八味锡类散灌肠对溃疡性结肠炎的治疗作用及其机制研究  

Therapeutic Effect and Mechanisms Study of Bawei Xilei Powder on Ulcerative Colitis Patients

作　　者：潘燕[1] 欧阳钦[2] 

机构地区：[1]四川省人民医院消化内科,成都610072 [2]四川大学华西医院消化内科,成都610041

出　　处：《中国中西医结合杂志》2014年第1期27-30,共4页Chinese Journal of Integrated Traditional and Western Medicine

摘　　要：目的探讨八味锡类散灌肠治疗溃疡性结肠炎(ulcerative colitis,UC)的疗效及机制。方法选择2009年6月—2010年10月在四川大学华西医院门诊就诊的活动期轻、中度左半结肠UC患者103例,随机分为治疗组(55例)和对照组(48例)。分别给予八味锡类散1 g(加入温开水60 mL)和氢化可的松灌肠液50 mg/60mL,每晚1次睡前灌肠,疗程4周。比较两组治疗前后疾病活动度(Mayo评分)、内镜和组织学评分,检测结肠组织中的Toll样受体4(toll-like receptor-4,TLR4)、核转录因子-κB(nuclear factor-κB,NF-κB)和紧密连接蛋白Occludin的表达。结果治疗组临床缓解率和有效率分别为78.2%(43/55)和89.1%(49/55),对照组分别为58.3%(28/48)和72.9%(35/48),两组比较差异有统计学意义(P<0.05)。治疗组内镜下结肠黏膜愈合度为50.9%(28/55),高于对照组31.3%(15/48),差异有统计学意义(P<0.05)。治疗组组织学缓解率和有效率分别为32.7%(18/55)和65.5%(36/55),对照组分别为27.1%(13/48)和58.3%(28/48),差异无统计学意义(P>0.05)。治疗组2例(3.8%)和对照组2例(4.3%)发生不良反应,差异无统计学意义(P>0.05)。治疗后结肠黏膜中TLR4、NF-κB较治疗前明显减少,差异有统计学意义(P<0.05),而Occludin表达较治疗前增加,差异有统计学意义(P<0.05)。结论八味锡类散灌肠治疗轻、中度活动性UC安全有效,其作用可能与调节炎性因子表达及增强结肠黏膜屏障功能有关。Objective To investigate the efficacy and mechanisms of Bawei Xilei Powder （BXP） in treating ulcerative colitis （UC）. Methods Totally 103 patients with left hemicolon mild to moderate UC in the active phase at the outpatient clinics of West China Hospital from June 2009 to October 2010 were randomly assigned to the treatment group （55 cases） and the control group （48 cases）. Patients in the treatment group were treated with BXP （adding 1 g in 60 mL worm boiled water） and those in the control group received by 50 mg/60 mL hydrocortisone edema solution （once every evening before sleep）. The therapeutic course for all was 4 weeks. The disease activity degree （Mayo scoring）, endoscopic, and histologic manifestations were compared between post-and pre-treatment in the two groups. The expression of toll-like receptor-4 （TLR4）, nuclear factor-KB （NF-KB）, and Occludin were detected. Results The clinical remission rate and the re- sponse rate in the treatment group were 78. 2% and 89. 1% respectively, higher than those of the control group （58. 3% and 72. 9%, P 〈0. 05）. The endoscopically mucosal healing rate was 50. 9% in the treatment group and 31.3% in the control group （P 〈0. 05）. The histological remission rate and the effective rate in the treatment group were 32.7% and 65. 5% respectively, but higher than those of the control group （27. 1% and 58. 3%, P 〉 0. 05）. The rate of adverse events was 3. 8% in the treatment （occurred in 2 cases） and 4.3% in the control group （occurred in 2 cases, P 〉0. 05）. Compared with pre-treatment, the expression of TLR4 and NF-κB p65 significantly decreased （P 〈0. 05）, while the expression of Occludin significantly increased （P 〈0. 05）. Conclu- sions BXP was effective and safe in patients with active mild to moderate UC. Its effects might be involved in regulating the expression of inflammatory factors and enhancing mucosa barrier functions.

关 键 词：溃疡性结肠炎 八味锡类散 灌肠治疗 

分 类 号：R285.5[医药卫生—中药学]