中药溃结康丸治疗急性期溃疡性结肠炎(脾虚湿蕴证)临床效果观察及对血清炎症因子影响研究

目的:通过中药溃结康丸治疗急性期脾虚湿蕴型溃疡性结肠炎,观察临床治疗效果并从血清炎症因子角度探究治疗机制。方法:收集于2015年9月—2017年12月期间在辽宁中医药大学附属第二医院脾胃病科就诊的急性期脾虚湿蕴型溃疡性结肠炎病例患者80例,根据患者病历号采用随机数表法将所有患者随机分成西药对照组和中药治疗组,每组患者40例。西药对照组患者予以常规西药美沙拉嗪缓释片口服治疗,1 g/次,4次/d;中药治疗组在对照组治疗基础上予以院内制剂溃结康丸口服,1袋/次,3次/d。治疗30 d。观察比较两组患者的临床治疗总有效率、中医症状积分、焦虑抑郁评分量表评分、IBDQ生活质量评分量表评分,血清TNF-α、IFN-γ、IL-8、IL-17等炎症因子水平。结果:治疗30 d后,中药治疗组临床治疗总有效率、各项中医症状评分、焦虑抑郁评分、IBDQ生活质量评分改善效果优于西药对照组(P0.05);中药治疗组患者血清TNF-α、IFN-γ、IL-8、IL-17等炎症因子水平改善明显优于对照组(P0.05)。结论:中药溃结康丸联合西药治疗能够起到协同治疗作用,提高临床治疗效果,改善患者中医症状、调节患者心理状态、提高患者生活质量。中药溃结康丸治疗溃疡性结肠炎能够通过调节患者血清TNF-α、IFN-γ、IL-8、IL-17等炎症因子起到治疗作用。     

健脾补肾方联合柳氮磺吡啶对慢性溃疡性结肠炎患者疗效及炎症因子影响*

目的探讨健脾补肾方联合柳氮磺吡啶对慢性溃疡性结肠炎患者疗效及炎症因子影响。方法选取慢性溃疡性结肠炎患者102例,随机分为治疗组51例和对照组51例。对照组给予柳氮磺吡啶治疗,治疗组在对照组基础上结合健脾补肾方治疗。2组疗程均为8周。比较2组治疗疗效,治疗前后中医证候积分、结肠组织病理积分、肠镜表现积分和炎症因子变化及不良反应。结果治疗组总有效率（92.16%）高于对照组（72.55%）（P<0.05）;治疗后2组中医证候积分较治疗前降低（P<0.05）,治疗组中医证候积分低于对照组（P<0.05）;2组结肠组织病理积分和肠镜表现积分较治疗前降低（P<0.05）,治疗组结肠组织病理积分和肠镜表现积分低于对照组（P<0.05）;2组血清IL-6、TNF-α和CRP水平较治疗前降低（P<0.05）,治疗组血清IL-6、TNF-α和CRP水平低于对照组（P<0.05）;治疗组不良反应发生率低于对照组。结论健脾补肾方联合柳氮磺吡啶肠溶片对慢性溃疡性结肠炎患者疗效明显,可减轻炎症反应,不良反应少。     

扶正平溃汤治疗溃疡性结肠炎患者的效果

目的:观察扶正平溃汤治疗溃疡性结肠炎患者的效果。方法:选取84例溃疡性结肠炎患者为研究对象,按照随机数字表法分为对照组与观察组各42例。对照组给予美沙拉秦肠溶片治疗,观察组在对照组基础上给予扶正平溃汤治疗。比较两组肠道菌群水平、炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平和复发率。结果:治疗后,两组肠球菌、乳酸杆菌和双歧杆菌水平均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);治疗后,两组TNF-α、IL-6水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组复发率为2.38%,低于对照组的19.05%,差异有统计学意义(P<0.05)。结论:在美沙拉秦肠溶片治疗基础上采用扶正平溃汤治疗溃疡性结肠炎患者可提高肠道菌群水平,以及降低炎性因子水平和复发率,效果优于单纯美沙拉秦肠溶片治疗。     

