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[目的]:观察解毒化瘀汤对湿热蕴结证活动期溃疡性结肠炎(UC)临床疗效。[方法]选取符合诊断和纳入标准的UC患者70例,按照随机数字表法分为对照组和治疗组。其中对照组35例,给予美沙拉嗪肠溶片口服;治疗组35例,在对照组的基础上给予解毒化瘀汤口服。2组疗程均为12周,分别观察2组患者临床疗效,ELISA法检测血浆COX-2、PGE_2、MMP-1水平,流式细胞术检测外周血T淋巴细胞亚群CD8~+CD28~+和CD8~+CD28~-含量。[结果]治疗组总有效率为93.3%,对照组为80.6%;治疗组COX-2、PGE2、MMP-1较本组治疗前明显降低(P<0.01);治疗后COX-2、MMP-1组间比较,差异有统计学意义(P<0.05),PGE_2组间比较,差异有统计学意义(P<0.01);治疗组CD8~+CD28~+、CD8~+CD28~-及CD8~+CD28~+/CD8~+CD28~-与本组治疗前比较,差异有统计学意义(P<0.01);治疗后CD8~+CD28~+、CD8~+CD28~+/CD8~+CD28~-组间比较,差异有统计学意义(P<0.01),CD8~+CD28~-组间比较,差异有统计学意义(P<0.05)。[结论]解毒化瘀汤能够明显改善湿热蕴结型活动期UC患者临床症状,降低COX-2、PGE_2、MMP-1水平,调控CD8~+CD28~+/CD8~+CD28~-平衡,减少复发率,疗效显著。
[Objective] To observe the clinical efficacy of Jiedu Huayu decoction on damp-heat accumulating syndrome active ulcerative colitis (UC). [Methods] Seventy patients with UC who met the criteria of diagnosis and inclusion were divided into control group and treatment group according to random number table. 35 cases in the control group were given mesalazine enteric-coated tablets orally; 35 cases in the treatment group were given oral administration of Jiedu Huayu decoction on the basis of the control group. The two groups were treated for 12 weeks. The clinical efficacy of two groups were observed. The levels of plasma COX-2, PGE_2 and MMP-1 were detected by ELISA. The levels of CD8 + CD28 + and T lymphocyte subsets in peripheral blood were detected by flow cytometry CD8 ~ + CD28 ~ - content. [Results] The total effective rate was 93.3% in the treatment group and 80.6% in the control group. The COX-2, PGE2 and MMP-1 in the treatment group were significantly lower than those before treatment (P <0.01) (P <0.05). There was significant difference between PGE_2 groups (P <0.01). The levels of CD8 ~ + CD28 ~ +, CD8 ~ + CD28 ~ - and CD8 ~ + CD28 ~ + / CD8 ~ + CD28 ~ - compared with before treatment in this group, the difference was statistically significant (P <0.01); after treatment CD8 ~ + CD28 ~ +, CD8 ~ + CD28 ~ + / CD8 ~ The difference between the two groups was statistically significant (P <0.01). There was significant difference between CD8 ~ + CD28 ~ - group (P <0.05). [Conclusion] Jiedu Huayu Decoction can significantly improve the clinical symptoms, reduce the levels of COX-2, PGE 2 and MMP-1 in UC patients with impaired damp-heat accumulation and regulate the balance of CD8 ~ + CD28 ~ + / CD8 ~ + CD28 ~ The recurrence rate, the curative effect is remarkable.