丹参注射液联合美沙拉嗪对轻中度活动期溃疡性结肠炎患者血清HIF-1α、炎症细胞因子水平的影响

Effects of Danshen Injection combined with mesalazine on serum HIF-1α and inflammatory cytokines levels in patients with mild to moderate active ulcerative colitis

目的观察丹参注射液联合美沙拉嗪对轻中度活动期溃疡性结肠炎患者血清组织缺氧诱导因子-1α(HIF-1α)及炎症细胞因子水平的影响。方法将78例轻中度活动期溃疡性结肠炎患者随机分为对照组与治疗组,每组39例。对照组予美沙拉嗪治疗,治疗组在此基础上加用丹参注射液。两组疗程均为2周,观察临床疗效,比较临床症状积分、血清HIF-1α、环氧化酶-2(COX-2)、炎症细胞因子水平及Sutherland疾病活动指数(DAI)、内镜下黏膜评分的变化情况。结果 (1)治疗组、对照组总有效率分别为92.31%、74.36%;治疗组临床疗效优于对照组(P<0.05)。(2)组间治疗后比较,治疗组腹泻、脓血便、腹痛、腹胀积分低于对照组(P<0.01)。(3)组间治疗后比较,治疗组DAI评分、内镜下黏膜评分低于对照组(P<0.05)。(4)组间治疗后比较,治疗组血清HIF-1α、COX-2、TNF-α、IL-6水平低于对照组(P<0.05),IL-10水平高于对照组(P<0.05)。结论丹参注射液联合美沙拉嗪治疗轻中度活动期溃疡性结肠炎疗效满意,与单纯使用美沙拉嗪相比,能更好地缓解患者的临床症状,促进肠黏膜修复,提高临床疗效,其机制可能与下调HIF-1α、上调IL-10的表达有关。

Objective To observe the effects of Danshen Injection combined with mesalazine on the serum levels of hypoxia inducible factor-1α（ HIF-1α） and inflammatory cytokines such as tumor necrosis factor-α（ TNF-α）,interleukin-6（ IL-6） and IL-10 in patients with mild to moderate active ulcerative colitis（ UC）.Methods 78 patients with mild to moderate active UC were randomly divided into the control group and treatment group,39 cases in each group.The control group was treated with mesalazine,and the treatment group was treated with Danshen Injection based on the treatment for the control group,with a course of 2 weeks.The clinical efficacy was observed.The changes on clinical symptom scores,serum levels of HIF-1α,cyclooxygenase-2（ COX-2） and inflammatory cytokines,Sutherland disease activity index（ DAI） score and endoscopic mucosal score were compared.Results（1）The total effective rates were 92.31% in the treatment group and74.36% in the control group,and the clinical efficacy of the treatment group was better than that of the control group（ P〈0.05）.（2）After treatment,the scores of diarrhea,pus and blood stool,abdominal pain and abdominal distension in the treatment group were lower than those in the control group（ P〈0.01）.（3） After treatment,the DAI score and endoscopic mucosal score in the treatment group were lower than those in the control group（ P〈0.05）.（4）After treatment,the serum levels of HIF-1α,COX-2,TNF-α and IL-6 in the treatment group were lower than those in the control group（ P〈0.05）,and the IL-10 level in the treatment group was higher than that in the control group（ P〈0.05）.Conclusion Danshen Injection combined with mesalazine shows satisfactory efficacy in treatment of mild to moderate active ulcerative colitis,compared with mesalazine alone,it can better relieve the clinical symptoms of patients,promote the intestinal mucosal repair and enhance the clinical efficacy.Its mechanism may be associated with down-regulating HIF-1α expression and up-regulating IL-10 expression.