葛芩消溃方联合美沙拉嗪治疗溃疡性结肠炎疗效及相关机制初步探讨  

Preliminary study on the efficacy and related mechanisms of Geqin Xiaokui Formula combined with mesalazine in the treatment of ulcerative colitis

作　　者：贾靖 徐甜甜 张毅[1] 汪洋[2] JIA Jing;XU Tiantian;ZHANG Yi;WANG Yang(Department of Gastroenterology,Huizhou Third People's Hospital,Huizhou,Guangdong,516000,China;Department of Gastrointestinal Surgery,Huizhou Third People's Hospital)

机构地区：[1]惠州市第三人民医院消化内科,广东惠州516000 [2]惠州市第三人民医院胃肠外科

出　　处：《中国中西医结合消化杂志》2024年第2期134-138,150,共6页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

摘　　要：目的:探讨中药葛芩消溃方联合美沙拉嗪治疗溃疡性结肠炎(UC)临床疗效。方法:选择惠州市第三人民医院2019年6月—2022年12月收治的UC患者90例,随机分为观察组和对照组,每组45例,对照组接受美沙拉嗪肠溶片治疗,0.5 g/次,3次/d;观察组在此基础上予以中药葛芩消溃方治疗,疗程均为8周。比较2组治疗前后中医证候评分、Baron评分、结肠组织病理评分、Sutherland疾病活动指数评分,并比较2组血清D-乳酸、二胺氧化酶(DAO)、内毒素(ETX)水平和肠黏膜叉头框蛋白A2(FOXA2)mRNA、低氧诱导因子1α(HIF-1α)mRNA、微小核糖核酸-31-3p(miR-31-3p)表达情况,比较2组治疗总有效率和不良反应率。结果:治疗后观察组中医证候评分、Baron评分、结肠组织病理评分、Sutherland疾病活动指数评分均低于对照组(P<0.01),血清D-乳酸、DAO、ETX水平均低于对照组(P<0.01),黏膜组织FOXA2 mRNA表达量高于对照组(P<0.01),HIF-1αmRNA、miR-31-3p表达量低于对照组(P<0.01),治疗总有效率高于对照组(P<0.05);2组不良反应率比较差异无统计学意义(P>0.05)。结论:葛芩消溃方联合美沙拉嗪可有效改善中医证候,保护肠黏膜功能,促进肠黏膜愈合,治疗UC效果显著,安全性好,其机制可能与调节黏膜组织FOXA2 mRNA、HIF-1αmRNA、miR-31-3p表达有关。Objective To explore the clinical efficacy of Geqin Xiaokui Formula combined with mesalazine in the treatment of ulcerative colitis(UC).Methods Ninety patients with UC admitted to our hospital from June 2019 to December 2022 were randomly divided into an observation group and a control group,with 45 patients in each group.The control group received mesalazine enteric-coated tablets,0.5 g each time,three times a day;The observation group was treated with Geqin Xiaokui Formula for 8 weeks.The traditional Chinese medicine(TCM)syndrome score,Baron score,colon histopathological score,Sutherland disease activity index score before and after treatment were compared,and the levels of serum D-lactate,diamine oxidase(DAO),endotoxin(ETX),intestinal mucosal forkhead box protein A2(FOXA2)mRNA,and hypoxia-inducible factor-1α(HIF-1α)mRNA,MicroRNA-31-3p(miR-31-3p)expression were compared,and the total effective rate and adverse reaction rate of the two groups were compared.Results After treatment,the TCM syndrome score,Baron score,colonic histopathological score,and Sutherland disease activity index score of the observation group were lower than those of the control group(P<0.01).The levels of D-lactic acid,DAO,and ETX in serum were lower than those of the control group(P<0.01),and the expression of FOXA2 mRNA in mucosal tissue was higher than that of the control group(P<0.01).The expression of HIF-1αmRNA and miR-31-3p of the two groups was lower than that of the control group(P<0.01),and the total effective rate of treatment was higher than that of the control group(P<0.05).There was no statistically significant difference in the rate of adverse reactions between the two groups(P>0.05).Conclusion Geqin Xiaokui Formula combined with mesalazine can effectively improve traditional Chinese medicine syndromes,protect intestinal mucosal function,promote intestinal mucosal healing,and have a significant effect and safety in the treatment of UC.The mechanism may be related to the expression of regulation of mucosal organization FOXA

关 键 词：溃疡性结肠炎 中药 葛芩消溃方 美沙拉嗪 机制 

分 类 号：R574.62[医药卫生—消化系统]