穴位埋线对溃疡性结肠炎的疗效评价及对NF-κB和5-LOX表达的影响

Effect Evaluation on Ulcerative Colitis Treated by Acupoints Catgut Embedding and the Influence on the Expression of NF- κB and 5- LOX

目的:通过检测结肠黏膜NF-κB p65及5-LOX的表达情况,探讨穴位埋线对溃疡性结肠炎(UC)的治疗效果。方法:选取活动期轻、中度UC患者60例,随机分为三组,即埋线组、拉嗪组和联合组,每组20例,另设20例健康体检者作为对照组,于治疗前后评估临床症状及结肠镜下病变活动性,ELISA法测定血清IL-8和TNF-α血清水平。然后分别运用RT-PCR及免疫组化检测SP法检测结肠黏膜5-LOX和NF-κB p65的mRNA及其蛋白在各组治疗前后的表达情况。结果:治疗后三组临床症状和结肠镜下病变活动性较治疗前有明显改善(P<0.05),且联合组的临床症状和结肠镜下病变活动性与穴位埋线组和美沙拉嗪组相比改善较为明显(P<0.05)。而且治疗后三组的IL-8和TNF-α血清水平明显低于对照组和治疗前。此外治疗前,三组患者结肠黏膜5-LOX和NF-κB p65的mRNA及蛋白表达亦明显高于对照组(P<0.05),治疗6周后,5-LOX和NF-κB p65的mRNA及蛋白表达较治疗前有明显下降(P<0.05)。结论:穴位埋线疗法联合美沙拉嗪治疗活动期轻、中度UC的疗效较好,其机制可能是通过抑制5-LOX和NF-κB p65的表达而起到治疗作用。

Objective： Evaluating the therapeutic effect of acupoint catgut embedding for ulcerative colitis（ UC） by observing the expression level of NF-κB p65 and 5-LOX in colonic mucosa. Methods： 60 patients with mild to moderate active UC were randomly divided into three groups： embedding group,mesalazine group and combination group and 20 cases in each group,and20 cases of healthy as controlled group. The changes of clinical symptoms and disease activity under endoscopy were evaluated before and after the treatment. Levels of serum interleukin- 8（ IL- 8） and tumor necrosis factor- alpha（ TNF- α） were detected by ELISA. The RT-PCR and immunohistochemistry SP were used to detect the expression level of NF-κB p65 and 5-LOX mRNA and protein in the colonic mucosa in both UC patients and normal controlled group. Results： The clinical symptoms and disease activity under endoscopy were improved more after the treatment in these three groups,and the clinical symptoms and disease activity under endoscopy were improved more in combination group than in acupoint catgut embedding and mesalazine group（ P〈0. 05）. Compared with the controlled group and before treatment,the serum levels of IL-8and TNF-α of the treatment group were significantly decreased（ P〈0. 05）. Moreover,the mRNA and protein expression of 5-LOX and NF-κB p65 were significantly higher compared with the controlled group and before treatment（ P〈0. 05）. The mRNA and protein expression of 5-LOX and NF-κB p65 were significantly decreased after 6weeks treatment in the three groups,and the expression of them was significantly lower in the combination group than that in the acupoint catgut embedding and the mesalazine group（ P〈0. 05）. Conclusion： The combination of acupoint catgut embedding and mesalazine is more effective than acupoint catgut embedding and mesalazine alone in treatment of mild to moderate active UC,and the mechanism probably by decreasing expression of 5-LOX and NF-κB p65.