中药溃结康丸治疗急性期溃疡性结肠炎(脾虚湿蕴证)临床效果观察及对血清炎症因子影响研究
|
摘要
目的:通过中药溃结康丸治疗急性期脾虚湿蕴型溃疡性结肠炎,观察临床治疗效果并从血清炎症因子角度探究治疗机制。方法:收集于2015年9月—2017年12月期间在辽宁中医药大学附属第二医院脾胃病科就诊的急性期脾虚湿蕴型溃疡性结肠炎病例患者80例,根据患者病历号采用随机数表法将所有患者随机分成西药对照组和中药治疗组,每组患者40例。西药对照组患者予以常规西药美沙拉嗪缓释片口服治疗,1 g/次,4次/d;中药治疗组在对照组治疗基础上予以院内制剂溃结康丸口服,1袋/次,3次/d。治疗30 d。观察比较两组患者的临床治疗总有效率、中医症状积分、焦虑抑郁评分量表评分、IBDQ生活质量评分量表评分,血清TNF-α、IFN-γ、IL-8、IL-17等炎症因子水平。结果:治疗30 d后,中药治疗组临床治疗总有效率、各项中医症状评分、焦虑抑郁评分、IBDQ生活质量评分改善效果优于西药对照组(P<0.05);中药治疗组患者血清TNF-α、IFN-γ、IL-8、IL-17等炎症因子水平改善明显优于对照组(P<0.05)。结论:中药溃结康丸联合西药治疗能够起到协同治疗作用,提高临床治疗效果,改善患者中医症状、调节患者心理状态、提高患者生活质量。中药溃结康丸治疗溃疡性结肠炎能够通过调节患者血清TNF-α、IFN-γ、IL-8、IL-17等炎症因子起到治疗作用。
Objective:The traditional Chinese medicine Kuijiekang Pill was used to treat spleen deficiency and retention of dampness syndrome ulcerative colitis,and the therapeutic effect was observed and the therapeutic mechanism was explored from the perspective of serum inflammatory factors.Methods:Eighty patients with spleen deficiency and retention of dampness syndrome ulcerative colitis who were admitted to the department of spleen and gastroenterology,the second affiliated hospital of Liaoning university of traditional Chinese medicine from September 2015 to December 2017 were collected from the patients' medical record number according to the patients' medical record number. The patients were randomly divided into a Western medicine control group and a Chinese medicine treatment group,with 40 patients in each group. The Western medicine control group was treated with conventional Western medicine mesalazine sustained-release tablets,1 g/time,4 times/d;the Chinese medicine treatment group was given the hospital preparation Kuijiekang Pill orally,1 bag/time,3 times/d. Treatment for 30 days. To observe and compare the total effective rate of clinical treatment,TCM symptom score,anxiety and depression score scale score,IBDQ quality of life score scale score,serum TNF-α,IFN-γ,IL-8,IL-17 and other inflammatory factors level. Results:After 30 days of treatment,the total effective rate,TCM symptom score,anxiety and depression score,and IBDQ quality of life score improved in the Chinese medicine treatment group were better than those in the Western medicine control group(P<0.05). The serum TNF-α and IFN in the Chinese medicine treatment group The levels of γ,IL-8,IL-17 and other inflammatory factors were significantly better than the control group(P<0.05).Conclusion:Traditional Chinese medicine Kuijiekang Pill combined with Western medicine can play a synergistic therapeutic effect,improve clinical treatment effect,improve patients' TCM symptoms,regulate patients' psychological state and improve patients' quality of life. Traditional Chinese medicine Kuijiekang Pill can treat ulcerative colitis by regulating the serum TNF-α,IFN-γ,IL-8,IL-17 and other inflammatory factors.
