健脾化瘀方治疗脾虚夹瘀型溃疡性结肠炎疗效观察及对细胞因子和D-2聚体的影响

发布时间：2018-11-25 22:50

【摘要】：目的：通过观察健脾化瘀方治疗溃疡性结肠炎脾虚夹瘀证的临床疗效,并对其临床安全性进行评价,以探讨健脾化瘀方对细胞因子和D-2聚体等其他理化指标的影响,及其治疗脾虚夹瘀型溃疡性结肠炎的可能作用机制。方法：将符合纳入标准的患者(共计60例)随机分成实验组和对照组,每组各30例。治疗上分别予两组患者美沙拉嗪颗粒口服作为基础治疗,实验组在基础治疗上加予健脾化瘀方口服,对照组单纯予以基础治疗,两组疗程均为12周。比较治疗前后患者的临床表现、结肠镜表现、血小板、D-2聚体、IL-6、 IL-10、免疫球蛋白,并进行统计分析。监测患者治疗前后的血常规、肝肾功能、心电图及治疗过程中的可能出现的不良反应。结果：1.实验组总有效率为90.0%,而对照组是73.3%,提示实验组优于对照组,且差异有显著统计学意义(P0.01)。2.实验组和对照组均可有效缓解临床症状,且实验组优于对照组,有显著统计学差异(P0.01)。3.实验组和对照组均可降低免疫球蛋白(IgG、IgA、IgM),治疗前后具有显著统计学差异(P0.01)。治疗后两组间IgG、IgA具有统计学差异(p0.05),并提示实验组优于对照组,而IgM无明显差异。4.实验组和对照组均可降低血小板、D-2聚体,其差异具有显著统计学意义(p0.01),且实验组优于对照组。5.实验组和对照组均可调节IL-6、IL-10,且实验组优于对照组,其差异具有显著统计学意义(p0.01)。6.治疗过程中未发现明显不良反应。结论：相较于单纯西药美沙拉嗪治疗,健脾化瘀方结合美沙拉嗪口服治疗脾虚夹瘀型溃疡性结肠炎在临床疗效等方面具有一定的优势。其可能的作用机理与调节免疫功能变化、改善微循环、调整细胞因子平衡等有关,值得进一步研究与推广。
[Abstract]:Objective: to observe the clinical efficacy of Jianpi Huayu recipe in treating ulcerative colitis with spleen deficiency and stasis syndrome, and to evaluate its clinical safety in order to explore the effect of Jianpi Huayu recipe on cytokines and other physical and chemical indexes such as D-2 polymer. And the possible mechanism of treating ulcerative colitis with spleen deficiency and stasis. Methods: 60 patients who met the inclusion criteria were randomly divided into experimental group and control group with 30 cases in each group. Two groups of patients were treated with mesalazine granules as the basic treatment, the experimental group in the basic treatment plus Jianpi Huayu prescription oral, the control group was given simple basic treatment, the two groups were treated for 12 weeks. The clinical manifestations, colonoscopy, platelet, D-2 polymer and IL-6, IL-10, immunoglobulin were compared before and after treatment. Blood routine, liver and kidney function, electrocardiogram and possible adverse reactions before and after treatment were monitored. Results: 1. The total effective rate of the experimental group was 90.0 and that of the control group was 73.3, indicating that the experimental group was superior to the control group, and the difference was statistically significant (P0.01). Experimental group and control group can effectively alleviate clinical symptoms, and the experimental group is better than the control group, there is significant statistical difference (P0.01). The immunoglobulin (IgG,IgA,IgM) was decreased in both the experimental group and the control group, and there was significant difference before and after treatment (P0.01). After treatment, there was a significant difference in IgG,IgA between the two groups (p0.05), indicating that the experimental group was superior to the control group, but the IgM had no significant difference. 4. Both experimental group and control group could reduce platelet and D-2 polymer, the difference was statistically significant (p 0.01), and the experimental group was better than the control group (P 0.01). Both the experimental group and the control group can regulate IL-6,IL-10, and the experimental group is superior to the control group, and the difference is statistically significant (p 0.01). No obvious adverse reactions were found in the course of treatment. Conclusion: compared with western medicine, the combination of Jianpi Huayu prescription and mesalazine orally has some advantages in the treatment of ulcerative colitis with spleen deficiency and stasis. The possible mechanism is related to the regulation of immune function, the improvement of microcirculation and the adjustment of cytokine balance, which is worthy of further study and popularization.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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