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大黄牡丹汤加味治疗溃疡性结肠炎(大肠湿热证)的临床观察

Effect of Dahuang Mudan Decoction in the Treatment of Ulcerative Colitis with Syndrome of Dampness-heat in Large Intestine

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目的 观察大黄牡丹汤加味治疗溃疡性结肠炎(UC)(大肠湿热证)的临床疗效.方法 将98例患者根据随机数字表法分为中西医联合组与单纯西药组各49例.单纯西药组予美沙拉嗪缓释颗粒口服,中西医联合组加用大黄牡丹汤口服.比较两组治疗效果、疾病活动改善评分、临床症状和肠黏膜病变评分、血清细胞间黏附分子-1(ICAM-1)与血管细胞黏附分子(VCAM-1)水平.结果 2周疗程结束后,中西医联合组总有效率为93.88％,显著高于单纯西药组的75.51％(P＜0.05);两组改良Mayo评分显著降低,且中西医联合组降低更显著(P＜0.05);两组主要症状与肠黏膜病变评分显著降低,且中西医联合组降低更显著(P＜0.05);两组血清ICAM-1与VCAM-1水平显著下降,且中西医联合组下降更明显(P＜0.05).结论 大黄牡丹汤加味治疗UC(大肠湿热证)患者的效果明显,能促进病情的控制,并下调血清ICAM-1与VCAM-1水平.
Objective:To observe the effect of modified Dahuang Mudan Decoction in the treatment of ulcer-ative colitis(UC)with syndrome of dampness-heat in large intestine.Methods:A total of 98 cases were divided into the combined Chinese and western medicine group and simple western medicine group according to random number table method,49 cases each.The simple Western medicine group received oral administration of mesala-zine granules,while the combined Western and Chinese meidcine group receivd oral administration of Dahuang Mudan Decoctiono on basis of the simple Western medicine group.The therapeutic effect,disease activity improve-ment score,the clinical symptoms and intestinal mucosal lesion score,serum levels of intercellular adhesion mole-cule-1(ICAM-1)and vascular cell adhesion molecule-1(VCAM-1)levels were compared between the two groups.Results:After 2 weeks of treatment,the total effective rate in the combined Chinese and western medi-cine group was 93.88％,which was significantly increased compared with 75.51％in the western medicine group(P＜0.05).Treatment,the modified Mayo scores in the two groups were significantly reduced,and the reduction was more significant in the combined group than that in the western medicine group(P＜0.05).The main symp-toms and intestinal mucosal lesion scores of the two groups were significantly decreased,and the decrease was more significant in the combined group(P＜0.05).After 2 weeks of treatment,serum ICAM-1 and VCAM-1 levels in two groups were significantly decreased,and the decrease was more obvious in the combined group(P＜0.05).Conclusion:The effect of modified Dahuang Mudan Decoction in the treatment of ulcerative colitis(UC)with syn-drome of dampness-heat in large intestine is evident,which can promote disease control,and down-regulate serum levels of ICAM-1 and VCAM-1.

Ulcerative colitisDahuang Mudan DecoctionIntercellular adhesion molecule-1Vascular endothe-lial cell adhesion molecule-1Syndrome of dampness-heat in large intestine

周玉、张萍

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江苏省中医院,江苏南京 210029

溃疡性结肠炎 大黄牡丹汤 细胞间黏附分子-1 血管细胞黏附分子-1 大肠湿热证

江苏省医院协会医院管理创新研究项目

JSYGY-3-2017-11

2024

10.3969/j.issn.1004-745X.2024.06.032

中国中医急症
中华中医药学会

中国中医急症

CSTPCD
影响因子：1.144
ISSN：1004-745X
年,卷(期)：2024.33(6)
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