Objective:The traditional Chinese medicine Kuijiekang Pill was used to treat spleen deficiency and retention of dampness syndrome ulcerative colitis,and the therapeutic effect was observed and the therapeutic mechanism was explored from the perspective of serum inflammatory factors.Methods:Eighty patients with spleen deficiency and retention of dampness syndrome ulcerative colitis who were admitted to the department of spleen and gastroenterology,the second affiliated hospital of Liaoning university of traditional Chinese medicine from September 2015 to December 2017 were collected from the patients' medical record number according to the patients' medical record number. The patients were randomly divided into a Western medicine control group and a Chinese medicine treatment group,with 40 patients in each group. The Western medicine control group was treated with conventional Western medicine mesalazine sustained-release tablets,1 g/time,4 times/d;the Chinese medicine treatment group was given the hospital preparation Kuijiekang Pill orally,1 bag/time,3 times/d. Treatment for 30 days. To observe and compare the total effective rate of clinical treatment,TCM symptom score,anxiety and depression score scale score,IBDQ quality of life score scale score,serum TNF-α,IFN-γ,IL-8,IL-17 and other inflammatory factors level. Results:After 30 days of treatment,the total effective rate,TCM symptom score,anxiety and depression score,and IBDQ quality of life score improved in the Chinese medicine treatment group were better than those in the Western medicine control group(P<0.05). The serum TNF-α and IFN in the Chinese medicine treatment group The levels of γ,IL-8,IL-17 and other inflammatory factors were significantly better than the control group(P<0.05).Conclusion:Traditional Chinese medicine Kuijiekang Pill combined with Western medicine can play a synergistic therapeutic effect,improve clinical treatment effect,improve patients' TCM symptoms,regulate patients' psychological state and improve patients' quality of life. Traditional Chinese medicine Kuijiekang Pill can treat ulcerative colitis by regulating the serum TNF-α,IFN-γ,IL-8,IL-17 and other inflammatory factors.
引文
[1]李娟,王燕,赵清喜.年龄对溃疡性结肠炎病人病变部位和程度及疗效影响[J].青岛大学医学院学报,2015,51(4):486-487.
[2]中华医学会消化病学分会炎症性肠病学组.炎症性肠病诊断与治疗的共识意见(2012年·广州)[J].胃肠病学,2012,32(12):763-781.
[3]中华中医药学会脾胃病分会,张声生.溃疡性结肠炎中医诊疗共识意见[J].中华中医药杂志,2010,25(6):891-895.
[4]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:120.
[5]Russel M G,Pastoor C J,Brandon S,et al. Validation of the Dutch translation of the Inflammatory Bowel Disease Questionnaire(IBDQ):a health-related quality of life questionnaire in inflammatory bowel disease[J]. Digestion,1997,58(3):282-288.
[7]段泉泉,胜利.焦虑及抑郁自评量表的临床效度[J].中国心理卫生杂志,2012,26(9):676-679.
[8]于海食,洪缨,王玉蓉.溃疡性结肠炎发病机制[J].实用医学杂志,2010,26(2):323-325.
[9]刘笃佳,王媛媛,马旭.溃疡性结肠炎的流行病学研究进展[J].中国烧伤创疡杂志,2017,29(3):214-217.
[10]梁笑楠,尹凤荣,张晓岚.炎症性肠病诊断与治疗的共识意见(2018年,北京)溃疡性结肠炎部分解读[J].临床荟萃,2018,33(11):987-990.
[11]樊锋.美沙拉嗪联合甲硝唑对溃疡性结肠炎炎症反应及疾病活动指数的影响[J].社区医学杂志,2017,15(19):45-46.
[12]柳汝明,吴斌,赵雨晋,等.美沙拉嗪与柳氮磺吡啶比较治疗溃疡性结肠炎疗效与安全性的系统评价[J].中国循证医学杂志,2011,11(2):181-186.
[13]李毅,樊新荣,刘力,等.基于因子分析与聚类分析对溃疡性结肠炎中医证候规律的研究[J].中国中西医结合杂志,2017,37(10):1191-1195.
[14]郑发鹃,张苏闽.《炎症性肠病生存质量问卷》评估活动期溃疡性结肠炎患者生存质量[J].中医学报,2015(8):1211-1214.
[15]钱彦,姜丽娜,周论朱利.延续性护理对溃疡性结肠炎患者的生活质量及心理健康水平的影响[J].中国临床护理,2018,10(1):24-26.
[16]柏亚妹,宋玉磊,卞秋桂,等.炎症性肠病患者服药依从性及其影响因素研究[J].中国全科医学,2017,20(32):4018-4022.
[17]美沙拉嗪对溃疡性结肠炎患者血清TNF-α、IL-6、IL-17表达及肠道屏障功能的影响[J].中国生化药物杂志,2017,37(1):182-184.
