溃结方治疗溃疡性结肠炎的临床疗效观察及作用机制研究

发布时间：2018-09-05 07:01

【摘要】：目的:观察溃结方治疗溃疡性结肠炎的临床疗效,以及对溃结患者临床活动指数、内镜指数及肠黏膜EGFR、MUC2表达的影响。材料与方法:病例来源于2012年1月~2015年12月期间辽宁中医药大学附属第二医院脾胃科门诊和沈阳军区总医院中医科门诊就诊的32例经美沙拉嗪常规治疗疗效不佳的溃疡性结肠炎患者。采用自身对照的方法,给予中药溃结方加减治疗(100ml,3次/d),疗程8周。观察治疗1、2、4、8周证候评分变化,包括大便性状,腹泻次数,腹痛程度及持续时间,是否伴随里急后重等临床症状,并按照轻、中、重进行评分,最后判断溃结方治疗的安全性;治疗前及疗程结束后进行电子肠镜复查的患者21例并钳取病变部位结肠黏膜,同时设10例健康体检者为正常组亦取其结肠黏膜,观察治疗前后两组临床活动指数及肠黏膜内镜指数,并应用免疫组化法检测正常组以及患者治疗前后的结肠黏膜EGFR、MUC2表达。结果:1.32例患者经治疗后各项中医证候积分均低于治疗前,尤其是在改善腹泻、黏液脓血便、腹痛和里急后重等症状方面明显优于治疗前,临床治疗总有效率为93.75%。2.溃疡性结肠炎患者经过中药溃结方治疗后,临床活动指数与内镜指数均明显下降(P0.01);EGFR表达水平治疗前后与正常组比较均明显上升(P0.05,P0.01),其中治疗后表达水平比治疗前上升更明显(P0.05);MUC2表达水平治疗前与正常组比较明显下降(P0.01),治疗后表达水平上升(P0.05)。结论:1.中药溃结方能够有效缓解溃疡性结肠炎患者的临床症状,具有较为满意的临床疗效,是安全有效的中药组方。2.中药溃结方可能通过调整肠黏膜组织EGFR、MUC2的表达发挥治疗作用。
[Abstract]:Aim: to observe the clinical efficacy of Kuijie recipe in treating ulcerative colitis and its effects on clinical activity index, endoscopic index and intestinal mucosal EGFR,MUC2 expression in patients with ulcerative colitis. Materials and methods: from January 2012 to December 2015, 32 patients who were treated with mesarazide in the Department of spleen and stomach of the second affiliated Hospital of Liaoning University of traditional Chinese Medicine and the Department of traditional Chinese Medicine of Shenyang military region General Hospital were treated with mezalazine. Of the patients with ulcerative colitis. The method of self-control was used to treat Kuijie recipe (100 ml / d) for 8 weeks. To observe the changes of syndrome score at 8 weeks after treatment, including stool traits, diarrhea times, abdominal pain degree and duration, whether or not the symptoms were accompanied by acute and severe symptoms, and to evaluate the safety of Kuijie recipe according to the scores of light, moderate and heavy. Before treatment and after the course of treatment, 21 patients underwent electronic enteroscopy and the mucous membrane of the lesion was removed by forceps, and 10 healthy persons were set up as normal group and their colonic mucosa was also taken. The clinical activity index and intestinal mucosal endoscopic index were observed before and after treatment, and the expression of EGFR,MUC2 in colon mucosa of normal group and patients before and after treatment were detected by immunohistochemical method. Results the scores of TCM syndromes of 1. 32 cases after treatment were lower than those before treatment, especially in improving diarrhea, mucus purulent stool, abdominal pain and severe after treatment. The total effective rate of clinical treatment was 93.75. 2. The patients with ulcerative colitis were treated with Kuijie recipe, The clinical activity index and endoscopic index were significantly decreased (P0.01) and EGFR expression level was significantly increased before and after treatment (P0.05 + P0.01). The expression level of MUC2 was significantly higher after treatment than that before treatment (P0.05). Significantly decreased (P0.01), the expression level increased after treatment (P0.05). Conclusion 1. Kuijie prescription can effectively alleviate the clinical symptoms of patients with ulcerative colitis, has a more satisfactory clinical efficacy, is a safe and effective prescription of traditional Chinese medicine. 2. Kuijie prescription may play a therapeutic role by regulating the expression of EGFR,MUC2 in intestinal mucosa.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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