自拟肠宁方联合美沙拉嗪调控PERK/NF-κB通路治疗溃疡性结肠炎  

Self-Prescribed Changning Formula Combined with Mesalazine Regulating PERK/NF-κB Pathway in the Treatment of Ulcerative Colitis

作　　者：胡选亚[1] 杨丛家 徐录梅 艾世鹏[1] 张福生 Hu Xuanya;Yang Congjia;Xu Lumei(Department of Proctology,Nanyang First People's Hospital,Henan Province,Nanyang 471002,China)

机构地区：[1]河南省南阳市第一人民医院肛肠科,南阳471002

出　　处：《华中科技大学学报(医学版)》2025年第2期255-260,共6页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：河南省医学科技攻关计划(联合共建)项目(No.LHGJ20191621)。

摘　　要：目的探讨自拟肠宁方复合美沙拉嗪治疗溃疡性结肠炎(UC)的效果,并分析其对蛋白激酶R样内质网激酶(PERK)/核因子κB(NF-κB)通路的影响。方法选取2021年1月~2024年1月南阳市第一人民医院收治的100例UC患者,按随机数字表法分为对照组、联合组,每组各50例。对照组予以美沙拉嗪,联合组予以自拟肠宁方联合美沙拉嗪。治疗2个月后比较两组治疗前后临床症状、疾病活动度(Mayo指数评分)、肠镜病理情况(Baron评分)、黏膜愈合情况(Geboes指数)及外周血单核细胞中PERK/NF-κB通路相关蛋白水平[磷酸化PERK(p-PERK)、磷酸化真核细胞起始因子2α(p-eIF2α)、磷酸化NF-κB(p-NF-κB)]、PERK/NF-κB通路下游细胞因子[白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)]水平及不良反应。结果联合组总有效率为96.00%,高于对照组的76.00%,临床症状评分低于对照组(均P<0.05);联合组治疗后Mayo指数评分、Baron评分、Geboes指数分别为(2.32±0.28)分、(0.51±0.11)分、(0.41±0.10)分,低于对照组的(3.45±0.50)分、(1.17±0.28)分、(1.00±0.22)分(均P<0.05);联合组治疗后外周血单核细胞中p-PERK、p-eIF2α、p-NF-κB水平分别为1.07±0.14、0.88±0.14、0.95±0.18,低于对照组的1.85±0.20、1.29±0.23、1.14±0.23(均P<0.05);联合组治疗后血清IL-1β、TNF-α、IL-6、IL-8水平分别为(4.02±1.26)pg/mL、(6.15±1.64)pg/mL、(8.52±2.04)pg/mL、(25.34±5.28)pg/mL,低于对照组的(6.00±1.54)pg/mL、(8.79±2.33)pg/mL、(11.23±3.19)pg/mL、(41.78±9.34)pg/mL(均P<0.05);联合组不良反应发生率为4.00%,与对照组(8.00%)比较无明显差异(P>0.05)。结论自拟肠宁方联合美沙拉嗪治疗UC的疗效确切且具有一定安全性,可改善临床症状,控制病情进展,缓解炎性反应,可能与抑制PERK/NF-κB通路活化有关。Objective To investigate the effectiveness of self-prescribed Changning Formula combined with Mesalazine in the treatment of ulcerative colitis(UC),and to analyze its effect on protein kinase R-like endoplasmic reticulum kinase(PERK)/nuclear factorκB(NF-κB)pathway.Methods A total of 100 patients with UC admitted to our hospital from January 2021 to January 2024 were selected and divided into control group and combined group by random number table method,with 50 cases in each group.The control group was given Mesalazine,and the combined group was given self-prescribed Changning Formula combined with Mesalazine.After 2 months of treatment,the effectivenesses in two groups were compared.The clinical symptoms,disease activity(Mayo index score),colonoscopy pathological status(Baron score),mucosal healing status(Geboes index)and PERK/NF-κB pathway-related protein levels in peripheral blood mononuclear cells[phosphorylated PERK(P-PERK),phosphorylated eukaryotic initiation factor 2α(P-eIF2α),phosphorylated NF-κB(P-NF-κB)],the levels of PERK/NF-κB pathway downstream factors[interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8)]before and after treatment,as well as adverse reactions were compared between the two groups.Results The total effective rate of the combined group was 96.00%,which was higher than that of the control group(76.00%),and the clinical symptom score was lower than that of the control group(both P<0.05).After treatment,the Mayo index score,Baron score,and Geboes index score in the combined group were(2.32±0.28),(0.51±0.11),and(0.41±0.10),respectively,which were lower than those in the control group[(3.45±0.50),(1.17±0.28),and(1.00±0.22),all P<0.05].After treatment,the levels of P-PERK,P-eIF2α,and P-NF-κB in peripheral blood mononuclear cells in the combined group were(1.07±0.14),(0.88±0.14),and(0.95±0.18),respectively,which were lower than those in the control group[(1.85±0.20),(1.29±0.23),and(1.14±0.23),all P<0.05].The levels of serum IL-1

关 键 词：溃疡性结肠炎 肠宁方 美沙拉嗪 蛋白激酶R样内质网激酶 核因子ΚB 疗效 

分 类 号：R574.62[医药卫生—消化系统]