复方苦参肠炎康片联合美沙拉嗪治疗对溃疡性结肠炎患者肠道菌群水平、肠黏膜ICAM-1、MMP-9蛋白表达的影响  

Effects of Compound Kushen Changyankang tablet combined with mesalazine on intestinal flora level and protein expressions of ICAM-1 and MMP-9 in intestinal mucosa in the treatment of UC

作　　者：高飞 张杰伟 徐琪[1] 林怡 GAO Fei;ZHANG Jie-wei;XU Qi(Department of Gastroenterology,The First Affiliated Hospital of Hainan Medical University,Haikou Hainan 570100,China)

机构地区：[1]海南医学院第一附属医院消化内科,海南海口570100

出　　处：《临床和实验医学杂志》2023年第13期1378-1382,共5页Journal of Clinical and Experimental Medicine

基　　金：海南省卫生健康行业科研项目(编号:21A200160)。

摘　　要：目的 探讨复方苦参肠炎康片联合美沙拉嗪治疗对溃疡性结肠炎(UC)患者肠道菌群水平、肠黏膜细胞间黏附分子(ICAM-1)、基质金属蛋白酶-9(MMP-9)蛋白表达的影响。方法 前瞻性选取2020年1月至2022年5月海南医学院第一附属医院消化内科收治的UC患者76例,按照随机数字表法将其分为对照组和观察组,每组38例。两组均给予常规对症治疗,对照组给予美沙拉嗪治疗,观察组在对照组的治疗基础上加予复方苦参肠炎康片治疗。观察两组临床疗效和电子肠镜黏膜疗效,比较治疗前及治疗6周后的肠道菌群水平和肠黏膜ICAM-1、MMP-9蛋白表达情况,评估两组药物安全性,对两组进行为期6个月的随访,记录两组复发率。结果 观察组的临床总有效率为94.74%,显著高于对照组(65.79%),观察组的电子肠镜黏膜总有效率为92.11%,显著高于对照组(65.79%),差异均有统计学意义(P<0.05)。治疗后,两组的肠道中双歧杆菌、乳酸杆菌的菌落数量较治疗前均显著增加,且观察组中分别为(9.92±1.82)、(7.29±1.46)lgCFU/g,显著高于对照组[(8.55±1.27)、(6.41±1.04)lgCFU/g],差异均有统计学意义(P<0.05);两组治疗前后和组间治疗后的肠球菌、肠杆菌的菌群数量比较,差异均无统计学意义(P>0.05)。治疗后,两组的肠黏膜ICAM-1、MMP-9蛋白表达水平均较治疗前下降,且观察组的肠黏膜ICAM-1、MMP-9蛋白表达水平分别为0.012±0.008、0.028±0.008,均显著低于对照组(0.019±0.009、0.036±0.012),差异均有统计学意义(P<0.05)。观察组的不良反应总发生率为2.63%,与对照组的5.26%比较,差异无统计学意义(P>0.05)。随访6个月,两组均未发现明显复发病例。结论 复方苦参肠炎康片、美沙拉嗪联合治疗UC疗效确切,可提高肠黏膜修复疗效,纠正肠道菌群水平失衡,可能是通过下调肠黏膜ICAM-1、MMP-9蛋白表达的作用机制,以改善肠黏膜通透性和修复肠黏膜屏障,不良反应�Objective To explore the effects of Compound Kushen Changyankang tablet combined with mesalazine in the treatment of ulcerative colitis(UC)on intestinal flora level and protein expressions of intestinal mucosal intercellular adhesion molecules-1(ICAM-1)and matrix metalloproteinase-9(MMP-9).Methods Seventy-six patients with UC admitted to Department of Gastroenterology,the First Affiliated Hospital of Hainan Medical University were selected between January 2020 and May 2022,and were divided into control group and observation group by means of the random number table method,with 38 cases in each group.The two groups were given conventional symptomatic treatment,and control group was given mesalazine,and observation group was additionally given Compound Kushen Changyankang tablet based on the treatment in control group.The clinical efficacy and efficacy of electron colonoscopy mucosa were observed in the two groups.The intestinal flora level and protein expressions of intestinal mucosal ICAM-1 and MMP-9 were compared before treatment and after 6 weeks of treatment.The medicine safety was evaluated in the two groups.The two groups were followed up for 6 months,and the recurrence rate was recorded in the two groups.Results The total clinical effective rate in observation group was 94.74%,which was significantly higher than that in control group(65.79%),the total effective rate of electron colonoscopy mucosa in observation group was 92.11%,which was significantly higher than that in control group(65.79%),the differences were statistically significant(P<0.05).After treatment,the number of bacterial colonies of Bifidobacterium,Lactobacillus in the intestines of both groups significantly increased compared to before treatment,and Bifidobacterium,Lactobacillus in the observation group were(9.92±1.82),(7.29±1.46)lgCFU/g,which were significantly higher than those in the control group[(8.55±1.27),(6.41±1.04)lgCFU/g],the differences were statistically significant(P<0.05);there was no significant difference in the number of

关 键 词：溃疡性结肠炎 复方苦参肠炎康片 美沙拉嗪 肠道菌群 细胞间黏附分子-1 基质金属蛋白酶-9 

分 类 号：R574.62[医药卫生—消化系统]