目的 探討鹽酸小檗堿片聯(lián)合柳氮磺吡啶腸溶片治療潰瘍性結(jié)腸炎的臨床療效。方法 選取2019年2月-2020年2月在漯河市中醫(yī)院診治的潰瘍性結(jié)腸炎患者94例，根據(jù)就診順序分為對照組（47例）和治療組（47例）。對照組口服柳氮磺吡啶腸溶片，初始劑量為1 g/次，若無不適增至2 g/次，3次/d，待癥狀緩解后減至1 g/次，2次/d。治療組在對照組的基礎(chǔ)上口服鹽酸小檗堿片，0.3 g/次，3次/d。兩組患者經(jīng)3個(gè)月治療。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者臨床癥狀改善時(shí)間，DAI、ESCA、IBDQ和SF-36評分，血清白細(xì)胞介素-17（IL-17）、IL-23、低氧誘導(dǎo)因子-1α（HIF-1α）、環(huán)氧化酶-2（COX-2）、基質(zhì)金屬蛋白酶-1（MMP-1）和β-內(nèi)啡肽（β-EP）水平，及二胺氧化酶（DAO）和D乳酸（D-LA）水平。結(jié)果 治療后，對照組臨床有效率為80.85%，顯著低于治療組的97.87%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，治療組患者癥狀改善時(shí)間均明顯早于對照組（P<0.05）。治療后，兩組患者DAI評分均顯著降低（P<0.05），而ESCA評分、IBDQ評分和SF-36評分均顯著升高（P<0.05），且治療組這些評分項(xiàng)目明顯好于對照組（P<0.05）。治療后，兩組患者IL-17、IL-23、HIF-1α、COX-2、MMP-1、β-EP、DAO、D-LA水平均明顯降低（P<0.05），且治療組患者明顯低于對照組（P<0.05）。結(jié)論 鹽酸小檗堿片聯(lián)合柳氮磺吡啶腸溶片治療潰瘍性結(jié)腸炎可顯著改善臨床癥狀，降低炎癥反應(yīng)，促進(jìn)腸道黏膜屏障功能改善，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy of Berberine Hydrochloride Tablets combined with sulfasalazine in treatment of ulcerative colitis. Methods Patients (94 cases) with ulcerative colitis in Luohe Hospital of traditional Chinese medicine from February 2019 to February 2020 were divided into control (47 cases) and treatment (47 cases) groups bases on visiting sequence. Patients in the control group were po administered with Sulfasalazine Enteric-coated Tablets, the initial dose was 1 g/time, if there was no discomfort, the dose was increased to 2 g/time, three times daily, and reduced the dose to 1 g/time after symptom relief, twice daily. Patients in the treatment group were po administered with Berberine Hydrochloride Tablets on the basis of the control group, 0.3 g/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacy was evaluated, and the disappearance time of clinical symptoms, the scores of DAI, ESCA, IBDQ and SF-36, the serum levels of IL-17, IL-23, HIF-1α, COX-2, MMP-1 and β-EP, and the levels of DAO and D-LA in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 80.85%, which was significantly lower than 97.87% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the improvement time of clinical symptoms in the treatment group was significantly earlier than that in the control group (P<0.05). After treatment, the DAI scores in two groups were significantly decreased (P<0.05), but the ESCA, IBDQ and SF-36 scores were significantly increased (P<0.05), and these scores in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the levels of IL-17, IL-23, HIF-1α, COX-2, MMP-1, β-EP, DAO and D-LA in two groups were significantly decreased (P<0.05), and these indexes in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Berberine Hydrochloride Tablets combined with Sulfasalazine Enteric-coated Tablets in treatment of ulcerative colitis can significantly improve the clinical symptoms, reduce the inflammatory reaction, promote the improvement of intestinal mucosal barrier function, which has a certain clinical application value.

R975

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目（201503236）