摘要
目的:观察单用美沙拉秦及联合乌梅丸治疗活动期溃疡性结肠炎(UC)的临床疗效、预后及对外周血T淋巴细胞亚群的影响。方法:将60例UC患者随机分为联合用药组和美沙拉秦组。美沙拉秦组予美沙拉嗪,联合用药组在此基础上加用乌梅丸,疗程均为8周。分别于入院后次日及治疗8周后,观察两组患者临床症状改善情况、结肠镜下表现及复发率,采用Mayo疾病活动指数进行评分;同时检测两组患者外周血T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)的变化及治疗过程中两组药物不良反应发生情况。结果:联合用药组总有效率(93.3%)高于美沙拉秦组(73.3%),而复发率(14.3%)低于美沙拉秦组(40.9%),差异均有统计学意义(P<0.05)。治疗前两组患者Mayo疾病活动指数无统计学差异(P>0.05),治疗后活动指数评分均较治疗前下降,且联合用药组治疗后疾病活动指数(1.03±1.00)低于美沙拉秦组(2.10±1.39),差异均有统计学意义(P<0.05)。两组患者治疗前外周血T淋巴细胞各项指标无统计学差异(P> 0.05)。治疗后,两组患者外周血CD3+、CD4+细胞百分比及CD4+/CD8+比值均高于治疗前,CD8+细胞百分比低于治疗前,差异均具有统计学意义(P <0.05)。联合用药组患者经治疗后,CD4+细胞百分比(45.9±2.7)%及CD4+/CD8+比值(0.80±0.08)%均高于美沙拉嗪组[分别为(32.1±2.2)%、(0.5±0.32)%],CD8+细胞百分比(57.3±3.6)%低于美沙拉秦组(64.7±2.2)%,差异均有统计学意义(P <0.05)。两组患者在治疗期间均未出现不良反应。结论:乌梅丸和美沙拉秦联用治疗活动期UC疗效显著、复发率低,可调节T淋巴细胞亚群的比例失衡,改善UC患者细胞免疫状态。乌梅丸可辅助治疗UC,二者联合应用值得临床推广。
Objective To observe the clinical efficacy, prognosis and effect on T-lymphocyte subgroup of mesalazine and Wumei Pill combination therapy in patients with active ulcerative colitis （UC）. Methods Sixty UC patients were randomly divided into mesalazine group and combination group. Patients in mesalazine group were administered with mesalazine, and on the basis of this, the patients in combination group were given Wumei Pill. The course of treatment was 8 weeks. The improvement of patients＇ clinical symptom and manifestation under colonoscope were observed on day 2 after hospitalization and 8 weeks after medication, and the recurrence rates were observed as well. Mayo disease activity index was used for scoring. Changes of T-lymphocyte subgroup （CD3＋, CD4＋, CD8＋ and CD4＋/CD8＋） and adverse reactions were also observed. Results The efficiency of combination group （93.3%） was higher than that of mesalazine group （73.3%）, and recurrence rate of combination group （14.3%） was lower than that of mesalazine group （40.9%）, the differences were both statistically significant （P〈0.05）. Before medication, the scores of Mayo disease activity index in two groups had no statistical difference （P〉0.05）. After treatment, the score after medication of combination group （1.03 ±1.00） was lower than that of mesalazine group （2.10 ± 1.39）; the differences were both statistically significant （P〈0.05）. The data of two groups on T-lymphocyte subgroup had no statistical difference （P〉0.05）.After treatment, the proportions of CD3＋, CD4＋and CD4＋/CD8＋ were increased in patients of two groups, while the proportions of CD8＋ of twogroups was decreased, the differences were both statistically significant （P〈0.05）. And the proportions of CD4＋ [（45.9 ± 2.7）%] and CD4＋/CD8＋ [（0.80 ± 0.08）%] after medication of the combination group were higher than those of mesalazine group [（32.1 ± 2.2）% and （0.5± 0.32）%], the proportion of CD8＋ after medication of the combination group [（57.3 ± 3.6）%] was lower than that of mesalazine group [（64.7 ± 2.2）%], the differences were both statistically significant （P〈0.05）. During the treatment, there were no adverse reactions in patients of both groups. Conclusion The combination therapy with mesalazine and Wumei Pills produced good effects on UC, with low recurrence rate. The therapy could adjust the imbalance of T lymphocyte subgroup and improve the cell immune status. Wumei Pills may play a role as adjuvant therapy for patients with UC. The therapy is worthy of clinical popularization and application on UC.
作者
孙盟朝
田晶晶
崔莉红
SUN Meng-zhao;TIAN Jing-jing;CUI Li-hong(Department of Gastroenterology,Tianjin Nankai Hospital,Tianjin（300100）,China)
出处
《中国中西医结合外科杂志》
CAS
2018年第5期545-549,共5页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
关键词
乌梅丸
溃疡性结肠炎
T淋巴细胞亚群
Wumei Pill
active ulcerative colitis
T-lymphocyte subgroup
