健脾化瘀方治療脾虛夾瘀型潰瘍性結(jié)腸炎療效觀察及對細(xì)胞因子和D-2聚體的影響
發(fā)布時(shí)間：2018-11-25 22:50
【摘要】：目的：通過觀察健脾化瘀方治療潰瘍性結(jié)腸炎脾虛夾瘀證的臨床療效,并對其臨床安全性進(jìn)行評價(jià),以探討健脾化瘀方對細(xì)胞因子和D-2聚體等其他理化指標(biāo)的影響,及其治療脾虛夾瘀型潰瘍性結(jié)腸炎的可能作用機(jī)制。方法：將符合納入標(biāo)準(zhǔn)的患者(共計(jì)60例)隨機(jī)分成實(shí)驗(yàn)組和對照組,每組各30例。治療上分別予兩組患者美沙拉嗪顆�？诜鳛榛A(chǔ)治療,實(shí)驗(yàn)組在基礎(chǔ)治療上加予健脾化瘀方口服,對照組單純予以基礎(chǔ)治療,兩組療程均為12周。比較治療前后患者的臨床表現(xiàn)、結(jié)腸鏡表現(xiàn)、血小板、D-2聚體、IL-6、 IL-10、免疫球蛋白,并進(jìn)行統(tǒng)計(jì)分析。監(jiān)測患者治療前后的血常規(guī)、肝腎功能、心電圖及治療過程中的可能出現(xiàn)的不良反應(yīng)。結(jié)果：1.實(shí)驗(yàn)組總有效率為90.0%,而對照組是73.3%,提示實(shí)驗(yàn)組優(yōu)于對照組,且差異有顯著統(tǒng)計(jì)學(xué)意義(P0.01)。2.實(shí)驗(yàn)組和對照組均可有效緩解臨床癥狀,且實(shí)驗(yàn)組優(yōu)于對照組,有顯著統(tǒng)計(jì)學(xué)差異(P0.01)。3.實(shí)驗(yàn)組和對照組均可降低免疫球蛋白(IgG、IgA、IgM),治療前后具有顯著統(tǒng)計(jì)學(xué)差異(P0.01)。治療后兩組間IgG、IgA具有統(tǒng)計(jì)學(xué)差異(p0.05),并提示實(shí)驗(yàn)組優(yōu)于對照組,而IgM無明顯差異。4.實(shí)驗(yàn)組和對照組均可降低血小板、D-2聚體,其差異具有顯著統(tǒng)計(jì)學(xué)意義(p0.01),且實(shí)驗(yàn)組優(yōu)于對照組。5.實(shí)驗(yàn)組和對照組均可調(diào)節(jié)IL-6、IL-10,且實(shí)驗(yàn)組優(yōu)于對照組,其差異具有顯著統(tǒng)計(jì)學(xué)意義(p0.01)。6.治療過程中未發(fā)現(xiàn)明顯不良反應(yīng)。結(jié)論：相較于單純西藥美沙拉嗪治療,健脾化瘀方結(jié)合美沙拉嗪口服治療脾虛夾瘀型潰瘍性結(jié)腸炎在臨床療效等方面具有一定的優(yōu)勢。其可能的作用機(jī)理與調(diào)節(jié)免疫功能變化、改善微循環(huán)、調(diào)整細(xì)胞因子平衡等有關(guān),值得進(jìn)一步研究與推廣。
[Abstract]:Objective: to observe the clinical efficacy of Jianpi Huayu recipe in treating ulcerative colitis with spleen deficiency and stasis syndrome, and to evaluate its clinical safety in order to explore the effect of Jianpi Huayu recipe on cytokines and other physical and chemical indexes such as D-2 polymer. And the possible mechanism of treating ulcerative colitis with spleen deficiency and stasis. Methods: 60 patients who met the inclusion criteria were randomly divided into experimental group and control group with 30 cases in each group. Two groups of patients were treated with mesalazine granules as the basic treatment, the experimental group in the basic treatment plus Jianpi Huayu prescription oral, the control group was given simple basic treatment, the two groups were treated for 12 weeks. The clinical manifestations, colonoscopy, platelet, D-2 polymer and IL-6, IL-10, immunoglobulin were compared before and after treatment. Blood routine, liver and kidney function, electrocardiogram and possible adverse reactions before and after treatment were monitored. Results: 1. The total effective rate of the experimental group was 90.0 and that of the control group was 73.3, indicating that the experimental group was superior to the control group, and the difference was statistically significant (P0.01). Experimental group and control group can effectively alleviate clinical symptoms, and the experimental group is better than the control group, there is significant statistical difference (P0.01). The immunoglobulin (IgG,IgA,IgM) was decreased in both the experimental group and the control group, and there was significant difference before and after treatment (P0.01). After treatment, there was a significant difference in IgG,IgA between the two groups (p0.05), indicating that the experimental group was superior to the control group, but the IgM had no significant difference. 