[18]何兰娟,朱向东,王燕,等.相关炎性因子在脾肾阳虚型溃疡性结肠炎模型大鼠血清和结肠组织的动态表达[J].中国中医药信息杂志,2017,24(1):59-62.
[19]杨云.美沙拉嗪治疗溃疡性结肠炎的临床效果及对血清IL-6、IL-8、TNF-α的影响[J].中国社区医师,2017,33(17):81.
[20]杨芳,葛桂萍,曹红艳,等.溃疡性结肠炎患者血清IL-23、IL-17水平变化与脾虚湿热证的相关性分析[J].世界中医药,2017,12(3):595-597.
[21]张颖.炎症性肠病患者生活质量与抑郁、焦虑关系研究[J].浙江中西医结合杂志,2017,27(6):507-509.
[2]中华医学会消化病学分会炎症性肠病学组.炎症性肠病诊断与治疗的共识意见(2012年·广州)[J].胃肠病学,2012,32(12):763-781.
[3]中华中医药学会脾胃病分会,张声生.溃疡性结肠炎中医诊疗共识意见[J].中华中医药杂志,2010,25(6):891-895.
[4]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:120.
[5]Russel M G,Pastoor C J,Brandon S,et al. Validation of the Dutch translation of the Inflammatory Bowel Disease Questionnaire(IBDQ):a health-related quality of life questionnaire in inflammatory bowel disease[J]. Digestion,1997,58(3):282-288.
[7]段泉泉,胜利.焦虑及抑郁自评量表的临床效度[J].中国心理卫生杂志,2012,26(9):676-679.
[8]于海食,洪缨,王玉蓉.溃疡性结肠炎发病机制[J].实用医学杂志,2010,26(2):323-325.
[9]刘笃佳,王媛媛,马旭.溃疡性结肠炎的流行病学研究进展[J].中国烧伤创疡杂志,2017,29(3):214-217.
[10]梁笑楠,尹凤荣,张晓岚.炎症性肠病诊断与治疗的共识意见(2018年,北京)溃疡性结肠炎部分解读[J].临床荟萃,2018,33(11):987-990.
[11]樊锋.美沙拉嗪联合甲硝唑对溃疡性结肠炎炎症反应及疾病活动指数的影响[J].社区医学杂志,2017,15(19):45-46.
[12]柳汝明,吴斌,赵雨晋,等.美沙拉嗪与柳氮磺吡啶比较治疗溃疡性结肠炎疗效与安全性的系统评价[J].中国循证医学杂志,2011,11(2):181-186.
[13]李毅,樊新荣,刘力,等.基于因子分析与聚类分析对溃疡性结肠炎中医证候规律的研究[J].中国中西医结合杂志,2017,37(10):1191-1195.
[14]郑发鹃,张苏闽.《炎症性肠病生存质量问卷》评估活动期溃疡性结肠炎患者生存质量[J].中医学报,2015(8):1211-1214.
[15]钱彦,姜丽娜,周论朱利.延续性护理对溃疡性结肠炎患者的生活质量及心理健康水平的影响[J].中国临床护理,2018,10(1):24-26.
[16]柏亚妹,宋玉磊,卞秋桂,等.炎症性肠病患者服药依从性及其影响因素研究[J].中国全科医学,2017,20(32):4018-4022.
[17]美沙拉嗪对溃疡性结肠炎患者血清TNF-α、IL-6、IL-17表达及肠道屏障功能的影响[J].中国生化药物杂志,2017,37(1):182-184.
[18]何兰娟,朱向东,王燕,等.相关炎性因子在脾肾阳虚型溃疡性结肠炎模型大鼠血清和结肠组织的动态表达[J].中国中医药信息杂志,2017,24(1):59-62.
[19]杨云.美沙拉嗪治疗溃疡性结肠炎的临床效果及对血清IL-6、IL-8、TNF-α的影响[J].中国社区医师,2017,33(17):81.
[20]杨芳,葛桂萍,曹红艳,等.溃疡性结肠炎患者血清IL-23、IL-17水平变化与脾虚湿热证的相关性分析[J].世界中医药,2017,12(3):595-597.
[21]张颖.炎症性肠病患者生活质量与抑郁、焦虑关系研究[J].浙江中西医结合杂志,2017,27(6):507-509.