基于TLR/MyD88信号通路探讨枫蓼肠胃康颗粒联合益生菌治疗溃疡性结肠炎效果及作用机制  

To explore the effect and mechanism of Fengliao changweikang granule combined with probiotics on ulcerative colitis based on TLR/MyD88 signaling pathway

作　　者：邵梅 陈曦 张敏芬 宣佶 SHAO Mei;CHEN Xi;ZHANG Min-fen;XUAN Ji(Department of Gastroenterology,Qinhuai Medical District,Eastern Theater General Hospital,Nanjing,Jiangsu 210002)

机构地区：[1]东部战区总医院秦淮医疗区消化科,210002

出　　处：《现代消化及介入诊疗》2022年第10期1273-1276,1281,共5页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：江苏省卫生健康委科研项目(H2019073)。

摘　　要：目的从Toll样受体/人髓样分化因子88(TLRs/MyD88)信号通路入手,探讨枫蓼肠胃康颗粒联合益生菌治疗溃疡性结肠炎(UC)的效果及作用机制,为UC的治疗方案选择提供方向。方法本研究为前瞻性随机对照试验,以2021年1月-12月在医院消化内科接受诊疗的116例UC患者作为研究对象,按照随机数字表法将116例患者平均分为试验组和对照组,各58例。对照组接受美沙拉嗪+益生菌治疗,试验组在此基础上联合枫蓼肠胃康颗粒治疗,两组均以治疗8周为疗效评估节点。观察指标包括治疗前、治疗8周时TLRs/MyD88信号通路相关因子[TLR-2、TLR-4、MyD88、可溶性尿激酶型纤溶酶原激活物受体(SuPAR)]、炎症因子[白细胞介素(IL)-1β、IL-6、肿瘤坏死因子(TNF)-α]及治疗期间药品不良反应(ADR)。结果两组总有效率相比较,差异无统计学意义(P>0.05);试验组疾病治愈率高于对照组,差异有统计学意义(P<0.05)。两组治疗8周时的外周血TLR-2、TLR-4、MyD88、SuPAR,IL-1β、IL-6、TNF-α均降低,试验组水平较对照组低,差异有统计学意义(P<0.05)。两组ADR总发生率比较,差异无统计学意义(P>0.05)。结论枫蓼肠胃康颗粒联合益生菌能够通过抑制TLRs/MyD88信号通路,减少炎症因子表达,从而减轻炎症反应,起到改善UC病情的作用,且联合用药兼具安全有效的优点。Objective To explore the effect and mechanism of Fengliao changweikang granule combined with probiotics in the treatment of ulcerative colitis(UC)based on Toll like receptor/human myeloid differentiation factor 88(TLRs/MyD88)signaling pathway,so as to provide a direction for the selection of treatment options for UC.Methods This study was a prospective randomized controlled trial.116 UC patients who were treated in the Department of Gastroenterology of the hospital from January to December 2021 were taken as the research objects.According to the random number table method,116 patients were divided into the test group and the control group,with 58 cases each.The control group was treated with mesalazine+probiotics,and the test group was treated with Fengliao changweikang granules on this basis.The two groups took 8 weeks of treatment as the evaluation node of efficacy.The observation indexes included TLRs/MyD88 signaling pathway related factors[TLR-2,TLR-4,MyD88,soluble urokinase type plasminogen activator receptor(SuPAR)],inflammatory factors[interleukin(IL)-1β,IL-6,tumor necrosis factor(TNF)-α]before and 8 weeks after treatment,and adverse drug reactions(ADR)during treatment.Results There was no statistical significant difference in the total effective rate between the two groups(P>0.05).The cure rate of the test group was higher than that of the control group,with a statistical significant difference(P<0.05).The levels of TLR-2,TLR-4,MyD88,SuPAR,IL-1β,IL-6 and TNF-αin the peripheral blood of the two groups decreased at 8 weeks after treatment.The levels in the test group were lower than those in the control group,with a statistical significant difference(P<0.05).There was no statistical significant difference in the total incidence of ADR between the two groups(P>0.05).Conclusion Fengliao changweikang granule combined with probiotics can reduce the expression of inflammatory factors by inhibiting TLRs/MyD88 signaling pathway,thus alleviating the inflammatory reaction and improving the condition of UC,and th

关 键 词：溃疡性结肠炎 TLRs/MyD88信号通路 炎症因子 枫蓼肠胃康颗粒 益生菌 

分 类 号：R574.62[医药卫生—消化系统]