目的 探究苦参胶囊联合柳氮磺吡啶治疗溃疡性结肠炎的临床效果。方法 选取2019年6月—2021年2月渭南市中心医院收治的122例溃疡性结肠炎患者，根据随机数字表法分为对照组和治疗组，每组各61例。对照组口服柳氮磺吡啶肠溶片，1g/次，3次/d。治疗组在对照组基础上口服苦参胶囊，4～6粒/次，3次/d。两组患者治疗4周。观察两组患者临床疗效，比较治疗前后两组患者内镜评分和Sutherland疾病活动指数（DAI）评分，血清白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）、血沉（ESR）和白细胞介素-10（IL-10）水平，及血清低氧诱导因子-1α（HIF-1α）和Toll样受体4（TLR4）水平。结果 治疗后，治疗组总有效率（93.44%）明显高于对照组（80.33%，P<0.05）。治疗后，两组内镜评分和DAI评分均明显降低（P<0.05），且治疗后明显低于对照组（P<0.05）。治疗后，两组血清IL-6、TNF-α、CRP及ESR水平均明显下降，而IL-10水平明显升高（P<0.05），且治疗组血清水平明显好于对照组（P<0.05）。治疗后，两组血清HIF-1α、TLR4水平均明显下降（P<0.05），且治疗组明显低于对照组（P<0.05）。结论 苦参胶囊联合柳氮磺吡啶治疗溃疡性结肠炎患者效果显著，可调节血清HIF-1α、TLR4水平，改善症状，缓解机体炎症，且安全性高。

Objective To explore the clinical effect of Kushen Capsules combined with sulfasalazine in treatment of ulcerative colitis. Methods Patients (122 cases) with ulcerative colitis in Weinan Central Hospital from June 2019 to February 2021 were prospectively selected and divided into control and treatment group, and each group had 61 cases by the random number table method. Patients in the control group were po administered with Sulfasalazine Enteric-Coated Tablets, 1 g/time, three times daily. Patients in the treatment group were po administered with Kushen Capsules on the basis of the control group, 4 — 6 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluation was evaluated, the endoscopic and DAI scores, serum levels of IL-6, TNF-α, CRP, ESR, IL-10, HIF-1α, and TLR4 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group (93.44%) was significantly higher than that of the control group (80.33%, P < 0.05). After treatment, the endoscopic score and DAI score in two groups were significantly decreased (P < 0.05), and which in the treatment group were significantly lower than those of the control group (P < 0.05). After treatment, the serum levels of IL-6, TNF-α, CRP and ESR in two groups were significantly decreased, while the level of IL-10 were significantly increased (P < 0.05), and the serum level in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the levels of serum HIF-1α and TLR4 in two groups were significantly decreased (P < 0.05), and those in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusions Kushen Capsules combined with sulfasalazine has a significant effect in the treatment of ulcerative colitis, can adjust serum HIF-1α and TLR4 levels, promote symptom improvement, relieve inflammation, and has high safety.

R975

陕西省重点研发计划项目（2019SF-293）