摘要
目的:研究鱼腥草蒸馏液灌肠治疗初发型溃疡性结肠炎(UC)患者的疗效及对远端结肠动力的影响。方法:应用鱼腥草蒸馏液灌肠治疗21例活动期UC患者,并与柳氮磺吡啶治疗组(21例)作对照研究,分别在治疗前后观察临床疗效。鱼腥草治疗组还观察结肠黏膜超微结构及细胞间黏附分子-1变化,并采用PC Polygraf HR高分辨多道胃肠功能测定仪检测其远端结肠动力变化。结果:鱼腥草治疗组临床疗效(完全缓解20例,93.2％;好转1例,4.8％)显著优于柳氮磺吡啶组(完全缓解15例,72.4％;好转5例,23.8％;无效1例,3.8％,P<0.01);且大便次数恢复正常天数(5.6±3.3d)、血便消失天数(6.7±3.8d)及腹痛消失天数(6.1±3.5d)均明显短于柳氮磺吡啶组(9.5±4.9d,11.7±6.1d,10.6±5.3d,P<0.01)。鱼腥草还可使结肠黏膜上皮细胞线粒体肿胀减轻,微绒毛和杯状细胞恢复正常,细胞凋亡减少,细胞间黏附分子-1表达下调(血腥草治疗前,结肠黏膜组织中ICAM-1阳性表达率为45.8±5.7％,鱼腥草治疗后为30.7±4.1％,P<0.05)。活动期UC患者推进性收缩波数目较正常人增多,平均推进速度(4.6±1.6 vs 3.2±1.8cm/min,P<0.05)加快,平均波幅降低(14.2±9.3 vs 18.4±8.0kPa,P<0.05),应用鱼腥草治疗后上述指标明显改善(17.3±8.3kPa,3.7±1.7cm/min,P<0.05)。正常人结肠餐后压力乙状结肠(2.9±0.9kPa)>降结肠(2.0±0.7kPa)>结肠脾曲(1.7±0.6kPa),活动期UC患者各部位压力(1.5±0.5kPa,1.4±0.6kPa,1.3±0.6kPa)均较正常人降低(P<0.05),不同部位压力无明显区别。鱼腥草治疗后基本恢复正常(2.6±0.8kPa,1.8±0.6kPa,1.6±0.5kPa)。活动期UC患者远端结肠对气囊扩张引起的疼痛阈值(67.3±18.9mL)较正常人(216.2±40.8mL)明显下降(P<0.05),经鱼腥草治疗后,上述指标基本恢复正常(187.4±27.2mL,P<0.05)。结论:鱼腥草治疗初发型溃疡性结肠炎患者的疗效优于柳氮磺吡啶,具有起效快、疗效好、无毒副反应等优点,并可改善远端结肠动力,抑制炎症反应。
AIM: To study the clinical effects of Heartleaf houttuynia injection on patients with ulcerative colitis (UC). METHODS: Forty-two first episode UC patients were ran- domly divided into two groups: Heartleaf houttuynia treatment group (n=21) and SASP group (n=21). Clinical effects were observed in the two groups while ultrastructure of colonic mucosa, ICAM-1 and the pressure of distant colon were studied in Heartleaf houttuynia treatment group. RESULTS: The clinical efficacy of Heartleaf houttuynia group (complete remission in 20 cases, 95.2%; improvement in one patient, 4.8 %) was better than that in SASP group (complete remission in 15 cases, 72.4 %, improvement in 5 patients, 23.8 %; ineffective in one patient, 3.8 %, P<0.01). The days of stool frequency recovering to normal (5.6±3.3 d), bloody stool disappearance (6.7±3.8 d) and abdominal pain disappearance (6.1±3.5 d) in Heartleaf houttuynia group were all shorter than those in SASP group (9.5±4.9 d, 11.7±6.1 d, 10.6±5.3 d,P<0.01). Heartleaf houttuynia herb could inhibit the epithelial cells apoptosis of colonic mucous membrane and the expression of ICAM-1 (45.8±5.7 vs 30.7±4.1 %, P<0.05). Compared with the normal subject, the mean promotional speed of contraction wave accelerated (4.6±1.6 vs 3.2±1.8 cm/min, P<0.05) and the mean amplitude of wave decreased (14.2±9.3 vs 18.4±8.0 kPa, P<0.05) in active UC patients, after treatment with Heartleaf houttuynia herb, these two indexes improved significantly (17.3±8.3 kPa, 3.7±1.7 cm/min, P<0.05). In normal person, the post-meal pressure of sigmoid (2.9±0.9 kPa)> descending colon (2.0±0.7 kPa)>splenic flexure (1.7±0.6 kPa), while the colonic pressure (1.5±0.5 kPa, 1.4±0.6 kPa, 1.3±0.6 kPa) decreased significantly (P<0.05) in active UC patients. After treatment with Heartleaf houttuynia herb, the colonic pressure (2.6±0.8 kPa, 1.8±0.6 kPa, 1.6±0.5 kPa) recovered to normal. The pain threshold of distant colon (67.3±18.9mL) in active UC decreased significantly compared with that of normal person(216.2±40.8 mL, P<0.05) and recovered to normal after treatment with Heartleaf houttuynia herb (187.4±27.2mL, P<0.05). CONCLUSION: The clinical efficacy of heartleaf houttuynia herb injection on ulcerative colitis is superior to that of SASP with fewer side effects.
出处
《世界华人消化杂志》
CAS
2003年第8期1207-1210,共4页
World Chinese Journal of Digestology
基金
山东省卫生厅青年基金项目
No.2001CA2EFB2
