The efficacy and mechanism of "Warm-qing common usage" in the treatment of ulcerative colitis
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摘要: 目的 研究“温清共用法”中的温阳药与清热药治疗溃疡性结肠炎的作用机制及临床疗效，为进一步研究“温清共用法”治疗溃疡性结肠炎奠定基础。方法 通过对106例就诊的溃疡性结肠炎患者应用调查问卷进行回顾性分析，对Mayo评分、有效率、黏膜缓解率及美沙拉嗪、激素减药停药情况进行分析。分别对温阳药、清热药、美沙拉嗪进行相关参数分析，分析其在治疗溃疡性结肠炎中的作用机制。结果 经统计，最终有效问卷共99份，“温清共用法”临床有效率为82.8%，临床缓解率为74.7%，具有较好的临床疗效，其主要药物核心成分为山奈酚、槲皮素等，核心靶点有PTGS1、PTGS2、NCOA2等。结论 “温清共用法”治疗溃疡性结肠炎具有较好的临床疗效，患者可在较短时间内停用美沙拉嗪，分析其作用机制可能与“温清共用法”复杂而广泛的药物成分有关，较明确地解释了药物作用靶点及通路的复杂性，为下一步的研究提供了基础。Abstract: Objective Based on questionnaire investigation and the network pharmacology method, the pharmacological mechanism of the treatment of ulcerative colitis by "Warm-qing common usage" was analyzed to guide the further study of the clinical application of this prescription.Methods A questionnaire investigation was conducted on the efficacy of 106 ulcerative colitis patients treated in our department through a questionnaire survey, and the Mayo score was evaluated before and after treatment. The relevant parameters of "Warm Yang medicine", "heat-clearing medicine" and mesalazine were analyzed, respectively, and analyzed the mechanism of drugs in the treatment of ulcerative colitis.Results The "Warm-qing common usage" has a good clinical effect, the clinical effect rate was 82.8%, and the clinical remission rate was 74.7%. The main drug core components of the method of "Warm-qing common usage" were quercetin, luteolin, kaemonol, etc. The core targets were PTGS1, PTGS2, NCOA2, etc.Conclusion This study initially revealed the complicated drug components of the treatment of ulcerative colitis by "Warm-qing common usage" and explained the complexity of drug action targets and pathways, which provided the bioinformatics basis for further research.
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Key words:
- Warm-qing common usage /
- ulcerative colitis /
- questionnaire investigation
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表 1 Mayo评分
排便次数 便血 内镜发现 评分/分 次数正常 未见出血 正常或无活动性病变 0 比正常排便次数增加1~2次/d 不到一半时间内出现便中混血 轻度病变(红斑、血管纹理减少、轻度易脆) 1 比正常排便次数增加3~4次/d 大部分时间内为便中混血 中度病变(明显红斑、血管纹理减少、易脆、糜烂) 2 比正常排便次数增加5次/d或以上 一直存在出血 重度病变(自发性出血、溃疡形成) 3 
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表 2 疗效评价指标及计分方法
评价指标 计分方法 临床有效率 总Mayo评分从基线水平降低≥30%和≥3分，同时伴有便血亚评分降低≥1分或便血亚评分的绝对分为0分或1分 临床缓解率 总Mayo评分≤2分且无单个分项评分>1分 内镜应答率 Mayo评分系统内镜亚评分相对于基线降低至少1分 黏膜愈合率 Mayo评分系统内镜亚评分的绝对分为0分或1分
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