摘要
目的:通过治疗溃疡性结肠炎患者,探究黄连配伍木香治疗的临床疗效与机制,并观察临床治疗有效率、生活质量改善、血清抗中性粒细胞胞浆抗体(ANCA)含量变化、结肠黏膜组织Smad7表达水平变化、结肠黏膜组织转录调节因子ⅠκBα表达水平变化。方法:采用随机对照方法收集2015年11月—2018年4月期间于我院肛肠科诊治的溃疡性结肠炎病例患者120例,采用随机数表法将其随机分成对照、观察两组,各60例患者。对照组患者采用5-氨基水杨酸口服联合5-ASA灌肠液治疗;观察组在对照组治疗基础上联合应用黄连、木香方剂进行治疗,治疗2个月后观察临床治疗有效率、生活质量改善,以及血清抗中性粒细胞胞浆抗体(ANCA)含量变化、结肠黏膜组织Smad7表达水平变化、结肠黏膜组织转录调节因子ⅠκBα表达水平变化。结果:观察组中医证候治疗总有效率(86.7%)显著高于对照组(63.3%)(P<0.05),观察组治疗后临床疗效率(61.7%)、肠镜疗效率(90.0%)均显著高于对照组(35.0%、40.0%)(P<0.05),差异具有统计学意义(P<0.05),提示黄连、木香方剂可明显提高疗效;与治疗前比较,两组IBDQ量表评分均显著提高(P<0.05),组间比较观察组提高明显,差异显著(P<0.05);治疗后两组患者Smad7表达水平均下降明显,组内及组间比较差异均具有统计学意义(P<0.05);治疗后两组患者ⅠκBα表达水平均下降,组内及组间比较差异均具有统计学意义(P<0.05);治疗后两组患者ANCA阳性率均下降明显,组内及组间比较差异均具有统计学意义(P<0.05)。结论:在常规西药治疗基础上联合应用黄连、木香中药治疗慢性溃疡性结肠炎患者可取得满意的临床综合疗效,显著改善生活质量,促进中医症状改善,在缓解腹泻、腹痛症状方面,溃疡性结肠炎患者采用黄连、木香治疗具有显著优势,应在临床中广泛应用。
Objective:To investigate the clinical efficacy and mechanism of Compatibility of Coptis Chinensis and Radix Aucklandiae in the treatment of patients with ulcerative colitis,and to observe the effectiveness of clinical treatment,improvement of quality of life,serum anti-neutrophil cytoplasmic antibody(ANCA)content,the expression level of Smad7 in mucosa and the expression level of transcriptional regulator IκBα in colonic mucosa were changed. Methods:A randomized controlled trial was performed to collect 120 patients with ulcerative colitis who were diagnosed and treated in our hospital from November to April 2018. They were randomly divided into control and observation groups by random number table method. The patients in the control group were treated with 5-aminosalicylic acid orally combined with 5-ASA enema solution. The observation group was treated with Coptis Chinensis and Radix Aucklandiae prescriptions on the basis of the control group. After two months of treatment,the clinical treatment efficiency and quality of life were observed. Improvement,as well as serum anti-neutrophil cytoplasmic antibody(ANCA)content changes,colonic mucosal tissue Smad7 expression levels,colonic mucosal tissue transcriptional regulator IκBα expression levels. Results:The total effective rate of TCM syndrome treatment in observation group(86.7%)was significantly higher than that in the control group(63.3%)(P<0.05). The clinical efficacy rate(61.7%)and endoscopic efficacy rate(90.0%)in the observation group. They were significantly higher than the control group(35.0%,40.0%)(P<0.05),the difference was statistically significant(P<0.05),suggesting that Coptis Chinensis and Radix Aucklandiae prescriptions can significantly improve the curative effect;compared with before treatment,the two groups of IBDQ scores were significantly increased(P<0.05). The difference between the two groups was significant(P<0.05). After treatment,the expression of Smad7 was significantly decreased in the two groups. The difference between the two groups was statistically significant(P<0.05);after treatment,the expression of IκBα decreased in both groups,and the difference between the two groups was statistically significant(P<0.05). After treatment,the positive rate of ANCA decreased significantly in both groups.The intra-and inter-group differences were statistically significant(P<0.05). Conclusion:On the basis of conventional Western medicine treatment,the Compatibility of Coptis Chinensis and Radix Aucklandiae Chinese medicine for the treatment of patients with chronic ulcerative colitis can achieve satisfactory clinical comprehensive effect,can significantly improve the quality of life,promote the improvement of TCM symptoms,in the relief of diarrhea,abdominal pain symptoms,treating ulcerative colitis patients with Coptis Chinensis and Radix Aucklandiae has significant advantages,should be widely used in clinical.
作者
毕夏
BI Xia(The Third Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110016,Liaoning,China)
出处
《辽宁中医药大学学报》
CAS
2019年第5期187-190,共4页
Journal of Liaoning University of Traditional Chinese Medicine
关键词
黄连
木香
溃疡性结肠炎
配伍
Coptis Chinensis
Radix Aucklandiae
ulcerative colitis
compatibility
