膈下逐瘀汤介导TLR4/NF-κB信号通路对溃疡性结肠炎的干预作用及对肠黏膜屏障的影响  

The intervention of TLR4/NF-κB signaling pathway mediated by Gexia Zhuyu decoction on ulcerative colitis and the effect on intestinal mucosal barrier

作　　者：黄蓓 孙兴伟 胡志飞 李媛媛 Huang Bei;Sun Xingwei;Hu Zhifei;Li Yuanyuan(Department of Colorectal Medicine,Xi′an Traditional Chinese Medicine Hospital,Xi′an 710000,China)

机构地区：[1]西安市中医医院肛肠科,西安710000

出　　处：《中国医师杂志》2025年第2期220-224,229,共6页Journal of Chinese Physician

基　　金：陕西省重点研发计划(2022SF-369)。

摘　　要：目的探讨膈下逐瘀汤介导Toll样受体4(TLR4)/核因子-κB(NF-κB)信号通路对溃疡性结肠炎的干预作用及对肠黏膜屏障的影响。方法前瞻性纳入2019年3月—2023年7月西安市中医医院收治的溃疡性结肠炎86例,按随机数字表法分为观察组与对照组,每组43例。对照组采用美沙拉嗪肠溶片治疗;观察组采用美沙拉嗪肠溶片联合膈下逐瘀汤治疗。比较两组患者临床疗效,治疗前后的中医证候积分、肠道黏膜屏障功能指标[二胺氧化酶(DAO)、D-乳酸(D-LA)]、TLR4/NF-κB信号通路表达情况及炎症因子指标[白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)],并比较其不良反应发生情况。结果观察组总有效率高于对照组(χ^(2)=4.074,P=0.044)。治疗前,两组各项中医证候积分比较差异均无统计学意义(均P>0.05);治疗后两组各项中医证候积分均较治疗前降低(均P<0.05),且观察组各项中医证候积分低于对照组(均P<0.05)。治疗前,两组D-LA、DAO水平比较差异均无统计学意义(均P>0.05);治疗后,两组D-LA、DAO水平均较治疗前降低(均P<0.05),且观察组D-LA、DAO水平低于对照组(均P<0.05)。治疗后,两组TLR4、NF-κB mRNA表达均较治疗前降低,且观察组TLR4、NF-κB mRNA表达低于对照组(均P<0.05)。治疗后,两组IL-6、IL-8、TNF-α水平均较治疗前降低(均P<0.05),且观察组IL-6、IL-8、TNF-α水平低于对照组(均P<0.05)。两组总不良反应发生率比较差异无统计学意义(χ^(2)=2.346,P=0.126)。结论膈下逐瘀汤用于治疗溃疡性结肠炎不仅能有效改善患者临床症状、体征以及肠道黏膜屏障功能,还能通过介导TLR4/NF-κB信号通路来改善其炎症反应。ObjectiveTo investigate the effect of Gexia Zhuyu decoction on Toll-like receptor 4(TLR4)/Nuclear factor-kappaB(NF-κB)signaling pathway on ulcerative colitis and intestinal mucosal barrier.MethodsA total of 86 cases of ulcerative colitis admitted to Xi′an Traditional Chinese Medicine(TCM)Hospital from March 2019 to July 2023 were prospectively included and divided into observation group and control group according to random number table method,with 43 cases in each group.The control group was treated with mesalazine enteric-coated tablets;The observation group was treated with mesalazine enteric-coated tablets combined with Gexia Zhuyu decoction for removing stasis.The clinical efficacy of the two groups was compared in terms of TCM syndrome score,intestinal mucosal barrier function index[diamine oxidase(DAO),D-lactic acid(D-LA)],TLR4/NF-κB signaling pathway expression and inflammatory factor index[interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)]before and after treatment.The occurrence of adverse reactions was also compared.ResultsThe total effective rate of observation group was higher than that of control group(χ^(2)=4.074,P=0.044).Before treatment,there was no significant difference in TCM syndrome scores between the two groups(all P>0.05).After treatment,the TCM syndrome scores of both groups were lower than those before treatment(all P<0.05),and the TCM syndrome scores of the observation group were lower than those of the control group(all P<0.05).Before treatment,there were no significant differences in D-LA and DAO levels between the two groups(all P>0.05).After treatment,the levels of D-LA and DAO in both groups were lower than before treatment(all P<0.05),and the levels of D-LA and DAO in the observation group were lower than those in the control group(all P<0.05).After treatment,the mRNA expressions of TLR4 and NF-κB in both groups were decreased compared with those before treatment,and the mRNA expressions of TLR4 and NF-κB in the observation group were lower than those

关 键 词：结肠炎 溃疡性 膈下逐瘀汤 TOLL样受体4 NF-ΚB 

分 类 号：R57[医药卫生—消化系统]