摘要
[目的]探讨柴芍六君汤加味方对溃疡性结肠炎(UC)患者的临床疗效以及对TLR4/MyD88/NF-κB信号通路的影响。[方法]选择2016年9月～2018年6月期间在我院消化科就诊的UC患者105例,随机分为对照组(49例)和观察组(56例)。对照组患者给予美沙拉嗪肠溶片,观察组患者给予柴芍六君汤加味方,连续给药12周。观察并评估治疗前后患者中医临床症状、临床疗效、肠镜下Barson内镜积分及安全性。采用ELISA法检测白介素(IL)-4、-10、-17,Toll样受体(TLR4)、髓样分化因子88(MyD88)、核因子-κB(NF-κB)水平。[结果]对照组和观察组患者总有效率分别为75.00%和90.91%,观察组患者治疗总有效率明显高于对照组患者(P<0.05)。治疗后,2组患者中医症状积分和Barson内镜积分均较治疗前有所降低,且观察组患者中医症状积分明显低于对照组(P<0.05),而2组患者治疗后Barson内镜积分差异无统计学意义。另外,治疗后观察组患者IL-4、IL-10水平较治疗前以及对照组都明显升高,而IL-17、TLR4、MyD88、NF-κB水平较治疗前和对照组均有所降低(P<0.05);对照组患者IL-4、IL-10水平较治疗前明显升高,TLR4、MyD88、NF-κB水平均较治疗前有所降低(P<0.05),但是IL-17水平与治疗前比较差异无统计学意义。[结论]柴芍六君汤加味方可能通过负性调控TLR4/MyD88/NF-κB信号通路有效改善UC患者的临床症状和病变结肠的严重程度,且安全可靠。
[Objective]To investigate the clinical efficacy of Chaishao Liujun Jiawei decoction in treatment of ulcerative colitis(UC)patients and the effect on Toll-like receptor 4/myeloid differentiation factou/nuclear factor-κB(TLR4/MyD88/NF-κB)signaling pathway.[Methods]105 UC patients admitted to our hospital from September 2016 to June 2018 were randomly divided into control group(mesalazine,n=49)and observation group(Chaishao Liujun Jiawei decoction,n=56).The patients in the control group were given mesalazine enteric-coated tablets,and the patients in the observation group were given Chaiqi Liujun Jiawei Decoction.After 12 weeks of treatment,the clinical syndrome,clinical effect,Barson scores by colonic endoscopy were observed and compared between the two groups.The serum IL-4,IL-10,IL-17,TLR-4.MyD88,NF-κB levels were detected by ELISA.[Results]The total effective rate of observation group was90.91%,which was higher than control group(75.00%)(P<0.05).After 12 weeks of treatment,the clinical syndrome scores and Barson endoscopic scores of patients in 2 groups were both lower than beforetreatment(P<0.05).And the clinical syndrome score of patients in observation group was significantly lower than control group(P<0.05).But there was no difference of Barson scores between observation group and control group.Besides,the levels of Il-4 and Il-10 were significantly increased in the observation group after treatment compared with those before treatment and the control group,while levels of IL-17,TLR4,MyD88,and NF-κB were significantly lower in the observation group than those before treatment and the control group(P<0.05);but IL-17 levels of patients in control group after treatment was no different from before treatment.[Conclusion]It’s suggested that chaishao liujun jiawei decoction can be effectively improve the clinical symptoms and reduce the degree of inflammation of colonic lesions by inhibiting the activation of TLR4/MyD88/NF-κB pathway,which is worthy of clinical promotion.
作者
崔娜娟
杨俭勤
CUI Na-juan;YANG Jian-qin(Department of Gastroenterology,Beijing Municipal Integrated Traditional Chinese and Western Medicine Hospital,Beijing 100039,China;Department of Spleen and Stomach Diseases,Wangjing Hospital,ChineseAcademy of Chinese Medical Sciences,Beijing 100102,China)
出处
《中国中西医结合消化杂志》
CAS
2018年第12期992-997,共6页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
