中药抗溃疡性结肠炎复发临床的研究.docVIP

PAGE \* MERGEFORMAT 1 中药抗溃疡性结肠炎复发临床研究【摘要】 目的 探讨中药抗溃疡性结肠炎(UC)复发的机制。方法 将103例UC患者随机分为治疗组和对照组,治疗组予中药治疗,对照组予柳氮磺胺吡啶治疗。经3个月治疗,共有53例患者完全缓解,测定其血清CD4+、CD8+、CD3+细胞计数,并观察中药对复发的影响。结果 UC复发患者CD8+细胞绝对计数与百分比、CD3+细胞绝对计数、CD4+细胞绝对计数均显著升高(P＜0.001),CD4+/CD8+显著降低(P＜0.001)。结论 中药抗UC复发可能是通过抑制T淋巴细胞亚群过度增殖、改善T淋巴细胞亚群比例失调、调节细胞免疫功能而实现的。 【关键词】 抗复发；溃疡性结肠炎；免疫学；T淋巴细胞亚群 Abstract：Objective To investigate the mechanism of Chinese herb in preventing recurrence of ulcerative colitis. Methods One hundred and three UC patients were divided into treatment group and control group randomly. The treatment group was treated by Chinese herb and the control group was treated by Sulfasalazine. After treated for three months, fifty three full remission patients were followed-up. CD4+, CD8+ and CD3+ cell count were performed and influence of Chinese herb on recurrence was observed. Results Either the cell count of CD3+, CD4+ and CD8+ or the percentage of CD8+ in the peripheral blood was significantly higher in recurrence group than those in the control (P＜0.001). The ratio of CD4+/CD8+ was significantly lower in the recurrence group than that in the control (P＜0.001). Conclusion The mechanism of Chinese herb in preventing recurrence may be involved in suppressing excessive proliferation of T lymphocyte subgroup, balancing the disequilibrium of T lymphocyte subgroup, and regulating the cellular immune function. Key words：anti-recurrence；ulcerative colitis；immunology；T lymphocyte subgroup 溃疡性结肠炎(Ulcerative colitis,UC),又称慢性非特异性溃疡性结肠炎,是一种病因尚未明确的慢性疾病,以大肠(直肠与结肠)黏膜与黏膜下炎症为主要特征,以腹泻、黏液脓血便和腹痛等为主要症状。往往反复发作,迁延数月、数年乃至数十年。笔者对分别采用中药和柳氮磺胺吡啶治疗3个月后完全缓解的53例UC患者血清CD4+、CD8+、CD3+细胞计数进行检测,观察中药的抗复发作用,现报道如下。 　　1 临床资料 观察病例来源于北京中医药大学东直门医院、东方医院及中国人民解放军第306医院门诊患者,均符合2000年(成都)“全国炎症性肠病学术研讨会”制定的诊断标准[1]。采用简单随机法分为2组：治疗组51例,年龄最小18岁,最大70岁,平均(41.77±14.67)岁；对照组52例,年龄最小16岁,最大70岁,平均(42.22±14.90)岁。2组分别经中药和柳氮磺胺吡啶治疗3个月后,治疗组完全缓解35例,其中女16例,男19例；对照组完全缓解18例,其中女8例,男10例。 　　2 观察方法 　　2.1 治疗方法 治疗组：采用王新月教授经验方加减治疗。方药组成：生黄芪20 g,炒陈皮10 g,炒白芍10 g,炒白术20 g,茯苓30 g,黄连10