金荞麦联合SASP治疗大肠湿热型UC的疗效及其对TLR4/NLRP3信号通路的影响  

Influence of Jinqiaomai Pill Combined with SASP on Treating UC with Dampness-Heat in Large Intestine and Its Effect on TLR4/NLRP3 Signal Pathway

作　　者：葛飞 刘丽娜[2] 严晶[2] 康安[2] 朱时林 田祖成 梅莉 代海峰 倪海军 GE Fei;LIU Li-na;YAN Jing;KANG An;ZHU Shi-lin;TIAN Zu-cheng;MEI Li;DAI Hai-feng;NI Hai-jun(Hai'an Hospital Affiliated to Nanjing University of Chinese Medicine Hanlin College,Nantong,226600,China;The First School of Clinical Medicine,Nanjing University of Chinese Medicine,Nanjing,210023,China)

机构地区：[1]南京中医药大学翰林学院海安附属医院,江苏南通226600 [2]南京中医药大学第一临床医学院,江苏南京210023

出　　处：《南京中医药大学学报》2021年第1期16-20,共5页Journal of Nanjing University of Traditional Chinese Medicine

基　　金：国家自然科学基金(81603578,81503536,81673795,81903974);江苏省自然科学基金(BK20181235);江苏省中医药局科技项目(YB2017066);全国中医药创新骨干人才项目;南通市“226高层次人才培养工程”项目。

摘　　要：目的观察金荞麦片联合柳氮磺吡啶(SASP)治疗溃疡性结肠炎(UC)的临床疗效,探讨其对Toll样受体4(TLR4)和核苷酸结合寡聚化结构域样受体3(NLRP3)信号通路相关蛋白的影响。方法门诊收集UC患者72例(大肠湿热型),随机分为治疗组和对照组,各36例。对照组给予SASP治疗,治疗组给予金荞麦片联合SASP治疗,观察2组治疗前后中医证候评分及改良Mayo评分、黏膜愈合率、血清促炎性细胞因子、结肠黏膜炎症相关信号蛋白变化及不良反应。结果治疗后2组除小便短赤外,中医证候评分均有所下降,而治疗组腹泻、腹痛、里急后重等中医症状评分较对照组降低更显著(P<0.05);2组改良Mayo评分均显著降低(P<0.05),2组的降低程度相当。治疗组黏膜愈合率66.67%,显著高于对照组(P<0.05)。2组血清白细胞介素1β(IL-1β)和肿瘤坏死因子α(TNF-α)等细胞因子水平均明显下降(P<0.05),且以治疗组下降更为显著(P<0.05)。治疗组的结肠病理结果及TLR4、NLRP3表达均有一定程度的下调(P<0.05)。2组不良反应发生率未见显著差异。结论金荞麦片联合SASP对UC的疗效优于单用SASP,其机制可能是通过TLR4/NLRP3信号通路干预UC发挥了抗炎及免疫调节作用。OBJECTIVE To observe the clinical efficacy of the Jinqiaomai pill combined with salazosulfapyridine(SASP)treating ulcerative colitis(UC),and to explore its effects on Toll-like receptor 4(TLR4)and nucleotide oligomerization structural domain-like receptor protein 3(NLRP3)signal pathway-related proteins.METHODS 72 outpatients with UC of dampness-heat in large intestine were enrolled and divided into the treatment group and control group,36 cases in each group.The control group was given SASP orally,and the treatment group was given the Jinqiaomai pill combined with SASP.Traditional Chinese medicine(TCM)syndrome scores,improved Mayo scores,mucosal healing rates,serum inflammatory cytokines,changes of colon mucosal inflammation-related proteins,and the adverse reactions in both groups were observed.RESULTS After treatment,except for scanty dark urine,the TCM syndrome scores in both groups were lower than those before treatment,and among which the scores of diarrhea,abdominal pain,tenesmus and others were significantly decreased(P<0.05).The improved Mayo scores of the two groups were significantly decreased(P<0.05),with equivalent reduction in both groups.The mucosal healing rate of the treatment group was 66.67%,obviously higher than the control group(P<0.05).The levels of serum interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)also dramatically declined(P<0.05),especially in the treatment group(P<0.05).The colon pathology,levels of TLR4,and NLRP3 of the treatment group were obviously declined(P<0.05).The adverse effect rates between the two groups showed no significant difference.CONCLUSION As for treating UC,Jinqiaomai pill combined with SASP has better effect than SASP alone.The mechanism may be through the intervention of the TLR4/NLRP3 signal pathway,functioning as anti-inflammatory and immune adjustment.

关 键 词：溃疡性结肠炎 金荞麦 柳氮磺吡啶 TLR4/NLRP3 

分 类 号：R256.3[医药卫生—中医内科学]