目的 探讨健脾止泻宁颗粒联合美沙拉嗪肠溶片治疗溃疡性结肠炎的临床疗效。方法 选取2019年1月—2020年5月天津市泰达医院收治的115例溃疡性结肠炎患者为研究对象，根据随机数字表法将所有患者分为对照组（57例）和治疗组（58例）。对照组口服美沙拉嗪肠溶片，0.5 g/次，3次/d。治疗组患者在对照组治疗的基础上温水冲服健脾止泻宁颗粒，20 g/次，4次/d。两组患者连续治疗2个月。观察两组的临床疗效，比较两组临床症状消失时间、改良Mayo评分和血清炎症因子水平。结果 治疗后，治疗组患者的总有效率为94.83%，对照组的总有效率为82.46%，组间比较差异有统计学意义（P<0.05）。治疗后，治疗组腹痛、腹泻、脓血便消失时间均短于对照组，差异有统计学意义（P<0.05）。治疗后，两组的便血、内镜结果、排便次数、总体评价评分显著降低，差异有统计学意义（P<0.05）；治疗后，治疗组的便血、内镜结果、排便次数、总体评价评分低于对照组，差异有统计学意义（P<0.05）。治疗后，两组的C反应蛋白（CRP）、白细胞介素-17（IL-17）、白细胞介素-23（IL-23）、单核细胞趋化蛋白-1（MCP-1）水平显著降低（P<0.05），以治疗组CRP、IL-17、IL-23、MCP-1水平降低的更明显（P<0.05）。结论 健脾止泻宁颗粒联合美沙拉嗪肠溶片可提高溃疡性结肠炎的疗效，减轻病情发展，降低炎症因子的水平，安全性良好。

Objective To investigate the clinical efficacy of Jianpi Zhixiening Granules combined with Mesalazine Enteric Coated Tablets in treatment of ulcerative enteritis.Methods Patients (115 cases) with ulcerative enteritis in Tianjin TEDA Hospital from January 2019 to May 2020 were randomly divided into the control group (57 cases) and the treatment group (42 cases). Patients in the control group were po administered with Mesalazine Enteric Coated Tablets, 0.5 g/time, three times daily. Patients in the treatment group were po administered with Jianpi Zhixiening Granules on the basis of the control group, 20 g/time, four times daily. Patients in two groups were treated for 2 months. After treatment, the clinical efficacies were evaluated, and clinical symptoms disappeared time, modified Mayo score, and serum inflammatory factor levels in two groups were compared.Results After treatment, the total effective rate of the treatment group was 94.83%, and that of the control group was 82.46%, and the difference was statistically significant between two groups (P<0.05). After treatment, the disappearance times of abdominal pain, diarrhea, and purulent bloody stool in the treatment group were shorter than those in the control group, and the difference was statistically significant (P<0.05). After treatment, the scores of bleeding, endoscopic results, frequency of defecation, and overall evaluation in two groups were significantly decreased, and the difference was statistically significant (P<0.05). After treatment, the scores of bleeding, endoscopic results, frequency of defecation and overall evaluation in the treatment group were lower than that of the control group, and the difference was statistically significant (P<0.05). After treatment, the levels of CRP, IL-17, IL-23, and MCP-1 in two groups were significantly decreased (P<0.05), and the levels of CRP, IL-17, IL-23, and MCP-1 in the treatment group were significantly lower than those in the control group, and the difference was statistically significant (P<0.05).Conclusion Jianpi Zhixiening Granules combined with Mesalazine Enteric Coated Tablets can improve the curative effect of ulcerative colitis, reduce the development of the disease, reduce the level of inflammatory factors, with good safety.

R975

天津市滨海新区卫生局科技项目（2014BWKY013）