【摘要】 目的 考察参苓薏苡三七方联合止血生肌汤灌肠对脾虚湿热证溃疡性结肠炎患者的临床疗效。方法 114例患者随机分为对照组和观察组，每组57例，对照组给予止血生肌汤灌肠，观察组在对照组基础上加用参苓薏苡三七方，疗程4周。检测临床疗效、中医证候评分、Baron内镜评分、改良Mayo评分、VAS评分、肠道菌群(肠球菌、乳酸杆菌、肠杆菌、双歧杆菌)、相关因子(FCP、ESR、IL-10、TNF-α、TLR4、PGE2)、肠道屏障功能因子(L/M、DAO、D-乳酸)、安全性指标变化。结果 观察组完全缓解率、总有效率高于对照组(P<0.05)。治疗后，2组中医证候评分、Baron内镜评分、改良Mayo评分、VAS评分、FCP、ESR、TNF-α、TLR4、PGE2、肠道屏障功能因子降低(P<0.05),IL-10升高(P<0.05),肠球菌、肠杆菌减少(P<0.05),乳酸杆菌、双歧杆菌增加(P<0.05),以观察组更明显(肠球菌除外)(P<0.05)。2组均未见明显不良反应。结论 参苓薏苡三七方联合止血生肌汤灌肠可安全有效地调节脾虚湿热证溃疡性结肠炎患者肠道菌群，改善肠道屏障功能，提高镇痛、消炎效果。更多还原

【Abstract】 AIM To investigate the clinical effects of Shenling Yiyi Sanqi Formula combined with enema of Zhixue Shengji Decoction on patients with ulcerative colitis due to Spleen Deficiency with Damp-Heat.METHODS One hundred and fourteen patients were randomly assigned into control group(57 cases) for 4-week intervention of enema of Zhixue Shengji Decoction, and observation group(57 cases) for 4-week intervention of both Shenling Yiyi Sanqi Formula and enema of Zhixue Shengji Decoction. The changes in clinical effects, TCM syndrome scores, Baron endoscopic score, modified Mayo score, VAS score, intestinal flora(Enterococcus, Lactobacillus, Enterobacterium, Bifidobacterium), correlation factors(FCP, ESR, IL-10, TNF-α, TLR4, PGE2), intestinal barrier function factors(L/M, DAO, D-lactic acid) and safety indices were detected.RESULTS The observation group demonstrated higher complete remission rate and total effective rate than the control group(P<0.05). After the treatment, the two groups displayed decreased TCM syndrome scores, Baron endoscopic score, modified Mayo score, VAS score, FCP, ESR, TNF-α, TLR4, PGE2, intestinal barrier function factors(P<0.05), increased IL-10(P<0.05), reduced Enterococcus, Enterobacterium, and enhanced Lactobacillus, Bifidobacterium(P<0.05), especially for the observation group(except for Enterococcus)(P<0.05). No obvious adverse reactions were observable in the two groups.CONCLUSION For the patients with ulcerative colitis due to Spleen Deficiency with Dampness-Heat, Shenling Yiyi Sanqi Formula combined with enema of Zhixue Shengji Decoction can safely and effectively regulate intestinal flora, improve intestinal barrier function, and enhance analgesic, anti-inflammatory effects.更多还原