目的:探讨痛泻要方联合高压氧(HBO)治疗溃疡性结肠炎(UC)肝郁脾虚证的临床疗效及其作用机制。方法:选取2019年3月至2019年9月青岛大学附属医院肛肠科确诊为溃疡性结肠炎98例患者作为研究对象，按照治疗方法分为观察组(n n＝52)和对照组(n n＝46)，观察组采用痛泻要方联合HBO治疗，对照组予以美沙拉嗪缓释颗粒治疗。治疗28 d后评估临床疗效及改良Mayo评分；酶联免疫吸附测定法(ELISA)检测血清肿瘤坏死因子-α(TNF-α)、白细胞介素-17(IL-17)水平；Western blotting实验检测前列腺素G/H合酶2(PTGS2)和Bcl-2蛋白含量。钳取治疗前后新鲜结肠组织，Western blotting实验检测治疗前后结肠组织中Yes相关蛋白(Yap1)、磷酸化Yes相关蛋白(P-Yap1)含量；内窥镜观察结肠黏膜水肿、溃疡愈合情况；显微镜观察治疗前后结肠黏膜组织固有层弥漫性炎性浸润、表面溃疡以及隐窝上皮中的中性粒细胞数量。n 结果:治疗28 d后，观察组临床有效率(80.8%)明显高于对照组(60.9%)(n P<0.05)；与治疗前比较，2组患者治疗后Mayo评分明显降低(n P<0.05)。观察组治疗后Mayo评分低于对照组(n P<0.05)。2组患者治疗后结肠黏膜水肿、溃疡较治疗前均有所改善，且观察组优于对照组。病理切片显示，治疗前2组患者结肠黏膜组织固有层弥漫性炎性浸润、腺体不规则、隐窝破坏及脓肿、表面溃疡，治疗后固有层和隐窝上皮中的中性粒细胞显著减少，弥漫性浸润转为灶性。2组患者治疗后血清TNF-α、IL-17水平较治疗前均明显下降(n P0.05)。2组患者结肠组织中PTGS2、Yap1表达较治疗前均明显下调，抗凋亡蛋白Bcl-2、P-Yap1蛋白表达均明显上调(n P0.05)。n 结论:痛泻要方联合HBO治疗UC肝郁脾虚证可获得高于单纯口服美沙拉嗪缓释颗粒的临床缓解率，明显降低改良Mayo评分，有效促进结肠黏膜溃疡愈合。“,”Objective:To observe and explore the clinical effect and mechanism of Tongxie Yaofang formula combined with hyperbaric oxygen (HBO) in the treatment of ulcerative colitis (UC) with liver stagnation and spleen deficiency syndrome.Methods:A total of 98 patients diagnosed as ulcerative colitis at the Department of Anorectal Medicine of the Affiliated Hospital of Qingdao University from March 2019 to September 2019 were selected as the research subjects and divided into observation group (n n=52) and control group (n n=46) according to treatment methods. The observation group was treated with Tongxie Yaofang formula combined with HBO, while the control group was treated with mesalazine sustained-release granules. The clinical efficacy and Mayo scores were evaluated after 28 days of treatment. The serum levels of tumor necrosis factor α (TNF-α) and interleukin-17 (IL-17) were detected by enzyme-linked immunosorbent assay (ELISA). The contents of prostaglandin endoperoxide synthase 2 (PTGS2) and B-cell lymphoma 2 (Bcl-2) proteins were detected by Western blotting. Fresh colon tissues before and after treatment were taken with biopsy forceps, and the contents of Yes-associated protein 1 (Yap1) and Phospho-Yes-associated protein 1 (PYap1) (Ser127) in colon tissue before and after treatment were detected by Western blotting. The healing of colonic mucosal edema and ulcer was observed by endoscope. The counts of neutrophilic granulocytes in the diffuse inflammatory infiltration of lamina propria of colonic mucosa, colonic mucosal surface ulcer, and crypt epithelium were observed microscopically before and after treatment.n Results:After 28 days of treatment, the clinical effective rate in the observation group (80.8%) was significantly higher than that in the control group (60.9%) (n P<0.05). Compared with those before treatment, the Mayo scores after treatment were significantly lower in both groups (n P<0.05). The Mayo score in the observation group was lower than that in the control group (n P<0.05). After treatment, the colonic mucosal edema and ulcer were improved, and the conditions of the observation group were better than those of the control group. Pathological observations showed that the patients in the two groups, before treatment, had diffuse inflammatory infiltration of the lamina propria of the colonic mucosa, irregular glands, destruction of the crypt epithelium, abscess, and surface ulcer. After treatment, the counts of neutrophilic granulocytes in the lamina propria and the crypt epithelium were significantly reduced, and the diffuse inflammatory infiltration turned into focal infiltration. The serum levels of TNF-α and IL-17 in both groups were significantly lower than those before treatment (n P0.05). The expressions of PTGS2 and Yap1 in colon tissues of the two groups were significantly down-regulated compared with those before treatment, and the expressions of anti-apoptotic proteins Bcl-2 and PYap1 were up-regulated(n P0.05).n Conclusion:Tongxie Yaofang formula combined with HBO in the treatment of UC with liver stagnation and spleen deficiency syndrome can achieve a better clinical remission rate than that of mesalazine sustained-release granule alone, and it more strengths in reducing the modified Mayo score, reducing the level of inflammatory factors, and effectively promoting mucosal ulcer healing.