IBDQ)评分;检测治疗前后血清IL-17,IL-21水平。结果:综合组临床疗效总有效率为90%,对照组为76.67%,综合组优于对照组(P0.05);综合组Baron评分和Sutherland DAI疾病活动性指数评价均低于对照组(P0.01);综合组腹泻、脓血便、腹痛和腹胀评分均低于对照组(P0.01);综合组IBDQ量表肠道症状、全身症状、情感能力及社会能力评分及总分均高于对照组(P0.01);治疗后两组血清IL-17,IL-21水平均较治疗前下降(P0.01),综合组血清IL-17,IL-21水平均低于对照组(P0.05)。结论:愈肠煎保留灌肠联合美沙拉嗪治疗(大肠湿热证)溃疡性结肠炎能减轻症状,控制疾病活动,临床疗效优于单纯美沙拉嗪,其作用机制可能与调节炎症因子有关。
[Abstract]:Aim: to observe the clinical efficacy of Yuchang decoction retention enema combined with mesalazine in the treatment of ulcerative colitis (UC) and its effect on serum interleukin-17 (IL-17) and interleukin-21 (IL-21) levels in patients with ulcerative colitis. Methods: 120 UC patients were randomly divided into two groups: control group (n = 60) and comprehensive group (n = 60). The control group was given mesalazine enteric-coated tablets (1 g / d, 4 times / d) without chewing. The combined group was treated with Yuchang decoction once a day on the basis of the control group, retaining enema. The course of treatment in both groups was 4 weeks. Before and after treatment, Baron endoscopy score, intestinal mucosal lesion activity index (Sutherland DAI) were used to evaluate the severity and activity of the disease, and the main symptoms and signs were recorded before and after treatment. Before and after treatment, inflammatory bowel disease questionnaire (IBDQ) score and serum IL-17,IL-21 level before and after treatment were measured. Results: the total effective rate was 90% in the comprehensive group and 76.67% in the control group, which was better than that in the control group (P0.05), and the Baron score and Sutherland DAI disease activity index in the comprehensive group were lower than those in the control group (P0.01). The scores of diarrhea, purulent stool, abdominal pain and abdominal distension in the comprehensive group were lower than those in the control group (P0.01), and the scores of intestinal symptoms, systemic symptoms, emotional and social abilities and total scores in the IBDQ scale in the comprehensive group were higher than those in the control group (P0.01). After treatment, the serum IL-17,IL-21 levels in both groups were lower than those before treatment (P0.01), and the serum IL-17,IL-21 levels in the combined group were lower than those in the control group (P0.05). Conclusion: Yuchang Jian retention enema combined with mesalazine can relieve symptoms and control disease activity in patients with ulcerative colitis. The clinical efficacy is better than that of methalazine alone. The mechanism of action may be related to the regulation of inflammatory factors.
【作者单位】：青海省中医院;
【分类号】：R574.62

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