益气愈溃汤对溃疡性结肠炎IL-33、IL-10及肠道菌群紊乱的纠正作用

Rectification of Disorder of Serum IL-33 and IL-10 and Intestinal Flora of Patients with Ulcerative Colitis by Yiqi Yukui Decotion

目的:通过观察血IL-33、IL-10水平及肠道菌群分布变化探讨益气愈溃汤治疗溃疡性结肠炎(ul-cerative colitis,UC)活动期患者的作用机制。方法:64例UC患者随机分为治疗组(n=33)和对照组(n=31)。入组后,两组患者均予常规对症支持处理并口服美沙拉嗪1.0 g/次,每天3次,连续2个月。治疗组在此基础上予以益气愈溃汤1剂/d,3周为1疗程,服用2个疗程。两疗程中间间隔1周。观察患者治疗前后临床症状、血IL-33、IL-10浓度及肠道菌群分布的变化。结果:治疗组痊愈率(60.6%)显著优于对照组(35.5%),(χ2=4.039,P=0.044);乳酸杆菌和双歧杆菌数量亦均高于对照组,差异有统计学意义(t=2.32,P<0.05;t=2.81,P<0.01)。治疗后,两组IL-33均较前降低,治疗组显著低与对照组(t=2.41,P<0.05);两组IL-10含量均较前增加,治疗组明显高于对照组(t=2.83,P<0.01)。同时,血IL-33水平与乳酸杆菌及双歧杆菌的数量均呈负相关(r=-0.605,P<0.05;r=-0.721,P<0.01);IL-10水平与乳酸杆菌及双歧杆菌的数量呈正相关(r=0.594,P<0.05;r=0.681,P<0.01);而IL-33与IL-10水平亦呈显著负相关关系(r=-0.725,P<0.01)。结论:益气愈溃汤可通过改善肠道菌群紊乱状态,纠正促炎因子IL-33及抑炎因子IL-10的平衡紊乱,提高UC活动期患者的临床痊愈率。

Objective ： To explore the mechanism of Yiqi Yukui Decotion on patients with ulcerative colitis （ UC ） by detecting the serum IL - 33, IL - 10 and intestinal flora. Methods ： 64 cases with UC were randomly divided into 2 groups, control group （n = 31 ） and treatment group （n = 33 ）. Both were applied with routine nursing and Mesalamine 1.0 g three times a day, lasting for 2 months. The treatment group was handled with Yiqi Yukui Decotion 1 dose per day based on the control group. 3 weeks was as a course and the two groups were treated for 2 courses. There was an interval of one week between the 2 courses. Clinical symptom, serum IL - 33 and IL - 10, as well as the intestinal flora distribution before and after treatment was detected. Results ： Cure rate of the treatment group as well as the amount of Laetobacillus and Bifidobacterium was increased when adding Yiqi Yukui Decotion, with statistical significance as compared with the control group. After therapy, serum IL - 33 concentration of both two groups were decreased remarkably while IL - 10 increased, and both IL - 33 and IL - 10 had a statistically significant difference between the two groups （ t = 2.41,2.83, P 〈 0.01 -0.05 ）. Moreover, there was a negative correlation between IL- 33 and the Lactobacillus （r = -0.605, P 〈 0.05 ） , and the Bifidobacterium（ r = - 0.721,P 〈 0.01 ） , as well as IL - 10 （ r = - 0. 725,P 〈 0.01 ） ; while there was a positive correlation between IL - 10 and the Lactobaeillus（ r = 0. 594, P 〈 0.05 ）, and the Bifidobacterium （ r = 0.681, P 〈 0.01 ）. Conclusions ： Yiqi Yukui Decotion could elevate the cure rate of UC by rectificating the disorder of serum IL - 33 and IL - 10, as well as the intestinal flora distribution.