莎尔福联合有益菌种对UC的效应及其机制

Clinical efficacy of Salofalk combined with beneficial bacteria in patients with ulcerative colitis

目的:比较单用莎尔福与有益菌种联合莎尔福治疗溃疡性结肠炎(ulcerative colitis,UC)的疗效,探讨其效应机制,为临床治疗UC提供科学用药依据.方法:将2010-09/2012-09于山东大学附属省立医院治疗UC的84例患者,采用随机分组法分为莎尔福组和联合用药组(n=42例),分别接受莎尔福与双歧三联活菌联合莎尔福的治疗方法.观察治疗期间两组的临床症状,采用Sutherland法分析两组患者的疾病活动指数,并比较两组的治疗总有效率和治疗前后的肠镜、病理组织学的分级变化.采用ELISA试剂盒(酶联免疫吸附剂测定法)测定患者血清中肿瘤细胞坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-8(interleukin-8,IL-8)及白介素-10(interleukin-10,IL-10)的水平,比较治疗前后炎症反应情况.结果:由Sutherland疾病活动指数总积分知,联合用药组(从5.36±1.01降至1.85±1.40)与莎尔福组(从5.42±1.53降至3.60±1.22)相比,下降幅度具有显著性差异(t=2.093,P=0.043).患者的治疗总有效率,联合用药组(92.8%)与莎尔福组(76.2%)相比,具有显著差异(P<0.05).经过治疗后,两组患者的TNF-α、IL-8水平均有所降低,联合用药组患者明显低于莎尔福组(P<0.05);而IL-10的水平均有所升高,联合用药组显著高于莎尔福组(P<0.05).结论:莎尔福与双歧三联活菌联合莎尔福对UC均有一定的治疗效应.联合有益菌种可以明显改善患者临床症状,提高治疗效果.其治疗作用机制可能与其显著减少炎症反应发生,提高免疫力减少复发有关.本研究虽没有更进一步的理论支持,但可为临床科学用药提供相关依据.

AIM： To compare the clinical efficacy of benefi-cial bacteria combined with Salofalk vs Salofalk alone in patients with ulcerative colitis （UC） and to explore the underlying mechanisms. METHODS： Eighty-four UC patients treated at our hospital from September 2010 to September 2012 were randomly and equally divided into two groups and treated with Bifidobacterium triple viable bacterial preparation with Salo- falk and Salofalk alone, respectively. The clini- cal symptoms in both groups were observed, and the Sutherland disease activity index was compared between the two groups. The total grade change of colonoscopy, pathological and therapeutic efficiency before and after treatment were also compared. ELISA assays were used to measure serum levels of tumor necrosis factor-α（TNF-α）, interleukin-8 （IL-8） and interleukin-10 （IL-IO）. RESULTS： After treatment, serum levels of TNF-α and IL-8 were decreased in both groups of patients, but the decline was more significant in the combined treatment group （P 〈 0.05）. Serum level of IL-10 in the combination group was significantly higher than that in the Salofalk group （P 〈 0.05）. Sutherland disease activity index score was decreased more significantly in the combined treatment group （from 5.36 ± 1.01 to 1.85 ±1.40） than in the Salofalk group （from 5.42 ± 1.53 to 3.60 ± 1.22） （t = 2.093, P = 0.043）. The total effective rate was significantly higher in the combined treatment group （92.8%） than in the Salofalk group （76.2%） （P 〈 0.05）. CONCLUSION： Salofalk combined with probiot- ics shows a good therapeutic effect for UC. Joint beneficial bacteria can significantly improve clinical symptoms and therapeutic effects possi- bly by reducing the inflammatory response and recurrence.