清化宁络方联合美沙拉秦治疗轻中度溃疡性结肠炎活动期疗效及对炎性因子和结肠黏膜组织中MHC-Ⅱ类分子表达影响

Effect of Qinghua Ningluo decoction combined with salad diazoxide on mild to moderate ulcerative colitis in active stage and on the expression of MHC-Ⅱ and inflammatory factors in colonic mucosa

目的观察清化宁络方联合美沙拉秦治疗轻中度溃疡性结肠炎活动期患者的临床疗效及对炎性因子和结肠黏膜组织中MHC-Ⅱ类分子表达影响。方法将64例溃疡性结肠炎轻中度活动期患者随机分为2组,西药组32例给予美沙拉秦口服,中西医结合组32例给予美沙拉秦联合清化宁络方治疗,治疗1个月后,统计2组中医证候疗效、综合疗效,观察2组治疗前后血沉、C反应蛋白、TNF-α水平变化情况,免疫组化SP法检测2组治疗前后结肠黏膜组织中MHC-Ⅱ类分子表达情况。结果治疗后中西医结合组中医证候疗效、综合疗效均明显优于西药组(P均<0.05);2组治疗后血沉、C反应蛋白、TNF-α水平及结肠黏膜组织中MHC-Ⅱ类分子表达量均显著降低(P均<0.05),且中西医结合组血清TNF-α水平及结肠黏膜组织中MHC-Ⅱ类分子表达量均明显低于西药组(P均<0.05),而2组治疗后血沉及C反应蛋白水平比较差异均无统计学意义(P均>0.05)。结论清化宁络方联合美沙拉秦治疗轻中度溃疡性结肠炎活动期患者疗效好,可明显减轻炎症反应,降低结肠黏膜组织中MHC-Ⅱ类分子表达。

Objective It is to observe the clinical effect of Qinghua Ningluo decoction combined with salad diazoxide on mild to moderate ulcerative colitis in active stage and on the expression of MHC- Ⅱ and inflammatory factors in colonic muco- sa. Methods Sixty-four patients with stage mild to moderate in active stage were randomly divided into combination treatment group including 32 cases who were treated with Qinghua Ninglno decoction combined with salad diazoxide, and western medi- cine group including 32 cases who were treated with salad diazoxide only. After treatment for a month, the comprehensive cur- ative effect,TCM syndrome curative effect were evaluated,the levels of ESR and C-reactive protein, serum TNF -α level were determined by ELISA,MHC-Ⅱ expression in colonic mucosa was detected by immunohistochemical SP before and after treat- ment. Results After treatment ,the TCM syndrome curative effect, comprehensive curative effect in combination group were better than that in western medicine group （P 〈 0.05 ） ; the levels of ESR, CRP, serum TNF-α and MHC- Ⅱ molecule expression in colonic mucosa were decreased significantly after treatment in both groups（P 〈 0.05） , and the serum level of TNF alpha and MHC- Ⅱ molecule expression in colon mucosa in combination group decreased more than western medicine group （P 〈 0.05 ） , but there was no significant difference in ESR and C-reactive protein level between the two groups （ P 〉 0.05 ）. Conclusion Qinghua Ningluo decoction combined with salad diazoxide has good curative effect on mild to moderate ulcerative colitis in active stage, which could relieve inflammatory reaction, decrease the expression of MHC-Ⅱin colonic mucosa.