目的 探讨复方黄柏液联合巴柳氮钠治疗溃疡性直肠炎的临床疗效。方法 选取2019年5月-2021年9月在郑州市第一人民医院肛肠外科治疗的溃疡性直肠炎患者70例,随机分为对照组和治疗组,每组各35例。对照组口服巴柳氮钠胶囊,5粒/次,3次/d。治疗组在对照组的基础上,外用复方黄柏液,100 mL药液加温开水100 mL,其药液温度38℃左右,将调好的药液用器具灌入直肠内,2次/d。两组均连续治疗15 d。观察两组的临床疗效及症状缓解情况,比较两组治疗前后的改良梅奥(Mayo)评分及白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)、白细胞介素-8(IL-8)血清水平和不良反应。结果 治疗后,治疗组的临床有效率明显高于对照组(97.14% vs 77.14%,P<0.05)。治疗后,治疗组患者贫血、腹泻、黏液脓血便、腹痛症状缓解时间均明显短于对照组(P<0.05)。治疗后,两组患者IL-6、IL-8、TNF-α、CRP水平明显下降(P<0.05),且治疗组治疗后的IL-6、IL-8、TNF-α、CRP水平均明显低于对照组(P<0.05)。治疗后,两组改良Mayo评分显著下降(P<0.05),且治疗组患者治疗后的改良Mayo评分明显低于对照组(P<0.05)。结论 复方黄柏液联合巴柳氮钠治疗溃疡性直肠炎效果确切,症状缓解明显,能有效降低机体炎症反应,且安全有效,值得临床推广借鉴。

Objective To investigate the clinical efficacy of Compound Huangbai Liquid combined with balsalazide disodium in treatment of ulcerative proctitis.Methods Patients (70 cases) with ulcerative proctitis in Zhengzhou First People’s Hospital from May 2019 to September 2021 were divided into control and treatment groups, and each group had 35 cases. Patients in the control group were po administered with Balsalazide Sodium Capsules, 5 grains/time, three times daily. Patients in the treatment group were external administered with Compound Huangbai Liquid on the basis of the control group, 100 mL added into warm water 100 mL. Its liquid temperature is about 38 ℃, and it is irrigated into the rectum by an instrument, twice daily. Patients in two groups were treated for 15 d. After treatment, the clinical evaluation and the improvement of clinical symptoms were evaluated, and the modified Mayo score, interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8) and adverse reactions in two groups before and after treatment were compared.Results After treatment, the clinical effective rates of the treatment group was better than that in the control group (97.14% vs 77.14%, P < 0.05). After treatment, the improvement time of diarrhea, abdominal pain, anemia, mucus, pus and blood in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the levels of IL-6, IL-8, TNF-α, and CRP in two groups were significantly decreased (P < 0.05), and the decrease was more obvious in the treatment group (P < 0.05). After treatment, the modified Mayo scores in two groups were significantly decreased (P < 0.05), and the decrease was more obvious in the treatment group (P < 0.05).Conclusion Compound Huangbai Liquid combined with balsalazide disodium in treatment of ulcerative proctitis has a definite therapeutic effect, with obvious symptom relief, can effectively reduce the body’s inflammatory response, is safe and effective, and is worthy of clinical promotion.

R975

河南省医学科技攻关计划项目(182102311146)