化毒愈肠方内服和灌肠治疗溃疡性结肠炎的疗效及对血清IL-22和IL-23的影响

目的:观察化毒愈肠方内服和灌肠治疗溃疡性结肠炎(UC)湿热内蕴证的疗效及其作用机制的探讨。方法:将96例UC患者按照数字表法将受试者随机分为治疗组和对照组各48例;对照组采用柳氮磺吡啶肠溶片口服,4 g·d~(-1),4次/d;曲安西龙片口服,10 mg·d~(-1),3次/d;治疗组在对照组治疗的基础上采取化毒愈肠方内服和灌肠治疗,内服方,1剂/d,2次/d;灌肠方,100 m L/次,3 h/次,1次/2 d;两组疗程均为8周。比较两组治疗前后中医症状、病理积分、结肠镜积分和Southerland疾病活动指数;分析两组治疗后的治疗效果;检测两组治疗前后血清白细胞介素(IL)-22和IL-23水平。结果:治疗组临床总有效率为97.92%,对照组为81.25%,治疗组优于对照组(P0.05);治疗组治疗后各项中医症状评分、病理积分、结肠镜积分和Southerland疾病活动指数评分均明显低于对照组(P0.01);治疗后治疗组患者血清IL-22和IL-23水平均明显低于对照组,比较差异有统计学意义(P0.01)。结论:化毒愈肠方内服和灌肠治疗UC湿热内蕴证可明显降低患者中医症状和Southerland疾病活动指数积分,改善病理和结肠情况,提高临床疗效,其作用机制可能与降低血清IL-22和IL-23水平相关,值得进一步探讨。

Curative Effect of Huadu Yuchang Decoction in Treating Ulcerative Colitis by Oral Administration and Enema Method as Well as Influences on Serum IL-22 and IL-23

Objective: To observe the curative effect of Huadu Yuchang decoction in treating ulcerative colitis (UC) of dampness-heat type by oral administration and enema method and investigate its mechanism of action. Method: Ninety-six patients of UC were randomly divided into treatment group and control group, 48 cases in each group. The patients in control group orally took sulfasalazine enteric-coated tablets (4 g · d^-1, qid) and triamcinolone tablets (10 mg · d^-1,tid). On the basis of the control treatment, the patients in treatment group also received Huadu Yuchang decoction by oral administration (1 dose/d, bid) and enema method (100 mL/time, 3 h/time, once/2 d). The treatment course was 8 weeks for both groups. Traditional Chinese medicine symptoms, pathological scores, colonoscopy scores and Southerland disease activity indexes were compared before and after treatment in 2 groups. The curative effects after treatment were analyzed in 2 groups. Serum levels of interleukin-22 (IL-22) and interleukin-23 (IL-23) were detected before and after treatment in both groups. Result: The total effective rate was 97.92% in treatment group, higher than 81.25% in control group (P< 0.05). Traditional Chinese medicine symptom scores, pathological scores, colonoscopy scores and Southerland disease activity indexes in treatment group were significantly lower than those in control group (P< 0.01). Serum levels of IL-22 and IL-23 in treatment group were significantly lower than those in control group, with statistically significant differences (P< 0.01). Conclusion: Huadu Yuchang decoction treating UC of dampness-heat type by oral administration and enema method could reduce Traditional Chinese medicine symptom scores and Southerland disease activity indexes, improve the pathological and colon conditions, and increase the clinical efficacy. Its action mechanism may be associated with reducing serum levels of IL-22 and IL-23, which is worthy of further discussion.