白头翁汤对溃疡性结肠炎黏膜愈合影响及部分机制研究.docVIP

白头翁汤对溃疡性结肠炎黏膜愈合影响及部分机制研究 　　摘要：目的 检测溃疡性结肠炎（UC）患者血清肿瘤坏死因子-α（TNF-α）和白细胞介素-10（IL-10）水平，探讨白头翁汤治疗UC的临床疗效、对结肠黏膜愈合的影响及其机制。方法 将66例UC患者随机分为治疗组和对照组，分别给予白头翁汤内服联合灌肠及口服美沙拉嗪缓释颗粒，疗程4周。采用Mayo评分系统及Baron内镜评分法评定UC活动度及临床疗效，采用ELISA检测血清TNF-α、IL-10水平，并与20名健康对照者进行比较。结果 治疗组内镜缓解率为51.4%（19/35），高于对照组的25.8%（8/31），差异有统计学意义（P0.05）。血清TNF-α水平与Mayo评分、Baron评分及组织学评分均呈明显正相关（r分别为0.836、0.735、0.527，P0.01），血清IL-10水平与Mayo评分、Baron评分及组织学评分均呈明显负相关（r分别为-0.704、-0.695、-0.509，P0.01）；治疗组治疗后血清TNF-α水平较治疗前明显降低（P0.05），血清IL-10水平较治疗前明显升高（P0.05）。结论 白头翁汤内服联合灌肠治疗活动性UC安全有效，其作用可能与改善促炎因子与抗炎因子失衡、促进肠黏膜愈合有关。 　　关键词：溃疡性结肠炎；白头翁汤；肿瘤坏死因子-α；白细胞介素-10 　　DOI：10.3969/j.issn.1005-5304.2016.07.008 　　中图分类号：R259.741 文献标识码：A 文章编号：1005-5304（2016）07-0030-05 　　Effects of Baitouweng Decoction on Intestinal Mucosal Healing of Ulcerative Colitis and Study on Partial Mechanism TAN Zhao-hui， LIU Rong-huo， ZOU Li-hua， CAO Ping， HU Hong-song （Longgang District People’s Hospital of Shenzhen， Shenzhen 518172， China） 　　Abstract： Objective To detect the levels of tumor necrosis factor-α （TNF-α） and interleukin 10 （IL-10） in the plasma of patients with ulcerative colitis （UC）； To investigate the clinical efficacy of Baitouweng Decoction for UC and its influence on intestinal mucosal healing and partial mechanism. Methods Totally 66 patients with UC were randomly assigned to the treatment group and the control group. Patients in the treatment group were treated with Baitouweng Decoction （oral and enema treatment） and those in the control group took Mesalazine for 4 weeks. Before and after treatment， the therapeutic effects were assessed by Mayo scoring system and the grading of activities was evaluated by Baron Endoscope. Serum levels of TNF-α and IL-10 were detected by ELISA. Besides， another 20 healthy volunteers were recruited as the healthy control group for comparison. Results The endoscopic remission rate was 51.4% （19/35） in treatment group， higher than that of the control group （25.8%， 8/31， P0.05）. Serum levels of TNF-α were obviously positive c