大肠湿热证溃疡性结肠炎与外周血髓样树突状细胞表型的相关性及连草泻痫胶囊的临床疗效分析  

Correlation between large intestine damp-heat syndrome and myeloid dendritic cell phenotype and clinical efficacy of Liancao Xieli capsules in the treatment of ulcerative colitis

作　　者：张雅丽 袁星星 王炳予 卢科强 ZHANG Yali;YUAN Xingring;WANG Bingyu;LU Keqiang(Heilongjiang Academy of Traditional Chinese Medicine,Harbin,150006,China)

机构地区：[1]黑龙江省中医药科学院,哈尔滨150006

出　　处：《中国中西医结合消化杂志》2022年第8期546-553,共8页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：黑龙江省卫生健康委科研课题(No:2020-291);黑龙江省自然科学基金联合引导项目(No:LH2019H095)。

摘　　要：目的:观察大肠湿热证溃疡性结肠炎(UC)与外周血髓样树突状细胞(mDC)表型的相关性及连草泻痫胶囊对大肠湿热证UC患者mDC表型的影响。方法:选取符合纳人标准的大肠湿热证UC患者62例,非大肠湿热证UC患者33例及健康受试者15例,检测外周血mDC频数、表型(MHC-Ⅱ、CD80、CD83和CD86)及血清炎症因子(TNF-α、IL-6、IL-12、IL-17A)水平在不同受试者之间的差异,并分析大肠湿热证症候积分与其相关性。随后用随机数字法将62例大肠湿热证UC患者分为连草泻痫组和对照组,对照组予美沙拉嗪肠溶片口服治疗,连草泻痫组在对照组的基础上予连草泻痢胶囊,两组均治疗8周。分别检测两组患者治疗前后大肠湿热证症候积分、炎症因子、mDC表型水平和改良Mayo活动指数评分,并评价其临床疗效。结果:外周血mDC频数在健康受试者中高于UC患者(P<0.01),而炎症因子及mDC表面分子水平在健康受试者中均低于UC患者(P<0.01),且在大肠湿热证UC患者中的水平高于非大肠湿热证患者(P<0.01)。相关性分析结果显示,大肠湿热证症候积分与外周血mDC表面MHC-II、CD80、CD83和CD86表达水平以及血清TNF-α、IL-6、IL-12、IL-17A水平和改良Mayo活动指数评分均呈显著正相关(P<0.05)。治疗前后比较,连草泻痢组和对照组患者中医症候积分、改良Mayo活动指数评分,血清炎症因子(TNF-α、IL-6、IL-12、IL-17A)水平及mDC表型(MHC-II、CD80、CD83和CD86)水平均降低(P<0.01)。治疗后组间临床疗效及中医症候疗效比较,连草泻痫组均优于对照组(P<0.05。结论:UC大肠湿热证症候积分与mDC的表型及炎症因子水平呈显著正相关。连草泻痫胶囊可通过抑制mDC的成熟分化,达到抑制大肠湿热证炎症的作用。Objective:To observe the correlation between peripheral blood myeloid dendritic cell(mDC)surface molecules and syndrome of dampness heat in the large intestine in patients with ulcerative colitis(UC)and the effect of Liancao Xielicapsule on mDC phenotype in UC patients with the syndrome of dampness heat in the large intestine.Methods:Sixty-two patients with UC with the syndromeof dampness heat in thelarge intestine,33 patients with UC without syndrome of dampness heat in large intestine and 15 healthy subjects who met the criteria for diagnosis and inclusion were selected.Then detect and analyze the differences in peripheral blood cell frequency,surface molecule,and serum inflammatory factorlevels between different subjects.Analyze the correlation of modified Mayo activity index score,serum inflammatory factors(TNF-α,IL-6,IL-12 and IL-17A),and mDC surface molecules(MHC-I,CD80,CD83 and CD86)with fractions of syndrome of dampness heat in large intestine.Sixty-two UC patients were randomly divided into Liancao Xieli group and control group,and the control group was treated with mesalazine extended-release granules orally.Moreover,the Liancao Xieli group was treated with Liancao Xieli capsules based on the control group.Both groups were treated for 8 weeks.The changes in modified Mayo activity index score,the score of syndromes of dampness heat in the large intestine,serum pro-inflammatory factor and mDC phenotype before and after treatment were observed in the two groups,and clinical fficacy was evaluated,too.Results:Peripheral blood cell frequency was higher in healthy subjects than in UC patients but the level of inflammatory factors and mDC surface molecules was lower in healthy subjects than in UC patients,And the level is higher in patients of UC with the syndrome of dampness heat in the large intestine than in patients of UC without syndrome of dampness heat in the large intestine.The correlation analysis results showed that the scores of syndromes of dampness heat in the large intestine were significantly po

关 键 词：溃疡性结肠炎 连草泻痫胶囊 树突状细胞 相关性分析 大肠湿热证 临床疗效 

分 类 号：R573.32[医药卫生—消化系统]