扶正培本中药结合肠溃宁治疗溃疡性结肠炎临床效果观察

目的观察扶正培本中药联合肠溃宁治疗溃疡性结肠炎的临床疗效。方法选取我院2012年1月到2013年12月收治的100例溃疡性结肠炎患者为研究对象,将其按照随机数字法分为研究组和对照组各50例,对照组给予常规的肠溃宁治疗,研究组在对照组基础上应用扶正培本中药治疗,观察两组的临床治疗效果。结果研究组临床治疗总有效率为94.0%,明显高于对照组的76.0%,差异有统计学意义(P<0.05)。治疗前两组患者的血清肿瘤坏死因子-α(TNF-α)水平比较差异无统计学意义(P>0.05),治疗后两组患者的TNF-α水平均较治疗前有不同程度的改善,且研究组改善程度明显优于对照组,差异有统计学意义(P<0.05)。研究组复发率为8.0%,明显低于对照组的36.0%(P<0.05)。结论临床中应用扶正培本中药联合肠溃宁治疗溃疡性结肠炎效果显著,能够提高其临床治疗效果,且降低复发率,值得临床中应用。     

溃结方联合隔药灸治疗大肠湿热型溃疡性结肠炎疗效观察

目的:观察溃结方灌肠联合隔药灸对大肠湿热型溃疡性结肠炎(UC)的治疗作用。方法:纳入符合标准的80例轻中度大肠湿热型UC患者,按照随机数字表法分为治疗组与对照组各40例,对照组给予美沙拉嗪肠溶片,每次1 g,日4次;治疗组以溃结方灌肠联合隔参苓白术散艾灸神阙穴治疗,连续治疗4周。评价治疗后两组患者血清白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)及中医症状积分、中医证候疗效、Baron内镜积分。同时选择40例健康体检者为正常组,检测IL-10、TNF-α水平作为基线。结果:两组治疗后血清IL-10、TNF-α及中医症状积分、中医证候疗效、Baron内镜积分均较治疗前改善,两组治疗后血清IL-10、TNF-α水平比较差异无统计学意义(P 0.05),但与正常组比较差异均有统计学意义(P0.05)。两组治疗后Baron内镜积分比较差异无统计学意义(P 0.05)。治疗组在改善患者腹痛、腹泻、里急后重方面优于对照组(P0.05),在改善患者黏液脓血便方面与对照组比较差异无统计学意义(P 0.05)。结论:溃结方联合隔药灸治疗大肠湿热型溃疡性结肠炎在改善患者临床症状、减轻肠道炎症方面优于美沙拉嗪口服治疗。     

自拟方联合溃结灌肠液治疗溃疡性结肠炎38例

目的观察口服自拟方联合溃结灌肠液治疗溃疡性结肠炎的临床疗效。方法将70例溃疡性结肠炎患者随机分成2组,治疗组38例患者每日给予自拟方联合溃结灌肠液治疗,对照组32例患者每日口服柳氮磺胺吡啶片。结果治疗组总有效率（92．10％）高于对照组（78．13％）。结论口服中药联合溃结灌肠液治疗溃疡性结肠炎有良好的疗效。     

培菲康治疗溃疡性结肠炎患者及对细胞因子的影响

目的:评价培菲康对溃疡性结肠炎患者的临床疗效及对血清和结肠组织TNF-α、IL-10、水平的影响。方法:将58例溃疡性结肠炎患者随机分为培菲康组和对照组,每组29例,对照组采用常规治疗,培菲康组在常规治疗的基础上加用培菲康胶囊,治疗2个月后进行疗效评定以及指标检测。结果:两组临床症状及结肠黏膜炎症均有明显减轻(P<0.01);且培菲康组临床症状、结肠黏膜炎症改善程度优于对照组(P<0.01)两组治疗后血清和结肠组织TNF-α、IL-10的表达均有明显变化(P<0.01),但试验血清和结肠组织TNF-α降低及IL-10的表达增高程度大于对照组(P<0.05)。结论:培菲康辅助治疗溃疡性结肠炎效果显著,能够下调TNF-α及上调IL-10水平,可能是其治疗溃疡性结肠炎的机制之一。     

