溃结灵颗粒对大肠湿热型溃疡性结肠炎患者Toll-like受体等指标的影响

Effect of Kuijieling Granules on Toll-like Receptor and Other Indexs in the Patient of Ulcerative Colitis of Damp Heat in the Large Intestine Stagnation Type

目的观察中药溃结灵颗粒配合柳氮磺胺吡啶(SASP)对活动期溃疡性结肠炎(UC)的疗效,探讨溃结灵颗粒治疗溃疡性结肠炎的机制。方法活动期UC(大肠湿热证)患者随机分为治疗组(溃结灵颗粒+SASP)和对照组(SASP),观察中医证候疗效、肠黏膜病变、主要症状积分变化。采用常规免疫组化S-P法检测治疗前后肠黏膜组织内的Toll-like受体4(TLR4)、CD14、核因子-κBp65(NF-κBp65)的蛋白表达情况。结果治疗组中医证候疗效、肠黏膜疗效高于对照组(P<0.05)。2组在改善腹泻、腹痛、腹胀、脓血便、黏液便、里急后重症状方面,治疗后较治疗前均有明显改善(P<0.01,P<0.05)。治疗组在改善腹泻、腹痛、腹胀、里急后重方面较对照组作用明显(P<0.01,P<0.05)。TLR4、CD14、NF-κBp65的IA值在UC病理分级间的表达差异有统计学意义(P<0.01)。2组治疗后TLR4、CD14、NF-κBp65表达较治疗前明显减少(P<0.01,P<0.05)。2组TLR4、CD14与NF-κBp65蛋白表达治疗后差值比较有显著性差异(P<0.01,P<0.05)。结论溃结灵颗粒配合SASP有确切的治疗UC的作用,效果显著。很可能是通过抑制TLR4和CD14蛋白表达、阻断其受体蛋白,磷酸化激活κB的功能减弱,使损伤的内皮细胞得以修复,继而达到治疗UC的目的。

Objective To observe the effect and study intervenient action of Kuijieling Granules （KG） in treating ulcerative colitis （UC） during the active period by the clinical experiment. Methods The patients of active UC （damp-heat syndrome） were randomly divided into 2 groups （KG＋SASP group and SASP group） to observe pathological changes of the mucosa, syndrome effect and main symptoms scores, and the protein expression of TLR4, CD14 and NF-K B p65 were detected by immunohistochemistry. Reults KG＋SASP group had better effect than SASP group in syndrome and mucosa （P〈0.05）. KG＋SASP group had better effect than SASP group on eliminating the syndrome such as diarrhea, abdomenache, burbulence and tenesmus （P〈0.05）. There was no difference in eliminating the syndrome about sanguinopurulent stool and pituitous stool （P〉0.05）. There were outstanding differences among the pathologic grade of UC about IA of TLR4, CD14 and NF-K B p65. The expression of TLR4, CD14 and NF-K B p65 were decreased by treatment （P〈0.01, P〈0.05）. About the KG＋SASP group, there was a obvious decline in the balance of TLR4, CD14 and NF- K B p65 （P〈0.01, P〈0.05） compared with SASP group. Conclusion KG has definite effect on UC. It probably controls the protein expression of TLR4 and CD14, and makes endothelial cells restored.