摘要
目的:观察木瓜三萜联合美沙拉嗪对溃疡性结肠炎(ulcerative colitis,UC)临床疗效、炎症因子及肠黏膜屏障保护因子的影响。方法:将入选的90例UC患者随机分为对照组和治疗组,每组各45例。对照组口服给予美沙拉嗪1. 0 g,治疗组在给予美沙拉嗪的同时加服木瓜三萜0. 375 g,每天3次,疗程8周。比较两组患者的临床疗效、不良反应发生率,计算临床症状体征积分、疾病活动指数(disease activity index,DAI)评分、结肠镜积分及病理组织学评分,检测外周血中TNF-α、IL-1β、IL-6、IFN-γ、IL-4、IL-10含量及结肠黏膜中髓过氧化物酶(MPO)活性和结肠黏膜中闭锁小带蛋白1(ZO1)、钙粘附蛋白E(E-cadherin)、紧密连接蛋白(occludin)、黏蛋白2(MUC2)、肠三叶因子(TFF3) mRNA表达。结果:UC患者治疗后,治疗组的总有效率(86. 67%)明显高于单用美沙拉嗪(66. 67%)对照组,不良反应的发生率明显低于对照组(P <0. 01);临床症状体征积分、DAI评分、结肠镜积分及病理组织学评分明显低于对照组(P <0. 05或P <0. 01);血液中TNF-α、IL-1β、IL-6、IFN-γ含量和结肠黏膜中MPO活性较对照组明显降低,IL-4、IL-10含量较对照组明显升高(P <0. 05或P <0. 01);结肠黏膜中ZO1、Ecadherin、occludin、MUC2、TFF3 mRNA表达较对照组明显上调(P <0. 05或P <0. 01)。结论:木瓜三萜与美沙拉嗪联用对UC患者有良好的治疗效果和较低不良反应,抑制促炎因子产生、恢复促炎和抗炎因子之间的平衡及上调肠黏膜屏障保护因子表达可能是其发挥对UC治疗作用的机制之一。
AIM: To investigate the clinical effect Muguasantie combined with mesalazine on the clinical efficacy,inflammatory and intestinal barrierprotective factors of ulcerative colitis. METHODS:Ninety patients with ulcerative colitis were randomly divided into the control group and treatment group,with 45 cases in each group. The control group was given mesalazine 1. 0 g each time,while the treatment group was given mesalazine plus Muguasantie0. 375 g each time,3 times a day for 8 consecutive weeks. The clinical efficacy,the adverse reaction incidence,clinical symptom and sign score,disease activity index( DAI) score,colonoscopy score and histopathology score of the two groups were compared; the contents of tumor necrosis factor( TNF)-α,interleukin( IL)-1β,IL-6,interferon( IFN)-γ,IL-4,IL-10 in the peripheral blood,and myeloperoxidase( MPO) activity,locked small band protein1( ZO1),calcium adhesion protein E( E-cadherin),occludin,mucin 2( MUC2),and intestinal trifolium factor( TFF3) mRNA expressions in colonic mucosa were detected,respectively. RESULTS:After treatment,the total effective rate of the treatment group( 86. 67%) was significantly higher than that of the control group( 66. 67%),and the incidence of adverse reactions was significantly lower than that of the control group( P < 0. 01); the symptom and sign score,the DAI score,colonoscopy score and histopathology score were significantlylower than those of the control group( P < 0. 05 or P< 0. 01,respectively); the contents of TNF-α,IL-1β,IL-6,IFN-γ in the peripheral blood,and MPO activity in colonic mucosa were significantly lower,and IL-4 and IL-10 was significantly higher than those of the control group( P < 0. 05 or P < 0. 01,respectively); the mRNA expressions of ZO1,Ecadherin,occludin,MUC2 and TFF3 in the colonic mucosa were significantly up-regulated than those of the control group( P < 0. 05 or P < 0. 01,respectively). CONCLUSION: Muguasantie combined with mesalazine has good therapeutic effect and lower side effect on patients with ulcerative colitis. Its mechanism is related to inhibiting the productions of pro-inflammatory factors,restoring the balance between pro-inflammatory and anti-inflammatory factors and up-regulating the expression of intestinal mucosal barrier protective factors.
作者
张继红
李小妹
石孟琼
熊兴军
李小琴
冯旻璐
许海燕
杨文雁
覃慧林
罗涛
ZHANG Jihong;LI Xiaomei;SHI Mengiong;XIONG Xiinjun;LI Xiaoqin;FENG Minlu;XU Haiyan;YANG Wenyan;QIN Huilin;LUO Tao(Department of Gastroenterology,Traditional Chinese Medicine Hospital of China Three Gorges University &Yichang Hospital of Traditional Chinese Medicine,Yichang 443001,Hubei,China;Hubei Key Laboratory of Natural Products Research and Development,College of Biological and Pharmaceutical Sciences,China Three Gorges University,Yichang 443002,Hubei,China;Experimental Center of Basic Medicine,College of Medical Sciences,China Three Gorges Universtiy,Yichang 443002,Hubei,China;Pharamacy Department,Changyang Hospital of Traditional Chinese Medicine,Changyang 443501,Hubei,China)
出处
《中国临床药理学与治疗学》
CAS
CSCD
2018年第10期1165-1173,共9页
Chinese Journal of Clinical Pharmacology and Therapeutics
关键词
木瓜三萜
溃疡性结肠炎
临床疗效
炎症因子
黏膜屏障保护因子
Muguasantie
ulcerative colitis
clinical efficacy
inflammatory factors
intestinal barrier protective factors
