中西医结合治疗溃疡性结肠炎

Experimental research on treatment of ulcerative colitis with integrative traditional Chinese and Western medicine

目的:探讨中西医结合灌肠治疗溃疡性结肠炎(ulcerative colitis,UC)的疗效及其作用机制．方法:建立小鼠UC动物模型后,中西医结合灌肠治疗,观察疗效并探讨其作用机制．结果:低、中、高剂量组及阳性对照组的疾病活动指数、病理组织学记分较阴性对照组有显著的统计学差异(5．10±4．07和8．00±6．38,0．80±1．87和1．30±1,49, 1．00±1．94和0．90±1．45,5．30±4．37和8．00±5．12,vs 8．60±1．26和13．20±1．69,所有P<0．05)．中剂量组的疾病活动指数、病理组织学记分较低剂量组、阳性对照组有显著的统计学差异(P<0．05),而与高剂量组比较无显著的统计学差异(P>0．05)．低、中、高剂量组及阳性对照组的IL-4组织含量较阴性对照组明显降低(P<0．05),而IFN-γ含量明显升高 (P<0．05)．结论:锡锡类散、地塞米松、庆大、黄连素结合灌肠治疗溃疡性结肠炎的疗效显著,其治疗作用可能是通过调节细胞因子IL-4、IFN-γ来实现的．

AIM： To explore the effect of the clyster treatment with integrated traditional Chinese and Western medicine on ulcerative colitis （UC）, and to investigate its mechanism. METHODS： The mouse model of UC was established, and then the rats were treated （clyster） with the combination of tin-like powder, dexamethasone, gentamicin, and berberine. Then the therapeutic effect was observed, and the mechanism of the treatment was analyzed. RESULTS： The disease active index （DAI） and histopathologic score （HPS） of the low dose （DAI： 5.10±4.07, HPS： 8.00±6.38）, the moderate dose （DAI： 0.80±1.87, HPS： 1.30±1.49）, the high dose （DAI： 1.00±1.94, HPS： 0.90±1.45）, and the positive control group （DAI： 5.30±4.37, HPS： 8.00±5.12） were markedly lower than those of the negative control group （DAI： 8.60±1.26, HPS： 13.20±1.69） （all P 〈0.05）. The DAI and HPS of the moderate dose group were markedly lower than those of the low dose group and the positive control group （all P 〈0.05）, but there was no significant difference between the moderate and high dose group （P 〉0.05）. The levels of interleukin-4 （IL-4） of the low, moderate, and high dose group, and the positive control group were markedly lower than those of the negative control group （32.33±15.30, 25.79±6.33, 29.92±12.81, 28.45±9.30 vs 63.89±11.31, all P 〈0.05）, but the levels of interferon-γ （IFNγ） were markedly higher than those of the negative control group （198.38±31.46, 187.49±13.04, 188.14±14.11, 207.64±41.44 vs 127.41±21.47, all P 〈0.05）. CONCLUSION： The combination enema of tin-like powder, dexamethasone, gentamicin, and berberine has definite therapeutic effect on UC, which may be related with its regulation on IL-4 and IFN-γ level.