4. Both experimental group and control group could reduce platelet and D-2 polymer, the difference was statistically significant (p 0.01), and the experimental group was better than the control group (P 0.01). Both the experimental group and the control group can regulate IL-6,IL-10, and the experimental group is superior to the control group, and the difference is statistically significant (p 0.01). No obvious adverse reactions were found in the course of treatment. Conclusion: compared with western medicine, the combination of Jianpi Huayu prescription and mesalazine orally has some advantages in the treatment of ulcerative colitis with spleen deficiency and stasis. The possible mechanism is related to the regulation of immune function, the improvement of microcirculation and the adjustment of cytokine balance, which is worthy of further study and popularization.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259
本文編號：2357595
[Abstract]:Objective: to observe the clinical efficacy of Jianpi Huayu recipe in treating ulcerative colitis with spleen deficiency and stasis syndrome, and to evaluate its clinical safety in order to explore the effect of Jianpi Huayu recipe on cytokines and other physical and chemical indexes such as D-2 polymer. And the possible mechanism of treating ulcerative colitis with spleen deficiency and stasis. Methods: 60 patients who met the inclusion criteria were randomly divided into experimental group and control group with 30 cases in each group. Two groups of patients were treated with mesalazine granules as the basic treatment, the experimental group in the basic treatment plus Jianpi Huayu prescription oral, the control group was given simple basic treatment, the two groups were treated for 12 weeks. The clinical manifestations, colonoscopy, platelet, D-2 polymer and IL-6, IL-10, immunoglobulin were compared before and after treatment. Blood routine, liver and kidney function, electrocardiogram and possible adverse reactions before and after treatment were monitored. Results: 1. The total effective rate of the experimental group was 90.0 and that of the control group was 73.3, indicating that the experimental group was superior to the control group, and the difference was statistically significant (P0.01). Experimental group and control group can effectively alleviate clinical symptoms, and the experimental group is better than the control group, there is significant statistical difference (P0.01). The immunoglobulin (IgG,IgA,IgM) was decreased in both the experimental group and the control group, and there was significant difference before and after treatment (P0.01). After treatment, there was a significant difference in IgG,IgA between the two groups (p0.05), indicating that the experimental group was superior to the control group, but the IgM had no significant difference. 4. Both experimental group and control group could reduce platelet and D-2 polymer, the difference was statistically significant (p 0.01), and the experimental group was better than the control group (P 0.01). Both the experimental group and the control group can regulate IL-6,IL-10, and the experimental group is superior to the control group, and the difference is statistically significant (p 0.01). No obvious adverse reactions were found in the course of treatment. Conclusion: compared with western medicine, the combination of Jianpi Huayu prescription and mesalazine orally has some advantages in the treatment of ulcerative colitis with spleen deficiency and stasis. The possible mechanism is related to the regulation of immune function, the improvement of microcirculation and the adjustment of cytokine balance, which is worthy of further study and popularization.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259
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