沙利度胺联合布拉氏酵母菌对难治性溃疡性结肠炎患者肠道菌群、肠黏膜屏障功能的影响  

Effects of Thalidomide Combined with Saccharomyces Boulardii on Intestinal Flora and Intestinal Mucosal Barrier Function in Refractory Ulcerative Colitis

作　　者：孟利军 郭晓鹤[1] 李文静 杨艳 朱艳丽[1] MENG Lijun;GUO Xiaohe;LI Wenjing;YANG Yan;ZHU Yanli(Department of Gastroenterology,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453000,China)

机构地区：[1]新乡医学院第一附属医院消化内科,河南新乡453000

出　　处：《河南医学研究》2025年第4期705-709,共5页Henan Medical Research

基　　金：河南省医学科技攻关计划项目(LHGJ20210539)。

摘　　要：目的回顾性探究沙利度胺联合布拉氏酵母菌治疗难治性溃疡性结肠炎(UC)的效果及对肠道菌群、肠黏膜屏障功能的影响。方法收集新乡医学院第一附属医院2020年9月至2023年9月收治的105例难治性UC病历资料,依据治疗方案分为两组,采用沙利度胺治疗51例为对照组,采用沙利度胺联合布拉氏酵母菌治疗54例为联合组。对比两组疗效、用药安全性、肠壁厚度、UC内镜下严重程度指数(UCEIS)评分、肠道菌群数量、肠黏膜屏障功能[二胺氧化酶(DAO)、D-乳酸、内毒素(ET)]、炎症因子[缺氧诱导因子-1α(HIF-1α)、白细胞介素-10(IL-10)、转化生长因子-β1(TGF-β1)、肿瘤坏死因子-α(TNF-α)]水平。结果治疗后两组总有效率、不良反应发生率、黏膜层厚度、肠壁总厚度及UCEIS评分对比,差异无统计学意义(P>0.05)。治疗后联合组D-乳酸、DAO、ET、HIF-1α、TNF-α低于对照组,TGF-β1、IL-10高于对照组(P<0.05)。治疗后联合组大肠杆菌较对照组少,乳酸杆菌、双歧杆菌较对照组多,差异有统计学意义(P<0.05)。结论布拉氏酵母菌联合沙利度胺治疗难治性UC可改善肠道菌群,提高肠黏膜屏障功能,抑制肠道炎症反应,有提高临床缓解率趋势,且安全性较好。Objective To investigate retrospectively the effects of thalidomide combined with Saccharomyces boulardii in the treatment of refractory ulcerative colitis(UC)and the effects on intestinal flora and mucosal barrier function.Methods A total of 105 cases of refractory UC in the First Affiliated Hospital of Xinxiang Medical University from September 2020 to September 2023 were collected and divided into two groups according to the treatment plans.There were 51 cases were treated with thalidomide as control group,and 54 cases were treated with thalidomide plus Saccharomyces boulardii as combination group.The efficacy,medication safety,intestinal wall thickness,UC endoscopic severity index(UCEIS)score,gut microbiota count,intestinal mucosal barrier function[diamine oxidase(DAO),D-lactate,endotoxin(ET)],inflammatory factors[hypoxia inducible factor-1α(HIF-1α),interleukin-10(IL-10),transforming growth factor-β1(TGF-β1),tumor necrosis factor alpha(TNF-α)]levels were compared between the two groups.Results After treatment,there were no significant differences in the total effective rate,incidence of adverse reactions,mucosal thickness,intestinal wall thickness and UCEIS score between the two groups(P>0.05).After treatment,D-lactic acid,DAO,ET,HIF-1αand TNF-αin combination group were lower than those in control group,and TGF-β1 and IL-10 were higher than those in control group(P<0.05).After treatment,the number of Escherichia coli in combination group was lower than that in control group,and the number of lactobacillus and bifidobacterium were higher than that in control group(P<0.05).Conclusion The combination of Saccharomyces boulardii and thalidomide in the treatment of refractory UC can improve intestinal flora,enhance intestinal mucosal barrier function,inhibit intestinal inflammatory response,and increase the clinical remission rate,with good safety.

关 键 词：难治性溃疡性结肠炎 沙利度胺 布拉氏酵母菌 肠道菌群 肠黏膜屏障 炎症因子 

分 类 号：R574.1[医药卫生—消化系统]