【摘要】 目的:观察愈疡消溃方治疗溃疡性结肠炎(UC)活动期近期疗效及对白细胞介数-17,21(IL-17,IL-21)的影响。方法:90例UC患者随机按数字法分为对照组和观察组各45例。对照组采用美沙拉嗪肠溶片,吞服勿咀嚼,1 g/次,4次/d。观察组在对照组基础上加用愈疡消溃I方,1剂/d,常规水煎分2次口服;愈疡消溃Ⅱ方,1剂/d,复煮浓缩至120 mL,睡前灌肠,连续5 d后停灌2 d。两组疗程均为8周。记录治疗前后Sutherland疾病活动指数(Sutherland DAI),并计算缓解率;观察肠镜表现及结肠组织病理改变情况;记录治疗前后主要症状体、体征评分;检测血清IL-17,IL-21水平。结果:两组治疗后Sutherland DAI评分、肠镜表现评分及肠组织病理改变评分均较治疗前下降(P<0.01),观察组上述指标评分均低于对照组(P<0.01);两组治疗后腹泻、脓血便、腹痛、腹胀、肛门灼热、里急后重、充血水肿、糜烂评分均较治疗前下降(P<0.01),观察组治疗后上述各主要症状、体征评分均低于对照组(P<0.01);观察组缓解31例,缓解率68.9%,对照组缓解20例,缓解率44.4%,观察组优于对照组(P<0.01);治疗后两组血清IL-17,IL-21水平均较治疗前下降(P<0.01),观察组血清IL-17,IL-21水平低于对照组(P<0.01)。结论:愈疡消溃方口服及灌肠能减轻活动期轻、中度UC患者疾病活动程度,能减轻UC患者临床症状、体证,促进其进入缓解期,其作用机制可能与减轻辅助性T细胞17细胞介导的炎证反应有关。更多还原

【Abstract】 Objective: The purpose is to observe recent curative effect of Yuyang Xiaokui decoction in the treatment of ulcerative colitis(UC) active stage and its influence on the leukocyte betweenness-17,21(IL-17,IL-21). Method: Ninety cases of patients with UC were randomly divided into control group(45 cases) and observation group(45 cases) according to numeric method. The patients in control group took the mesalazin enteric-coated tablets,to swallow not chew,1 g/time,4 times/day. For patients in observation group,they took Yuyang Xiaokui I decoction on the basis of the control group,1 dose/day,conventional water decoction,orally,2 times; Yuyang Xiaokui Ⅱ decoction,1 dose/day,severe times boiling concentration to 120 mL,enema before sleeping,continue 5 days before 2 days suspend. The treatment course was 8 weeks. The Sutherland disease activity index(Sutherland DAI) was recorded before and after treatment and the response rate was calculated. The colonoscopy expression and colon tissue pathological changes were observed. The main symptoms,signs score were recorded before and after the treatment and the level of serum IL-17,IL-21 was detected. Result: After treatment,the Sutherland DAI,colonoscopy performance score and intestinal tissue pathological change score of two groups were decreased(P < 0. 01),while the related scores of observation group were all lower than the control group(P <0. 01). The diarrhea,purulent blood,abdominal pain,abdominal distension,anus hot,anal congestion edema and erosion rate were decreased(P < 0. 01),while the main symptoms and related scores of observation group were all lower than the control group(P < 0. 01). There are 31 cases remission in observation group and 20 cases remission in control group with remission rate 68. 9% and 44. 4%,respectively. The observation group is better than that of control group(P < 0. 01). The levels of serum IL-17,IL-21 of two groups were decreased after treatment(P < 0. 01),while the level of serum IL-17,IL-21 of observation group is lower than the control group(P <0. 01). Conclusion: The oral taking and enema of Yuyang Xiaokui decoction can reduce degree of disease activity of patients with UC in light and moderate degree of active stage,alleviate clinical symptoms and sign of patients with UC and promote it into remission. Its mechanism may be related to reduce inflammatory reaction that mediated by Th17 cells.更多还原