【目的】 探究祛瘀生新方（由黄芪、太子参、白术、生地黄、鸡眼草、地锦草、桃仁、川芎等组成）对溃疡性结肠炎 （UC）患者肠道菌群多样性、肠黏膜屏障指标及中医证候积分的影响。【方法】 选取2022年11月至2024年10月在上海中医药 大学附属第七人民医院就诊的脾胃气虚型UC患者100例，按照随机数字表法将患者随机分为常规组和祛瘀生新组，每组各 50例。常规组给予美沙拉嗪肠溶片联合双歧杆菌乳杆菌三联活菌片的西医常规治疗，祛瘀生新组在常规组的基础上联合祛 瘀生新方治疗。2组均以1个月为1个疗程，连续治疗3个疗程。观察2组患者治疗前后肠道菌群多样性、肠黏膜屏障指标、 中医证候积分的变化情况，并评价2组患者的临床疗效。【结果】（1）临床疗效方面，治疗3个月后，祛瘀生新组的总有效率 为 96.00%（48/50），常规组为 82.00%（41/50），组间比较（χ2检验），祛瘀生新组的疗效明显优于常规组（P＜0.05）。（2）肠道菌 群多样性方面，治疗后，2组患者的双歧杆菌、乳酸杆菌均较治疗前明显增多（P＜0.01），肠球菌、肠杆菌均较治疗前明显 减少（P＜0.01），且祛瘀生新组对双歧杆菌、乳酸杆菌的增多程度及对肠球菌、肠杆菌的减少程度均明显优于常规组（P＜ 0.05）。（3）肠黏膜屏障指标方面，治疗后，2 组患者的血清二胺氧化酶（DAO）、D-乳酸、内毒素（ET）水平均较治疗前下降 （P＜0.01），且祛瘀生新组的下降幅度均明显优于常规组（P＜0.05）。（4）中医证候积分方面，治疗后，2组患者的腹痛、腹泻、 黏液血便、食少纳差等中医证候积分均较治疗前明显下降（P＜0.01），且祛瘀生新组的下降幅度均明显优于常规组（P＜ 0.05）。【结论】 祛瘀生新方在脾胃气虚型UC患者的治疗中临床疗效突出，能明显缓解黏液血便、腹痛等症状，显著降低中 医证候积分；能显著提升患者肠道菌群多样性，促进双歧杆菌、乳酸杆菌等益生菌增殖，抑制致病菌生长，优化肠道微生 态环境，修复受损肠黏膜屏障，增强肠道防御功能。研究结果体现了祛瘀生新方在调节UC患者的肠道菌群、修复肠黏膜及 改善临床症状方面的综合优势。

Objective To investigate the effects of Quyu Shengxin Formula （composed of Astragali Radix， Pseudostellariae Radix， Atractylodis Macrocephalae Rhizoma， Rehmanniae Radix， Kummerowiae Herba， Euphorbiae Humifusae Herba， Persicae Semen， and Chuanxiong Rhizoma） on gut microbiota diversity， intestinal mucosal barrier indicators，and traditional Chinese medicine （TCM） syndrome scores in patients with ulcerative colitis （UC）. Methods A total of 100 UC patients with spleen-stomach qi deficiency syndrome treated at the Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine between November 2022 and October 2024 were randomized into two groups using a random number table method：the conventional group （n=50） and the Quyu Shengxin group （n=50）. The conventional group received standard western medicine treatment with Mesalazine Enteric-Coated Tablets combined with Bifidobacterium and Lactobacillus triple viable tablets. The Quyu Shengxin group received Quyu Shengxin Formula in addition to the conventional treatment. Both groups were treated for three treatment courses，with one month as a course. Changes in gut microbiota diversity， intestinal mucosal barrier indicators，and TCM syndrome scores were observed before and after treatment，and clinical efficacy was evaluated. Results （1） Regarding clinical efficacy，after three months of treatment，the total effective rate was 96.00% （48/50） in the Quyu Shengxin group and 82.00% （41/50） in the conventional group. The intergroup comparison （by chi-square test） showed that the Quyu Shengxin group demonstrated significantly superior efficacy compared to the conventional group （P＜0.05）.（2） In terms of gut microbiota diversity，after treatment，both groups showed significant increases in Bifidobacterium and Lactobacillus（P＜0.01） and significant decreases in Enterococcus and Enterobacter compared to pre-treatment level （P＜0.01）. The Quyu Shengxin group exhibited significantly greater increases in Bifidobacterium and Lactobacillus and greater reductions in Enterococcus and Enterobacter than the conventional group （P＜0.05）.（3） For intestinal mucosal barrier indicators， after treatment， both groups showed significant decreases in serum diamine oxidase （DAO）， D-lactic acid， and endotoxin （ET） levels （P＜0.01），with the Quyu Shengxin group demonstrating significantly greater reductions than the conventional group （P＜0.05）.（4） Regarding TCM syndrome scores， after treatment， both groups exhibited significant reductions in scores for abdominal pain，diarrhea，mucoid bloody stool，and poor appetite （P＜0.01），with the Quyu Shengxin group showing significantly greater reductions than the conventional group （P＜0.05）. Conclusion Quyu Shengxin Formula demonstrates remarkable clinical efficacy in treating UC patients with spleen-stomach qi deficiency syndrome. It significantly alleviates symptoms such as mucoid bloody stool and abdominal pain，reduces TCM syndrome scores，enhances gut microbiota diversity，promotes the proliferation of probiotics including Bifidobacterium and Lactobacillus，inhibits the growth of pathogenic bacteria，optimizes the intestinal microecological environment，repairs the damaged intestinal mucosal barrier，and strengthens intestinal defense function. These findings highlight the comprehensive advantages of Quyu Shengxin Formula in regulating gut microbiota，repairing the intestinal mucosa，and improving clinical symptoms of the UC patients.

R259.746

国家自然科学基金资助项目（编号：82274531）；中央财政支持中医药传承创新发展示范试点项目（编号：YC-2023-0122）