枫蓼肠胃康颗粒联合美沙拉秦治疗溃疡性结肠炎大肠湿热证临床研究

Clinical Study on Fengliao Changweikang Granules Combined with Mesalazine for Ulcerative Colitis with Damp-Heat Accumulating in Intestine Syndrome

摘要:

目的：观察枫蓼肠胃康颗粒联合美沙拉秦治疗溃疡性结肠炎大肠湿热证患者的临床疗效。方法：选取2023年2月1日—2025年10月1日宁波市中西医结合医院姜山分院收治的68例溃疡性结肠炎大肠湿热证患者，按随机数字表法分为观察组和对照组各34例。其中观察组因擅自使用其他治疗药物剔除1例，对照组失访剔除1例，最终2组各纳入33例。对照组给予美沙拉秦治疗，观察组在对照组基础上加用枫蓼肠胃康颗粒治疗。连续治疗8周，随访6个月。比较2组临床疗效及不良反应发生情况，以及治疗前后中医证候评分、内镜下严重程度评分（UCEIS）、改良Mayo活动指数（Mayo） 评分、炎性肠病生活质量问卷（IBDQ） 评分、血清学指标［白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、丙二醛（MDA）、缺氧诱导因子-1α（HIF-1α）］水平。结果：治疗后，观察组总有效率为96.97%（32/33），对照组为78.79%（26/33），2组比较，差异有统计学意义（P＜0.05）。治疗后，2组腹泻、腹痛、血便、脘腹胀满等中医证候评分均较治疗前下降（P＜0.05），且观察组各项评分均低于对照组（P＜0.05）。治疗后，2组UCEIS、Mayo评分均较治疗前降低（P＜0.05），且观察组UCEIS、Mayo 评分均低于对照组（P＜0.05）；2 组IBDQ 评分均较治疗前升高（P＜0.05），且观察组IBDQ评分高于对照组（P＜0.05）。治疗后，2组血清IL-6、TNF-α、MDA、HIF-1α水平均较治疗前降低（P＜0.05），且观察组各项指标水平均低于对照组（P＜0.05）。在治疗期间，2组均未发生不良反应。结论：枫蓼肠胃康颗粒联合美沙拉秦治疗溃疡性结肠炎大肠湿热证患者疗效良好，可降低机体炎性反应，改善临床症状及肠道病理变化，提高患者生活质量。

Abstract:

Abstract： Objective： To observe the clinical efficacy of Fengliao Changweikang Granules combined with Mesalazine in the treatment of patients with ulcerative colitis with damp-heat accumulating in intestine syndrome. Methods：A total of 68 patients with ulcerative colitis with damp-heat accumulating in intestine syndrome admitted to Jiangshan Branch of Ningbo Hospital of Integrated Traditional Chinese and Western Medicine from February 1，2023， to October 1，2025，were enrolled. They were randomly divided into the observation group and the control group using the random number table method， with 34 cases in each group. Among them， 1 case in the observation group was excluded due to unauthorized use of other therapeutic drugs， and 1 case in the control group was lost to follow-up， resulting in 33 cases finally included in each group. The control group was treated with Mesalazine， while the observation group received Fengliao Changweikang Granules in addition to the treatment of the control group. Both groups were treated continuously for 8 weeks and followed up for 6 months. The clinical efficacy and incidence of adverse reactions were compared between the two groups， as well as the traditional Chinese medicine syndrome scores， Ulcerative Colitis Endoscopic Index of Severity （UCEIS）， modified Mayo Activity Index （Mayo）， Inflammatory Bowel Disease Quality of Life Questionnaire （IBDQ），and serum levels of interleukin-6 （IL-6），tumor necrosis factor-α （TNF-α），malondialdehyde （MDA），and hypoxia-inducible factor-1α （HIF-1α） before and after treatment. Results： After treatment， the total effective rate was 96.97% （32/33） in the observation group and 78.79%（ 26/33） in the control group，with a statistically significant difference between the two groups（ P＜0.05）. After treatment， the traditional Chinese medicine syndrome scores for diarrhea， abdominal pain， bloody stool， and abdominal distension and fullness in both groups decreased compared to before treatment （P＜0.05），and the scores in the observation group were lower than those in the control group （P＜0.05）. After treatment， the UCEIS and Mayo scores in both groups decreased compared to before treatment （P＜0.05），and the scores in the observation group were lower than those in the control group （P＜0.05）； the IBDQ scores in both groups increased compared to before treatment （P＜0.05），and the score in the observation group was higher than that in the control group （P＜0.05）. After treatment， the serum levels of IL-6， TNF-α， MDA， and HIF-1α in both groups decreased compared to before treatment （P＜0.05）， and the levels of these indicators in the observation group were lower than those in the control group （P＜0.05）. No adverse reactions occurred in either group during treatment. Conclusion： The combination of Fengliao Changweikang Granules and Mesalazine demonstrates good efficacy in the treatment of patients with ulcerative colitis with damp-heat accumulating in intestine syndrome. It can reduce the systemic inflammatory response，improve clinical symptoms and intestinal pathological changes，and enhance the patients' quality of life.