摘要
目的:观察木瓜三萜与瑞巴派特联用治疗非甾体抗炎药(NSAIDs)致小肠损伤的临床疗效、安全性及炎症因子和肠黏膜屏障保护因子的影响。方法:将入选的96例NSAIDs致小肠损伤患者完全随机分为对照组和治疗组,各组各48例。对照组口服给予瑞巴派特0. 3g,治疗组在给予瑞巴派特的同时加服木瓜三萜0. 375g,每天3次,疗程8周,记录2组患者每天的腹泻次数,评价腹胀、腹痛、腹泻症状改善情况、治疗效果及安全性;检测外周血中肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1β、IL-6、γ-干扰素(IFN-γ)、IL-4、IL-10、黏蛋白2(MUC2)、肠三叶因子(TFF3)含量及髓过氧化物酶(MPO)活性。结果:治疗后,治疗组的总有效率(87. 50%)明显高于单用瑞巴派特(66. 67%)对照组,不良反应的发生率明显低于对照组;腹泻次数,腹痛、腹胀和腹泻症状积分明显低于对照组;血液中TNF-α、IL-1β、IL-6、IFN-γ含量和MPO活性较对照组明显降低,IL-4、IL-10、MUC2和TFF3含量较对照组明显升高。结论:木瓜三萜与瑞巴派特联用对NSAIDs致小肠损伤患者有良好的治疗效果和较低的不良反应,抑制促炎因子的产生、恢复促炎和抗炎因子之间的平衡及增加肠黏膜屏障保护因子的表达可能是其发挥作用的机制之一。
Objective： To investigate the clinical efficacy of Muguasantie combined with Rebamipide in the treatment of small bowel injury induced by nonsteroidal anti-inflammatory drugs（NSAIDs）,safety,inflammatory and intestinal barrier protective factors. Methods： 96 patients with small bowel injury induced by NSAIDs were randomly divided into the control group and treatment group,48 cases in each group. The control group was given Rebamipide 0. 3 g each time,while the treatment group was given Rebamipide plus Muguasantie 0. 375 g each time,3 times a day for 8 weeks. The diarrhea was recorded,the improvements of diarrhea,abdominal pain and bloating,safety,and clinical efficacy were evaluated,the contents of tumor necrosis factor（TNF）-α,interleukin（IL）-1β,IL-6,interferon（IFN）-γ,IL-4,IL-10,mucin 2（MUC2）,trifolium factor 3（TFF3） and myeloperoxidase（MPO） activity in the peripheral blood were detected respectively. Results： After treatment,the total effective rate of the treatment group（87. 50%） was significantly better 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 times of diarrhea were significantly relieved than that of before treatment in both groups,and the treatment group was better in the both groups（P 〈 0. 05 or P 〈 0. 01,respectively）,the symptom scores of diarrhea,abdominal pain and bloating were significantly lower 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 and MPO activity were significantly lower,and IL-4,IL-10,MUC2 and TFF3 in the peripheral blood were significantly higher than those of the control group（P 〈 0. 05 or P 〈 0. 01,respectively）. Conclusion： The combination of Muguasantie with Rebamipide has good therapeutic effect and low side effect on small bowel injury patients induced by NSAIDs,its mechanism is relative 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
贺海波
李小妹
李小琴
覃慧林
李爽
陈刚
周琴
张永峰
罗涛
张继红
向长青
He Haibo;Li Xiaomei;Li Xiaoqin;Qin Huilin;Li Shuang;Chen Gang;Zhou Qin;Zhang Yongfeng;Luo Tao;Zhang Jihong;Xiang Changqing(College of Biological and Pharmaceutical Sciences,China Three Gorges University;Traditional Chinese Medicine Hospital of China Three Gorges University ＆ Yichang Hospital of Traditional Chinese Medicine;Renhe Hospital of China Three Gorges University;The Second People＇s Hospital of China Three Gorges University ＆ Yichang Second Hospital,Yichang 443002)
出处
《中药药理与临床》
CAS
CSCD
北大核心
2018年第4期172-176,共5页
Pharmacology and Clinics of Chinese Materia Medica
基金
三峡大学硕士学位论文培优基金(No.2017YPY086
2018SSPY140)
湖北省生物酵素技术研究中心开放基金(No.JS2018-06)
关键词
木瓜三萜片
瑞巴派特片
非甾体抗炎药
小肠损伤
临床疗效
炎症因子
黏膜屏障保护因子
Muguasantie tablet
Rebamipide tablet
nonsteroidal anti-inflammatory drugs
small bowel injury
clinical efficacy
inflammatory factors
intestinal barrier protective factors
