基于TLR4/MyD88/NF-κB信号通路探讨安肠汤联合艾灸治疗肝郁脾虚证腹泻型肠易激综合征的疗效及其机制  

Based on TLR4/MyD88/NF-κB Signaling Pathway to Explore Efficacy and Mechanism of Anchang Decoction Combined with Moxibustion in the Treatment of Diarrhea-Predominant Irritable Bowel Syndrome with Liver Stagnation and Spleen Deficiency Syndrome

作　　者：符荣朋 宁小英 吴苑 李景濠 熊文生[3] FU Rong-peng;NING Xiao-ying;WU Yuan;LI Jing-hao;XIONG Wen-sheng(The First ClinicalMedical College of Guangzhou University of Traditional ChineseMedicine,Guangzhou,Guangdong,510006,China;Department of Traditional Chinese Medicine,Foshan Nanhai District People's Hospital,Foshan,Guangdong,528200,China;Department of Spleen and Stomach Diseases,The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,Guangzhou,Guangdong,510405,China)

机构地区：[1]广州中医药大学第一临床医学院,广东广州510006 [2]佛山市南海区人民医院中医科,广东佛山528200 [3]广州中医药大学第一附属医院脾胃病科,广东广州510405

出　　处：《现代生物医学进展》2024年第3期470-474,共5页Progress in Modern Biomedicine

基　　金：广东省自然科学基金项目(2017A030310486)。

摘　　要：目的:基于Toll样受体4(TLR4)/髓样分化因子88(MyD88)/核因子-κB(NF-κB)信号通路探讨安肠汤联合艾灸治疗肝郁脾虚证腹泻型肠易激综合征(IBS)的疗效及其机制。方法:采用随机数字表法,将广州中医药大学第一附属医院在2019年4月~2022年12月期间收治的108例腹泻型IBS患者分为对照组(常规药物联合艾灸治疗,n=54)和研究组(对照组基础上接受安肠汤治疗,n=54)。对比两组疗效、中医证候总积分、IBS症状严重程度问卷(IBS-SSS)评分、肠屏障功能指标、TLR4/MyD88/NF-κB信号通路相关信使核糖核酸(mRNA)表达水平。结果:研究组的临床总有效率高于对照组(P<0.05)。两组治疗后中医证候总积分、IBS-SSS评分下降,且研究组低于对照组(P<0.05)。两组治疗后肠脂肪酸结合蛋白(IFABP)、D-乳酸及二胺氧化酶(DAO)下降,且研究组低于对照组(P<0.05)。两组治疗后TLR4、MyD88、NF-κB mRNA表达下降,且研究组低于对照组(P<0.05)。结论:安肠汤联合艾灸治疗肝郁脾虚证腹泻型IBS患者,可有效改善临床症状和肠屏障功能,疗效较好,可能与调节TLR4/MyD88/NF-κB信号通路有关。Objective:Based on Toll-like receptor 4(TLR4)/myeloid differentiation factor 88(MyD88)/nuclear factor-κB(NF-κB)signaling pathway to explore efficacy and mechanism of anchang decoction combined with moxibustion in the treatment of diarrhea-predominant irritable bowel syndrome(IBS)with liver stagnation and spleen deficiency syndrome.Methods:According to random number table method,108 patients with diarrhea type IBS who were admitted to the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from April 2019 to December 2022 were divided into control group(treated with conventional drugs combined with moxibustion,n=54)and study group(treated with Anchang Tang on the basis of the control group,n=54).The efficacy,chinese medicine syndrome total scores,IBS symptom severity questionnaire(IBS-SSS)score,intestinal barrier function index,TLR4/MyD88/NF-κB signaling pathway related messenger ribonucleic acid(mRNA)expression level were compared between two groups.Results:The total clinical effective rate in study group was higher than that in control group(P<0.05).Chinese medicine syndrome total scores and IBS-SSS scores in two groups decreased after treatment,and study group was lower than that of control group(P<0.05).The intestinal fatty acid binding protein(IFABP),D-lactate and diamine oxidase(DAO)decreased in two groups after treatment,and study group was lower than that of control group(P<0.05).TLR4,MyD88 and NF-κB mRNA decreased expression in two groups after treatment,and study group was lower than that of control group(P<0.05).Conclusion:Anchang decoction combine with moxibustion can effectively improve the clinical symptoms and intestinal barrier function of diarrhea-predominant IBS patients with liver depression and spleen deficiency syndrome,and the curative effect is good,which may be relate to the regulation of TLR4/MyD88/NF-κB signaling pathway.

关 键 词：TLR4/MyD88/NF-κB信号通路 安肠汤 艾灸 腹泻型肠易激综合征 肝郁脾虚证 疗效 

分 类 号：R242[医药卫生—中医临床基础] R256.34[医药卫生—中医学]