Efficacy of Five-Flavor Sophora flavescens Enteric-Coated Capsules Combined with Thalidomide Tablets in the Treatment of Refractory Ulcerative Colitis and its Effects on Inflammatory Factors,Immune Function and Oxidative Stress
Objective:To explore the efficacy of Five-Flavor Sophora flavescens enteric-coated capsules combined with thalidomide tablets in the treatment of refractory ulcerative colitis(UC)and its effects on inflammatory factors,immune function and oxidative stress.Methods:A total of 86 patients with refractory UC treated in a hospital from June 2018 to June 2022 were selected and divided into the control group and observation group by random number table method,with 43 patients in each group.The control group was treated with thalidomide tablets alone,whereas the observation group with thalidomide tablets combined with Five-Flavor Sophora flavescens enteric-coated capsules,and both groups were continuously treated for 4 weeks.The pre-and post-treatment levels of peripheral blood T lymphocyte subsets(CD3+,CD4+,CD8+and CD4+/CD8+),levels of inflammatory factors[hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),intercellular adhesion molecule-1(ICAM-1),vascular cell adhesion molecule-1(VCAM-1)and interleukin-10(IL-10)]and levels of oxidative stress markers[superoxide dismutase(SOD),malondialdehyde(MDA)],modified Mayo endoscopic scores,clinical responses,times to improvement of clinical symptoms(abdominal pain,diarrhea,bloody purulent stool,burning sensation around the anus)were observed and compared between the two groups.Results:After treatment,the levels of CD3+,CD4+and CD4+/CD8+in both groups were increased from respective levels before treatment,and were higher in the observation group as compared with the control group(P<0.05),while the CD8+level was decreased from the figure before treatment,and was lower in the observation group as compared with the control group(P<0.05).After treatment,the levels of hs-CRP,TNF-α,ICAM-1 and VCAM-1 in both groups were decreased from respective levels before treatment,and were lower in the observation group as compared with the control group(P<0.05),while the IL-10 level was increased from the figure before treatment,and was higher in the observation group as compared with the control group(P<0.05).As compared with respective levels before treatment,the SOD level was increased after treatment while the MDA level was decreased(P<0.05)in both groups with greater degree of change in the observation group(P<0.05).After treatment,the modified Mayo endoscopic score in both groups was lower than that before treatment,and was lower in the observation group as compared with the control group(P<0.05).The total response rate was higher in the observation group(93.02%)as compared with the control group(79.07%,P<0.05).After treatment,the time to improvement of such clinical symptoms as abdominal pain,diarrhea,bloody purulent stool and burning sensation around the anus in the observation group was shorter than that in the control group(P<0.05).Conclusion:Compared with thalidomide tablets alone,the combination treatment with Five-Flavor Sophora flavescens enteric-coated capsules and thalidomide tablets can improve the clinical symptoms in patients with refractory UC,shorten the time to symptom improvement,regulate the levels of peripheral blood T lymphocytes,improve the levels of inflammatory factors and oxidative stress,demonstrating a promising therapeutic prospect.Hence,it is worthy of clinical application.
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