刘毅 胡娇娇 潘杰 张善超 张卓

摘要 目的：探讨升阳除湿汤加减对慢性肠炎疗效及可能机制。方法：选取2016年7月至2018年12月湖北医药学院附属随州医院收治的慢性肠炎患者136例作为研究对象，按照随机数字表法随机分为对照组和观察组，每组68例，对照组给予美沙拉嗪治疗，观察组采用美沙拉嗪+升阳除湿汤治疗。观察2组治疗前、治疗后氧化应激因子和肠道黏膜屏障、炎性反应因子、免疫功能、中医症状积分变化并比较，8周治疗后比较疗效。结果：观察组患者在提升SOD、IL-10、CD3+、CD4+、CD4+/CD8+水平，及下调MAD、DAO、D-乳酸、IL-6、IL-17、TNF-α、IgA、IgM、IgG、CD8+水平方面较对照组患者更具优势（P<0.05），且在改善患者腹痛腹胀、腹泻、里急后重、神疲乏力、恶心呕吐、食欲不振症状严重程度优势明显（P<0.05），观察组治愈率39/71%、总有效率91.18%，显著高于对照组治愈率22.06%、总有效率79.41%（P<0.05）。结论：升阳除湿汤加减能抑制慢性肠炎氧化应激和保护肠道黏膜屏障，抑制炎性反应，促进机体免疫功能恢复，从而改善肠炎临床症状，提高疗效。

关键词 升阳除湿汤;慢性肠炎;氧化应激;肠道黏膜屏障;炎性反应因子;T淋巴细胞亚群;免疫球蛋白;臨床症状

Study on the Therapeutic Effect and Possible Mechanisms of Shengyang Chushi Decoction on Chronic Enteritis

LIU Yi，HU Jiaojiao，PAN Jie，ZHANG Shanchao，ZHANG Zhuo

（Department of Traditional Chinese Medicine，Suizhou Hospital Affiliated to Hubei University of Medicine，Suzhou 441300，China）

Abstract Objective：To explore the possible mechanism of Shengyang Chushi Decoction on chronic enteritis.Methods：A total of 136 patients admitted to Suizhou Hospital Affiliated to Hubei University of Medicine with chronic enteritis were selected as the research objects and were divided into a control group （n=68） and an observation group （68 cases）.The control group was treated with mesalazine，and the observation group was treated with mesalazine+Shengyang Chushi Decoction.The changes of oxidative stress factor，intestinal mucosal barrier，inflammatory factor，immune function and TCM symptom score before and after treatment were observed and compared between the 2 groups.The efficacy was compared after the completion of 8 weeks of treatment.Results：The observation group had more advantages than mesalazine group in improving SOD，IL-10，CD3+，CD4+，CD4+/CD8+，and down regulating MAD，DAO，D-lactic acid，IL-6，IL-17，TNF-α，IgA，IgM，IgG，CD8+levels （P<0.05），and had obvious advantage in abdominal pain，abdominal distension，diarrhea，tenesmus，fatigue，nausea and vomiting，anorexia.The cure rate of Shengyang Chushi group was 39/71%，and the total effective rate was 91.18%，which was significantly higher than that of the control group （22.06% and 79.41%，P<0.05）.Conclusion：Modified Shengyang Chushi Decoction can inhibit the oxidative stress of chronic enteritis，protect intestinal mucosal barrier，inhibit inflammatory reaction，promote the recovery of immune function，so as to improve the clinical symptoms of enteritis and improve the curative effect.

Keywords Shengyang Chushi Decoction; Chronic enteritis; Oxidative stress; Intestinal mucosal barrier; Inflammatory factor; T Lymphocyte subgroup; Immunoglobulin; Clinical symptoms

中图分类号：R259文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.03.019

慢性肠炎主要有炎症性肠炎、放射性肠炎、慢性细菌性肠炎等，可由急性肠炎、急性菌痢迁延或反复发作而成，其病程均>2个月以上[1]。该疾病具有反复性、长期性，易造成营养不良、精神不振、四肢乏力、腹泻、便秘、贫血等，急性发作者会伴有发热、脱水、酸中毒、休克等表现，严重影响生命质量，危及生命。西医认为，细菌或病毒、寄生虫、长期心理应激、疲乏、营养不良、变态反应等均可诱发慢性肠炎。西医在治疗上以止泻、解痉、抗生素等治疗。而从中医角度看，该疾病属于“痢疾”“泄泻”范畴，病机不外乎感受外邪、饮食所伤、情志失调、病后体虚、禀赋不足等，为“本虚标实”证，其根本为“脾虚”，因脾胃为后天之本、气血生化之源，若饮……