清化止泻方治疗脾胃湿热型腹泻型肠易激综合征的疗效及对患者血清炎症因子和TLR4/MyD88/NF-κB信号通路相关蛋白的影响  

Clinical effect of Qinghua Zhixie Decoction on diarrhoea-predominant irritable bowel of spleen-stomach damp-heat syndrome and its effect on TCM syndromes,anxiety and depression,serum inflammatory factors,and protein expression related TLR4/MyD88/NF-κB signaling pathway

作　　者：赵平[1] 严晶[2] 季利江[1] ZHAO Ping;YAN Jing;JI Lijiang(Anorectal Center of Changshu Traditional Chinese Medicine Hospital,Jiangsu,Changshu 215500;不详)

机构地区：[1]江苏省常熟市中医院肛肠中心,江苏常熟215500 [2]南京中医药大学第一临床医学院实验室,江苏南京210023

出　　处：《河北中医》2021年第3期375-379,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(编号:81503536);江苏省常熟市科学技术局科技发展计划项目(编号:CS202030)。

摘　　要：目的观察清化止泻方治疗脾胃湿热型腹泻型肠易激综合征(IBS-D)的临床疗效及对患者血清炎症因子和Toll样受体4(TLR4)/髓样分化因子88(MyD88)/核转录因子κB(NF-κB)信号通路相关蛋白的影响。方法将120例脾胃湿热型IBS-D患者按照随机数字表法分为2组,对照组60例予匹维溴铵片治疗,治疗组60例在对照组治疗基础上加用清化止泻方治疗。2组均治疗4周。比较2组疗效;比较2组治疗前后中医证候评分变化;比较2组治疗前后焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分变化;比较2组治疗前后血清白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平变化,以及TLR4/MyD88/NF-κB信号通路相关蛋白TLR4、MyD88、NF-κB p65表达变化。结果治疗组总有效率93.3%(56/60),对照组总有效率80.0%(48/60),治疗组疗效优于对照组(P<0.05)。2组治疗后中医证候各项评分及总评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后SAS评分、SDS评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后血清IL-1β、IL-6及TNF-α水平均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后TLR4、MyD88、NF-κB p65表达水平均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。结论清化止泻方可能通过调控血清TLR4、MyD88、NF-κB p65表达,降低血清IL-1β、IL-6、TNF-α水平来改善脾胃湿热型IBS-D患者临床症状,缓解焦虑、抑郁状态。Objective To observe clinical effect of Qinghua Zhixie Decoction on diarrhoea-predominant irritable bowel syndrome(IBS-D)of spleen-stomach damp-heat syndrome and its effect on TCM syndromes,anxiety and depression,serum inflammatory factors,and protein expression related TLR4/MyD88/NF-κB signaling pathway.Methods Totally 120 patients with IBS-D of spleen-stomach damp-heat syndrome were randomly divided into the two groups,60 cases in each group.The control group was treated with pinaverium bromide tablets,and the treatment group was additionally treated with Qinghua Zhixie Formula on the basis of the control group.Treating for 4 weeks in the both groups.TCM syndrome scores,self-rating anxiety scale(SAS)scores,self-rating depression scale(SDS)scores,inflammatory cytokines levels including serum interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),as well as protein expression of TLR4,MyD88,NF-κB p65 related to the signaling pathway were compared between the two groups before and after treatment.Results Total effective rate in the treatment group was better than that in the control group[93.3%(56/60)vs 80.0%(48/60),(P<0.05),respectively].After treatment,TCM syndromes scores,SAS scores,SDS scores,inflammatory cytokines including serum IL-1β,IL-6 and TNF-α and TLR4,MyD88,NF-κB p65 expression level in the two groups were lower than those before treatment in this group(all P<0.05),and which in the treatment group significantly decreased than the control group(P<0.05).Conclusion For patients with IBS-D of spleen-stomach damp-heat syndrome,Qinghua Zhixie Decoction may improve clinical symptoms,relieve anxiety and depression by regulating expression of serum TLR4,MyD88,NF-κB p65 and reducing serum IL-1β,IL-6 and TNF-αlevels.

关 键 词：结肠疾病 功能性 中药疗法 白细胞介素 Toll样受体4 

分 类 号：R574.62[医药卫生—消化系统] R289.56[医药卫生—内科学]