健脾化瘀解毒复方对溃疡性结肠炎患者炎症因子及免疫屏障影响  

Effects of Jianpi Huayu Jiedu Prescription on Inflammatory Cytokines and Immune Barrier in Patients with Ulcerative Colitis

作　　者：陈亮[1] 景姗[1] 孙蓓[1] 徐逸[1] 顾庆华[1] 

机构地区：[1]南京中医药大学附属南通市中医院

出　　处：《辽宁中医药大学学报》2018年第2期98-101,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：南通市卫计委青年基金项目(WQ2016053);南通市科技计划项目(HS2013037);南通市科技局项目(MS22016064)

摘　　要：目的：观察健脾化瘀解毒复方的临床疗效,探讨其对炎症因子及免疫屏障的影响。方法：选取2014年1月—2016年9月医院诊治的60例慢性复发型活动期或慢性持续型轻中度的溃疡性结肠炎患者,随机分为对照组30例和观察组30例,对照组给予美沙拉嗪颗粒4 g/d,口服,观察组予以健脾化瘀解毒复方口服2次/d,连续治疗3个月,比较两组治疗前后血沉（ESR）、血清降钙素原（PCT）、疾病活动指数（DAI）及肠镜下黏膜病变的变化,酶联免疫法（ELISA）检测血清白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、白细胞介素-10（IL-10）及黏膜地址素细胞黏附分子（MAd CAM-1）的水平。结果：治疗前两组患者ESR、PCT、DAI、肠镜下黏膜病变及血清中IL-6、IL-8、IL-10、MAd CAM-1无统计学差异（P〉0.05）。与治疗前相比,两组治疗后ESR、PCT、DAI显著降低（P〈0.01）,血清中IL-6、IL-8、MAd CAM-1表达明显降低（P〈0.01,P〈0.05）,而血清中IL-10表达显著升高（P〈0.01）;与对照组相比,观察组ESR、DAI明显降低（P〈0.01,P〈0.05）,血清中IL-6显著降低、IL-10显著升高均具有统计学差异（P〈0.05）;且两组患者黏膜充血水肿、糜烂、溃疡均有显著好转（P〈0.01,P〈0.05）,健脾化瘀解毒复方在改善黏膜充血水肿、糜烂方面较美沙拉嗪具有更明显优势（P〈0.05）。结论：健脾化瘀解毒复方具有明显的修复肠道黏膜、减轻肠道炎症的作用,其机制可能与调节肠道黏膜屏障,提高肠道局部免疫能力有关;在调节IL-6、IL-10平衡方面其作用优于美沙拉嗪。Objectives To study the effect of inflammatory cytokines and immune barrier by using Jianpi Huayu Jiedu（JPHYJD）prescription on patients with ulcerative colitis（UC）based on the clinical efficacy.Methods：60 cases with mild-to-moderate ulcerative colitis which is chronic recurrent active type or chronic persistent type in gastroenterology department of our hospital from January 2014 to September 2016 were selected as the research objects,and randomly divided into controlled group（n=30）and observation group（n=30）,the controlled group was given mesalazine particles 4 g once a day,the treatment group was given JPHYJD prescription twice a day for consecutive three months.The serum levels of erythrocyte sedimentation rate（ESR）,procalcitonin（PCT）,disease activity index（DAI）of patients were detected and compared between the two groups,the intestinal mucosa lesions were observed by colonoscopy.ELISA was performed to detect the levels of interleukin-6（IL-6）,interleukin-8（IL-8）,interleukin-10（IL-10）and mucosal addressin cell adhesion molecule-1（MAd CAM-1）.Results：Compared with before treatment,ESR,PCT,DAI,IL-6,IL-8 and MAd CAM-1 significantly decreased（P0.01,P0.05）,the level of significantly Increased（P0.01）.Compared with controlled group,ESR,DAI and IL-6 significantly decreased（P0.01,P0.05）,the level of IL-10 was significantly higher（P0.05）.The hyperemia,edema,erosion and ulceration of intestinal mucosa significantly improved after therapy compared with before treatment（P0.01,P0.05）,JPHYJD prescription group was better than mesalazine group in prove of hyperemia,edema and erosion（P0.05）.Conclusion：JPHYJD prescription had significant effect of repairing intestinal mucosa and reducing the inflammation,the mechanism may be related to regulating the intestinal mucosal barrier and improving the intestinal local immune ability,JPHYJD prescription was better than mesalazine in regulating IL-6/IL-10 balance.

关 键 词：健脾化瘀解毒 溃疡性结肠炎 IL-6 IL-8 IL-10 MADCAM-1 

分 类 号：R574.62[医药卫生—消化系统]