肠炎Ⅰ号方治疗大肠湿热型溃疡性结肠炎疗效观察

目的 观察肠炎Ⅰ号方治疗大肠湿热型溃疡性结肠炎（ulcerative colitis,UC）的临床疗效及其对血清炎性因子含量的影响。方法 将60例大肠湿热型UC患者分为对照组和治疗组,每组30例,对照组患者给予美沙拉嗪栓1.0 g塞肛,治疗组患者给予肠炎Ⅰ号方保留灌肠。每晚1次,1个月为1个疗程,治疗2个疗程后采用ELISA法分别检测两组患者血清白介素 (interleukin,IL)-6和肿瘤坏死因子 (tumor necrosis factor,TNF)-α含量,观察两组患者治疗前后Sutherland疾病活动指数变化及临床疗效。结果 两组患者临床疗效分布比较,差异有统计学意义（P<0.05）。治疗后两组血清IL-6、TNF-α含量,Sutherland 疾病活动指数均较治疗前明显降低（P<0.05）;两组治疗前后IL-6、TNF-α含量,Sutherland 疾病活动指数差值比较,差异均有统计学意义（P<0.05）。结论 肠炎Ⅰ号方保留灌肠治疗UC疗效显著,可以明显降低患者血清IL-6、TNF-α水平。     

4种提取工艺制备溃结康栓对溃疡性结肠炎大鼠的治疗作用

目的 研究4种提取工艺制备的溃结康栓对2,4,6-三硝基苯磺酸(TNBS)诱导溃疡性结肠炎(UC)大鼠的治疗作用.方法 SD雄性大鼠随机分为正常对照组、模型组、美沙拉秦栓组和4种提取工艺制备的溃结康栓组共7组,每组10只,用TNBS法复制UC大鼠模型,各给药组给予相应栓剂治疗,连续14 d.以各组实验大鼠疾病活动指数(DAI)、结肠黏膜损伤度、组织病理学改变、肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)、白介素-4(IL-4)等为指标,对其治疗疗效进行评价.结果 模型组大鼠DAI评分、结肠黏膜损伤评分,血清中TNF-α、IL-1β 及IL-4水平与正常对照组比较差异有统计学意义(P<0.01),美沙拉秦栓组、各工艺溃结康栓组DAI评分、结肠黏膜损伤评分显著降低,TNF-α、IL-1β 及IL-4水平与模型组比较有统计学意义(P<0.05);美沙拉秦栓组与工艺Ⅰ溃结康栓组、工艺Ⅳ溃结康栓组DAI评分,TNF-α、IL-1β 及IL-4水平比较无统计学意义.结论 4种提取工艺制备的溃结康栓均对TNBS诱导的UC模型大鼠有治疗作用,其中以提取工艺Ⅳ制备的溃结康栓疗效尤为显著,可为溃结康栓制剂研究提供工艺基础.     

中药结肠灌洗联合血浆置换对慢性重型乙型肝炎患者血清肿瘤坏死因子-α、白介素-18及内毒素水平的影响简

目的 观察中药结肠灌洗联合血浆置换对慢性重型乙型肝炎患者肝功能、血清TNF-α、IL-18及内毒素水平的影响,并探讨其机理.方法 选择慢性重型乙型肝炎患者112例,分为中药结肠灌洗联合血浆置换组（治疗组）、血浆置换组（对照组）,分别检测治疗前后肝功能、血清TNF-α、IL-18及内毒素水平的变化.结果 治疗组治疗后血清TNF-α、IL-18及内毒素水平较治疗前显著下降（P＜0.05）;同对照组比较血清总胆红素、血氨、血清TNF-α、IL-18及内毒素水平有显著性差异（P＜0.05）.结论 中药结肠灌洗联合血浆置换治疗慢性重型乙型肝炎可更有效降低肝功能、血清TNF-α、IL-18及内毒素的水平,提高重型肝炎患者的存活率.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.