自拟清热化湿凉血化瘀汤治疗急性期溃疡性结肠炎的疗效及外周血TLR4、NF-κB表达变化研究  

Study on the therapeutic effect of self-prepared Qingre Huashui Liangxue Huayu Decoction on acute ulcerative colitis and the expression changes of TLR4 and NF-κB in peripheral blood

作　　者：羌艳 吉哲 张明敏 QIANG Yan;JI Zhe;ZHANG Mingmin(Department of Proctology,Haian Hospital of Traditional Chinese Medicine,Haian 226600,China)

机构地区：[1]海安市中医院肛肠科,江苏海安226600

出　　处：《生命科学仪器》2023年第4期46-49,共4页Life Science Instruments

基　　金：江苏省南通市卫生和计划生育委员会科研课题(QB2019015)

摘　　要：目的探究自拟清热化湿凉血化瘀汤治疗急性期溃疡性结肠炎(UC)疗效及外周血Toll样受体4(TLR4)、核因子-κB(NF-κB)表达变化。方法选取2020年4月至2022年4月海安市中医院肛肠科就诊的68例急性期UC(大肠湿热证)患者,经随机数字表均分为对照组(n=34)、研究组(n=34),对照组口服美沙拉嗪,观察组予以美沙拉嗪+自拟清热化湿凉血化瘀汤治疗,治疗4周后,比较两组中医症状分级量化评分、改良Mayo评分、肠黏膜Baron评分、临床疗效,检测外周血TLR4 mRNA、NF-κB mRNA表达。结果与治疗前相比,治疗4周后两组腹泻、腹痛、脓血便、里急后重、腹胀、肛门灼热量化评分,改良Mayo评分、Baron评分,外周血TLR4 mRNA、NF-κB mRNA表达量均降低(P<0.05);治疗4周后研究组腹泻、腹痛、脓血便、里急后重、腹胀、肛门灼热量化评分,改良Mayo评分、Baron评分,TLR4 mRNA、NF-κB mRNA表达量低于对照组(P<0.05)。治疗4周后,两组临床总有效率比较,差异无统计学意义(P>0.05),研究组愈显率高于对照组(P<0.05)。结论自拟清热化湿凉血化瘀汤用于急性期UC治疗,对缓解症状、减轻疾病活动度、提高临床疗效有积极意义,其作用机制可能与下调外周血TLR4、NF-κB表达有关。Objective:To explore the therapeutic effect of self-prepared Qingre Huashu Liangxue Huayu Decoction on acute ulcerative colitis(UC)and the expression changes of toll-like receptor 4(TLR4)and nuclear factor-κB(NF-κB)in peripheral blood.Methods:A total of 68 patients with acute stage UC(large intestine damp-heat syndrome)who were treated in the anorectal Department of Haian Hospital of Traditional Chinese Medicine from April 2020 to April 2022 were selected and divided into control group(n=34)and study group(n=34)by random number table.The control group was given mesalazine orally,and the observation group was treated with mesalazine+self-prepared heat-clearing damp-cooling blood-removing stasis decoction.The quantitative score of TCM symptom classification,modified Mayo score,Baron score of intestinal mucosa and clinical efficacy of the two groups were compared,and TLR4 mRNA and NF-κB mRNA expression in peripheral blood were detected.Results:Compared with before treatment,after 4 weeks of treatment,the quantitative scores of diarrhea,abdominal pain,abscess,blood stool,posterior tenesia,abdominal distension,anal burning,modified Mayo score,Baron score,peripheral blood TLR4 mRNA,NF-κB mRNA expression were decreased in both groups(P<0.05).After 4 weeks of treatment,the quantitative scores of diarrhea,abdominal pain,abscess,blood stool,posterior tenesia,abdominal distension,anal burning,modified Mayo score and Baron score were lower in the study group than in the control group(P<0.05).After 4 weeks of treatment,there was no significant difference in the total clinical effective rate between the two groups(P>0.05),and the cure rate of the study group was higher than that of the control group(P<0.05).Conclusion:Self-prepared Qingre Huasheng Liangxue Huayu Decoction has positive significance in relieving symptoms,reducing disease activity and improving clinical efficacy in acute UC.The mechanism of action may be related to down-regulating TLR4 and NF-κB expression in peripheral blood.

关 键 词：溃疡性结肠炎 急性期 大肠湿热证 自拟清热化湿凉血化瘀汤 TOLL样受体4 核因子-ΚB 

分 类 号：R516.1[医药卫生—内科学]