清肠汤联合美沙拉嗪治疗热盛血瘀型活动期溃疡性结肠炎患者的临床效果及其作用机制  

Clinical effect and mechanism of Qingchang Decoction combined with Mesalazine on ulcerative colitis patients with syndrome of blood stasis due to exuberant heat

作　　者：王晓瑜[1] 缪志伟[1] 张耀辉[1] 张春雨[1] 徐艳[1] WANG Xiaoyu;MIAO Zhiwei;ZHANG Yaohui;ZHANG Chunyu;XU Yan(Department of Gastroenterology,Zhangjiagang Hospital Affiliated to Nanjing University of Chinese Medicine,Jiangsu Province,Suzhou215600,China)

机构地区：[1]南京中医药大学附属张家港医院脾胃病科,江苏张家港215600

出　　处：《中国医药导报》2022年第19期115-119,共5页China Medical Herald

基　　金：国家自然科学基金青年科学基金项目(82104792);江苏省苏州市科技发展计划项目(SYSD2016003);江苏省张家港市科技支撑计划项目(ZKS1730、ZKS1949、ZKS2119)。

摘　　要：目的研究清肠汤联合美沙拉嗪对热盛血瘀型活动期溃疡性结肠炎患者的临床疗效及作用机制。方法选择2018年10月至2019年12月南京中医药大学附属张家港医院就诊的热盛血瘀型活动期溃疡性结肠炎患者60例,按照随机数字表法分为治疗组(清肠汤+美沙拉嗪缓释颗粒)和对照组(美沙拉嗪缓释颗粒),每组各30例。治疗后3个月比较两组临床疗效、中医症状积分、Mayo评分、内镜黏膜愈合率,分析两组肿瘤坏死因子受体相关因子6(TRAF6)、核因子κB(NF-κB)的免疫组织化学表达和Toll样受体4(TLR4)的免疫荧光表达情况。结果治疗组临床疗效优于对照组(P<0.05)。治疗后,两组中医证候单项积分及总积分均较治疗前降低,且治疗组低于对照组(P<0.05)。治疗后,两组Mayo评分均较治疗前降低,且治疗组低于对照组(P<0.05)。治疗后,治疗组黏膜愈合率高于对照组(P<0.05)。治疗后,两组TRAF6、NF-κB表达情况均较治疗前降低,且治疗组低于对照组(P<0.05)。治疗后两组免疫荧光TLR4表达情况较治疗前降低,且治疗组低于对照组(P<0.05)。结论清肠汤联合美沙拉嗪可有效改善热盛血瘀型活动期溃疡性结肠炎患者的临床症状、肠道黏膜愈合,提高治疗效果。清肠汤的抗炎效果可能是通过抑制TLR4/TRAF6/NF-κB信号通路来实现的。Objective To research the clinical effect and mechanism of Qingchang Decoction combined with Mesalazine on ulcerative colitis patients with syndrome of blood stasis due to exuberant heat.Methods A total of 60 patients of active ulcerative colitis with syndrome of blood stasis exuberant from Zhangjiagang Hospital Affiliated to Nanjing University of Chinese Medicine were divided into treatment group(Qingchang Decoction and Mesalazine Sustained-release Granules)and control group(Mesalazine Sustained-release Granules)according to the random number table method,with30 cases in each group.Three months after treatment,the clinical efficacy,traditional Chinese medicine symptom score,Mayo score,and endoscopic mucosal healing rate of each group were compared,immunohistochemical expression of tumor necrosis factor receptor-associated factor(TRAF)6,nuclear transcription factorκB(NF-κB)and immunofluorescence staining of Toll-like receptors(TLR4)in mucosal tissues of two groups were analyzed.Results The clinical effect of the treatment group was better than that of the control group(P<0.05).After treatment,the single scores and total score of traditional Chinese medicine syndrome in both groups were lower than those before treatment,and those in the treatment group were lower than those in the control group(P<0.05).After treatment,Mayo scores in both groups were lower than those before treatment,and that in the treatment group was lower than that in the control group(P<0.05).After treatment,the mucosa healing rate in the treatment group was higher than that in the control group(P<0.05).After treatment,the expression of TRAF6 and NF-κB in both groups were lower than those before treatment,and the expression levels of TRAF6 and NF-κB in treatment group were lower than those in control group(P<0.05).After treatment,the expression of immunofluorescence TLR4 in both groups were lower than those before treatment,and that in the treatment group was lower than that in the control group(P<0.05).Conclusion Qingchang Decoction combin

关 键 词：清肠汤 溃疡性结肠炎 热盛血瘀型 临床疗效 Toll样受体4/肿瘤坏死因子受体相关因子6/核因子κB 

分 类 号：R259[医药卫生—中西医结合]