思连康与美沙拉秦对溃疡性结肠炎患者肠黏膜TLR4、NF-κb表达与肠道菌群的影响

Clinical Efficacy of Siliankang Combining with Mesalazine in Treatment of Ulcerative Colitis and Effects on Intestinal Mucosa TLR4 and NF-κb Expressions and Intestinal Microflora

目的:探讨思连康联合美沙拉秦用于溃疡性结肠炎的疗效及对肠道黏膜肠黏膜Toll样受体(TLR)4、核转录因子(NF)-κb表达与肠道菌群的影响。方法:选择2015年1月至2017年1月我院接诊的92例溃疡性结肠炎患者,通过随机数表法分为观察组(n=46)和对照组(n=46),对照组给予美沙拉秦肠溶片治疗,观察组联合思连康治疗,均连续治疗6周。比较两组治疗前后临床症状评分、Baron内镜评分、肠粘膜TLR4、NF-κb表达、肠道菌群数量的变化及不良反应的发生情况。结果:治疗后,两组临床症状评分、Baron内镜评分均较治疗前均明显降低(P<0.05),且观察组腹痛、腹泻、脓血便及Baron内镜评分均明显低于对照组(P<0.05);两组肠粘膜TLR4、NF-κb的表达较治疗前均明显降低(P<0.05),且观察组肠粘膜TLR4、NF-κb表达均明显低于对照组(P<0.05);两组双歧杆菌、乳杆菌、酵母菌、梭菌数量较治疗前均显著改变(P<0.05),且观察组双歧杆菌、乳杆菌数量明显多于对照组,酵母菌、梭菌数量明显少于对照组(P<0.05);两组治疗过程中均未有明显不良反应,差异无统计学意义(P>0.05)。结论:思连康联合美沙拉秦治疗溃疡性结肠炎的临床效果显著,可有效缓解临床症状,促进粘膜修复,其内在机制可能和降低肠粘膜TLR4、NF-κb的表达及调节肠道微生态平衡相关。

Objective： To study the curative efficacy of siliankang combining with mesalazine in the treatment of ulcerative colitis and effects on the intestinal mucosa toll like receptor （TLR4）, nuclear factor （NF-κb） expressions and intestinal microflora. Methods： 92 patients with ulcerative colitis who were treated from January 2015 to January 2017 in our hospital were selected and divided into the ob- servation group （n=46） and the control group （n=46） according to random number table. The control group was treated with mesalazine, while the observation group was combined with siliankang, they were continuously treated for 6 weeks. The changes of clinical symptom score, Baron endoscopy score, intestinal mucosal TLR4 and NF-κb expressions and intestinal flora before and after treatment as well as the incidence of adverse events were compared between the two groups. Results： After treatment, the clinical symptom score and Baron endoscopic score of both groups were significantly lower than those before treatment （P 〈 0.05）; the bellyache, diarrhea, pus and blood stool and endoscopic Baron score in the observation group were significantly lower than those of the control group （P〈0.05）; the intestinal mucosal TLR4 and NF-κb expressions of both groups were significantly lower than those before treatment （P 〈 0.05）; the intestinal mu- cosal TLR4 and NF-κb expressions in the observation group were significantly lower than those of the control group （P〈0.05）; the num- ber of bacillus bifidus, lactobacilli, microzyme and clostridium of both groups was significantly changed compared with those before treatment （P〈0.05）; the number of bacillus bifidus, and lactobacilli of observation group were significantly higher than those of the con- trol group, the number ofmicrozyme and clostridium were significantly lower than those of the control group（P〈0.05）; there was no ob- vious adverse reaction in the two groups （P〉0.05）. Conclusion： Siliankang combined with mesalazine can effectively relieve the clinical symptoms and promote mucosal repair of patients with ulcerative colitis, the underlying mechanism may be related to the reduction of in- testinal mucosal TLR4 and NF-κb expressions and the regulation the intestinal microecological balance.