目的 探究五味苦參腸溶膠囊聯(lián)合英夫利西單抗治療中重度潰瘍性結(jié)腸炎（UC）的療效。方法 選自2022年6月—2024年6月湖南中醫(yī)藥大學(xué)第二附屬醫(yī)院收治的中重度UC患者90例，依據(jù)組間匹配原則分為對(duì)照組和治療組，每組各45例。對(duì)照組給予注射用英夫利西單抗，分別于0、2、6、8周注射1次，劑量為3～5 mg/kg。治療組在對(duì)照組基礎(chǔ)上口服五味苦參腸溶膠囊，1.6 g/次，3次/d。兩組患者均治療8周。觀察兩組患者臨床療效，比較治療前后兩組患者超敏C反應(yīng)蛋白（hs-CRP）、腫瘤壞死因子-α（TNF-α）、血管細(xì)胞黏附分子-1（VCAM-1）、白細(xì)胞介素-10（IL-10）、CD3⁺、CD4⁺、CD8⁺、二胺氧化酶（DAO）、內(nèi)毒素（ET）和D-乳酸水平（D-LA）水平，及Mayo評(píng)分。結(jié)果 治療后，治療組總有效率明顯高于對(duì)照組（95.56% vs 75.56%，P＜0.05）。治療后，兩組hs-CRP、TNF-α、VCAM-1、CD8⁺、DAO、ET和D-LA水平明顯下降，而IL-10、CD3⁺和CD4⁺水平明顯升高（P＜0.05），且治療后治療組炎癥因子水平、免疫功能和腸道屏障功能均好于對(duì)照組（P＜0.05）。治療后，兩組患者M(jìn)ayo評(píng)分比治療前明顯下降（P＜0.05），且治療后治療組Mayo評(píng)分下降幅度均大于對(duì)照組（P＜0.05）。結(jié)論 UC患者在常規(guī)干預(yù)基礎(chǔ)上聯(lián)合五味苦參腸溶膠囊與英夫利西單抗治療，可顯著提高治療效果、改善機(jī)體炎癥與免疫功能，增強(qiáng)腸道屏障，促進(jìn)臨床癥狀恢復(fù)。

Objective To explore the curative effect of Wuwei Kushen Enteric-Coated Capsules combined with infliximab in treatment of moderate and severe ulcerative colitis. Methods Patients (90 cases) with moderate and severe ulcerative colitis in the Second Affiliated Hospital of Hunan University of Traditional Chinese Medicine from June 2022 to June 2024 were divided into control and treatment group based on the principle of inter-group matching, and each group had 45 cases. Patients in the control group were administered with Infliximab for injection, which were injected once at weeks 0, 2, 6 and 8 with a dose of 3 — 5 mg/kg. Patients in the treatment group were po administered with Wuwei Kushen Enteric-Coated Capsules on the basis of the control group, 1.6 g/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical evaluations were evaluated, and the levels of hs-CRP, TNF-α, VCAM-1, IL-10, CD3⁺, CD4⁺, CD8⁺, DAO, ET and D-LA, and Mayo scores in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was significantly higher than that in the control group (95.56% vs 75.56%, P < 0.05). After treatment, the expression levels of hs-CRP, TNF-α, VCAM-1, CD8⁺, DAO, ET and D-LA were significantly decreased in two groups, while the levels of IL-10, CD3⁺ and CD4⁺ were significantly increased (P < 0.05). After treatment, the levels of inflammatory factors, immune function and intestinal barrier function in the treatment group were better than those in the control group (P < 0.05). After treatment, the Mayo scores in two groups were significantly decreased compared with those before treatment (P < 0.05), and the decrease in the treatment group was more significant than that in the control group (P < 0.05). Conclusion On the basis of routine intervention, the combination of Wuwei Kushen Enteric-Coated Capsules and infliximab can significantly improve the therapeutic effect, improve the inflammation and immune function, strengthen the intestinal barrier, and promote the recovery of clinical symptoms.

R975

湖南省中醫(yī)藥管理局科學(xué)基金資助項(xiàng)目（B2023095）；湖南省中醫(yī)藥管理局科學(xué)基金資助項(xiàng)目（C2024017）