伴有食物不耐受的腹泻型肠易激综合征患者NF-κB和TLR4的表达及健脾法对其表达的影响

Expressions of NF-κB and TLR4 in patients with diarrhea-predominant irritable bowel syndrome complicating with food intolerance and the influences of invigorating spleen decoctions on them

目的观察伴有食物不耐受的腹泻型肠易激综合征(D-IBS)患者十二指肠黏膜中NF-κB和TLR4的表达及健脾法对其表达的影响。方法选择60例伴有食物不耐受的D-IBS患者,随机分为治疗组30例和对照组30例。治疗组口服健脾为主的中药,每日1剂;对照组口服匹维溴铵片,50 mg/次,每日3次,治疗4周后进行疗效评价。治疗前后内镜下取十二指肠黏膜,应用免疫组化方法检测NF-κB和TLR4的表达情况。结果治疗组总有效率(93%)显著高于对照组(70%)(P<0.01);2组治疗后主要症状评分均显著低于治疗前。治疗前2组NF-κB和TLR4免疫组化染色阳性细胞数无显著性差异,治疗后治疗组NF-κB和TLR4免疫组化染色阳性细胞数显著低于对照组(P均<0.05)。结论 NF-κB和TLR4参与伴有食物不耐受的D-IBS患者的发病,健脾法治疗伴有食物不耐受的D-IBS有效,有可能与通过调节NF-κB和TLR4在肠黏膜的表达有关。

Objective It is to observe the expressions of NF-κB and TLR4 in patients with diarrhea-predominant irritable bowel syndrome（D-IBS） complicating with food intolerance and the influences of invigorating spleen decoctions on them.Methods 60 food intolerance patients with D-IBS were assigned randomly to treatment group and control group,each group had 30 cases.The treatment group was treated with invigorating spleen decoctions once a day,and the control group was treated with pinaverium bromide tablet（PVB） 50 mg three times a day.The curative effects were evaluated after 4 weeks.The expressions of NF-κB and TLR4 in duodenal mucosa were detected with immunohistochemistry method before and after treatment.Results The total effective rate of treatment group（93%） was significantly higher than that of control group（70%）（P0.01）.The scores of main symptoms after treatment were significantly lower than that before treatment in both groups（P0.01）.There was no significant difference between two groups in the expression of NF-κB and TLR4 pre-treatment.The expression of NF-κB and TLR4 in treatment group after therapy was significantly lower than that of control group（P0.05）.Conclusion NF-κB and TLR4 play a role in the pathogenesis of D-IBS with food intolerance patients.The method of invigorating spleen is effective for treating D-IBS with food intolerance,which maybe due to regulate the expressions of NF-κB and TLR4 in duodenal mucosa.