大肠湿热型溃疡性结肠炎患者Toll-like受体表达及溃结灵的干预作用

Effect of Kuijieling Granule(KG) on Toll-like Receptor and Other Lndexs in the Patient of Ulcerative Colitis of Damp Heat In the Large Intestine Stagnation Type

目的观察溃结灵颗粒配合柳氮磺胺吡啶(SASP)对大肠湿热型溃疡性结肠炎(UC)的疗效。方法将活动期UC(大肠湿热证)患者随机分为治疗组予(溃结灵和SASP)和对照组(予SASP),以中医证候疗效、肠黏膜病变、主要症状积分作为观察指标;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2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;两组腹泻、腹痛、腹胀、脓血便、黏液便、里急后重症状均有明显改善,治疗组多项症状改善较对照组更明显。随着病变组分级程度的增高,患者TLR2的蛋白表达逐渐增强,治疗组治疗后TLR2的蛋白表达明显减少;对照组则无明显变化。结论溃结灵配合SASP有确切的治疗UC作用,其可能是通过抑止TLR4和CD14蛋白表达,减弱CD14和TLR2的协同作用,抑止TLR2依赖的脂蛋白(BLP)信号转导,进而磷酸化激活κB的功能减弱,使损伤的内皮细胞得以修复。

Objective： To observe the effect of Kuijieling Granule （KG） combined with SASP in treating ulcerative colitis（UC）. Methods： The patients of active UC （dampheat syndrome） were randomly divided into treatment group （KG and SASP） and control group （SASP only） to observe pathological changes of the mucosa, syndrome effect and main symptoms scores. The protein expression of TLR2 in all cases were detected by immunohisissions. Results： The treatment group had better effect than control group in syndrome and the mucosa effect, about eliminating the syndrome such as diarrhea, abdomenache, hurbulence and tenesmus. There was no difference in eliminating the syndrome about sanguinopundent stool and pituitousstool. There were outstanding differences among the pathologc grade of UC about IA of TLR2. The expression of TLR2 were decreased by treatment. About the treatment group, there was a obvious decline in the balance of TLR2. Conclusion： KG combined with SASP has definite effect on UC. It probably controls the protein expression of TLR4 and CD14, singal conduction of BLP depend on by TLR2 and makres endothelial cells restored.