【摘要】 目的 探讨疏肝健脾活血汤联合西药治疗溃疡性结肠炎(UC)的临床效果及对中医证候积分、肠道菌群、炎症因子的影响。方法 选取2023年6月至2024年12月洛阳市第一人民医院收治的112例UC患者,按随机数表法分为研究组(56例)、对照组(56例)。对照组接受常规西药(美沙拉秦肠溶片)治疗,研究组接受疏肝健脾活血汤联合常规西药治疗,两组患者均治疗6周。比较两组治疗效果,治疗前后相关量表评分(Geboes组织学评分指数、中医证候积分、Baron内镜评分)、肠道菌群水平、炎症因子[超敏C反应蛋白(hs-CRP)、白细胞介素-23(IL-23)]水平、趋化因子[CXC趋化因子配体10(CXCL10)、CC类趋化因子配体22(CCL22)]水平及不良反应总发生率。结果 研究组治疗总有效率(96.43%)高于对照组患者(82.14%)(P<0.05);治疗后,研究组中医证候积分、Geboes组织学评分指数、Baron内镜评分低于对照组(P<0.05);治疗后,研究组乳酸杆菌、双歧杆菌水平高于对照组,肠球菌、大肠杆菌水平低于对照组(P<0.05);研究组不良反应总发生率(5.36%)与对照组(8.93%)比较,差异无统计学意义(P >0.05)。结论 疏肝健脾活血汤联合西药治疗UC患者可有效缓解临床症状,调控肠道菌群水平,下调炎症因子、趋化因子水平,提升效果,且不良反应较小。更多还原

【Abstract】 Objective To explore the clinical effect of Shugan Jianpi Huoxue Decoction combined with Western medicine in the treatment of ulcerative colitis(UC),and its influence on traditional Chinese medicine syndrome score,intestinal flora,and inflammatory factors. Methods A total of 112 patients with UC admitted to the First People’s Hospital of Luoyang from June 2023 to December 2024 were selected and assigned to a study group(56 cases) and a control group(56 cases) using a random number table method. Patients in the control group were treated with conventional Western medicine(mesalazine enteric-coated tablets),while those in the study group received a combination of Shugan Jianpi Huoxue Decoction and conventional Western medicine. The patients of the two groups underwent treatment for 6 weeks. The therapeutic effects and total incidence of adverse reactions were compared between the two groups,as well as the scores of relevant scales(Geboes histological scoring index,traditional Chinese medicine symptom score,Baron endoscopic score),intestinal flora levels,levels of inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),interleukin-23(IL-23) ],chemotactic factors [CXC chemokine ligand 10(CXCL10),CC chemokine ligand 22(CCL22) ] before and after treatment. Results The total effective rate of treatment in the study group(96. 43%) was higher than that in the control group(82. 14%)(P < 0. 05). After treatment,the traditional Chinese medicine syndrome score,Geboes histological scoring index,and Baron endoscopic score in the study group were lower than those in the control group(P < 0. 05). After treatment,the levels of Lactobacillus and Bifidobacterium in the study group were higher than those in the control group,while the levels of Enterococcus and Escherichia coli were lower than those in the control group(P < 0. 05). The overall incidence of adverse events in the study group(5. 36%) showed no statistically significant difference compared to the control group(8. 93%)(P > 0. 05). Conclusion The combination of Shugan Jianpi Huoxue Decoction and Western medicine can effectively alleviate clinical symptoms in patients with UC,regulate intestinal flora levels,downregulate inflammatory and chemotactic factor levels,enhance therapeutic efficacy,and cause fewer adverse reactions.更多还原