半夏泻心汤结合保留灌肠治疗缓解期溃疡性结肠炎及对肠道内菌群水平的影响

目的:探究半夏泻心汤结合保留灌肠治疗缓解期溃疡性结肠炎(UC)的效果以及对肠道内菌群水平的影响。方法:将缓解期UC患者80例按照随机数字表法分为西医组和中医组,每组40例。西医组给予美沙拉嗪治疗,中医组给予半夏泻心汤加减内服结合中药保留灌肠。2组均以4周为1个疗程,治疗1个疗程。采用中医证候评分评价患者证候,采用Geboes指数量表评价肠黏膜病变情况,采用炎症性肠病生存质量问卷表(IBDQ)评价患者生活质量,收集大便标本,检测菌群水平,并评价疗效。结果:治疗后,2组中医证候评分、Geboes评分降低,IBDQ评分升高(P<0.05);中医组中医证候评分、Geboes评分低于同期西医组,IBDQ评分高于西医组(P<0.05)。治疗后,2组大肠杆菌含量降低,双歧杆菌、乳酸杆菌含量升高(P<0.05)。中医组治疗后大肠杆菌含量低于西医组,双歧杆菌、乳酸杆菌含量高于西医组(P<0.05)。中医组总有效率为92.50%,西医组总有效率为72.50%,中医组总有效率高于西医组(P<0.05)。结论:对缓解期UC患者使用半夏泻心汤加减内服结合中药保留灌肠治疗,能够有效调节患者肠道内菌群平衡,促进黏膜恢复,改善症状以及提高生活质量,疗效显著。

Effect of Banxia Xiexin Tang Combined with Retention Enema on Ulcerative Colitis at Remission Stage and on Levels of Intestinal Bacteria

Objective: To discuss the effect of the therapy of Banxia Xiexin tang combined with retention enema on ulcerative colitis(UC) at remission stage and on the levels of intestinal bacteria. Methods: A total of 80 UC patients at remission stage were divided into the western medicine group and the Chinese medicine group according to the random number table method, 40 patients in each group. The western medicine group was treated with mesalazine, and the Chinese medicine group was treated with modified Banxia Xiexin tang orally combined with Chinese herbal retention enema.Both groups were treated one course of treatment for four weeks. The syndromes of patients were evaluated through Chinese medicine syndrome score,the intestinal mucosal lesions were evaluated through the Geboes Score,and the quality of life was observed through Inflammatory Bowel Disease Questionnaire(IBDQ). The levels of bacteria were detected by stool samples of patients and the clinical effect was evaluated. Results:After treatment,the Chinese medicine syndrome scores and Geboes scores in the two groups were decreased, while the IBDQ scores were increased(P<0.05). The Chinese medicine syndrome score and Geboes score in the Chinese medicine group were lower than those in the western medicine group at the same period,while the IBDQ score was higher(P<0.05). After treatment,the amount of escherichia coli was decreased in both groups, while the amount of bifidobacteria and lactobacillus was increased(P<0.05). The amount of escherichia coli in the Chinese medicine group was lower than that in the western medicine group, and the amount of bifidobacteria and lactobacillus was higher(P<0.05). The total effective rate was 92.50% in the western medicine group,higher than that of 72.50% in the Chinese medicine group(P<0.05). Conclusion:The therapy of modified Banxia Xiexin tang combined with Chinese herbal retention enema for UC patients at remission stage, can effectively regulate the balance of intestinal bacteria,promote the recovery of mucosa,improve symptoms as well as the quality of life.