自拟扶正平溃汤联合针灸治疗慢性溃疡性结肠炎的疗效及对肠道菌群失调和Th17/Treg细胞免疫平衡的影响

Effect of Fuzheng Pingkui Decoction combined with acupuncture on chronic ulcerative colitis and its effects on intestinal dysbacteriosis and Th17/Treg cell immune balance

目的观察自拟扶正平溃汤联合针灸治疗慢性溃疡性结肠炎的疗效及对肠道菌群失调和Th17/Treg细胞免疫平衡的影响。方法将100例慢性溃疡性结肠炎患者随机分为观察组50例和对照组50例,2组均给予常规西医治疗,观察组在常规治疗基础上给予针灸联合自拟扶正平溃汤治疗,2组疗程均为3个月。记录2组治疗前后主要临床症状体征、结肠炎症评分、肠道菌群及Th17/Treg细胞免疫平衡变化情况。结果 2组治疗后腹痛、腹胀、大便次数、大便性状、血便、食少纳差、神疲少言、肢体乏倦评分均显著降低(P均<0.05),观察组上述评分均低于对照组(P均<0.05);2组治疗后结肠炎症评分均有显著改善(P均<0.05),观察组中0分、1分的比例高于对照组(P均<0.05),3分、4分的比例低于对照组(P均<0.05);2组治疗后双歧杆菌、乳酸杆菌数量均升高(P均<0.05),大肠埃希菌、肠球菌数量均减少(P均<0.05),观察组上述菌群的改善情况优于对照组(P均<0.05);2组治疗后Th17细胞比例、Th17/Treg比值显著降低,Treg细胞比例显著升高,观察组上述细胞比例改善情况优于对照组(P均<0.05)。结论自拟扶正平溃汤联合针灸能够显著缓解慢性溃疡性结肠炎患者的临床症状体征,抑制患者肠道黏膜炎性损害,机制可能与改善肠道菌群失调,促进Th17/Treg细胞免疫平衡,从而抑制炎性反应有关。

Objective It is to observe the effect of self-made Fuzheng Pingkui decoction combined with acupuncture on chronic ulcerative colitis and its effect on intestinal dysbacteriosis and Th17/Treg cell immune balance.Methods One hundred patients with chronic ulcerative colitis were randomly divided into observation group(50 cases)and control group(50 cases).Both groups were treated with conventional western medicine,additionally,the observation group was given self-made Fuzheng Pingkui Decoction combined with acupuncture.Both groups were treated for 3 months.The changes of main clinical symptoms and signs,colon inflammation scores,intestinal flora,and Th17/Treg cell immune balance before and after treatment were recorded in both groups.Results After treatment,the scores of abdominal pain,bloating,stool frequency,stool traits,bloody stools,poor appetite,weak fatigue,and tired limbs were significantly reduced in both groups(P<0.05),and the scores above in the observation group were lower than those in the control group(P<0.05).The scores of colon inflammation were significantly improved in both groups after treatment,and the proportions of 0 points and 1 point were higher while the proportions of 3 points and 4 points were lower in the observation group than those in the control group(P<0.05).The number of Bifidobacterium and Lactobacillus was increased and the number of E.coli and Enterococci was decreased after treatment in both groups(P<0.05).The improvements of the above bacteria in the observation group were better than those in the control group(P<0.05).The proportion of Th17 cells and the ratio of Th17/Treg were significantly decreased,the proportion of Treg cells was significantly increased,the percentage of these cells in the observation group was better than that of the control group(P<0.05).Conclusion Self-made Fuzheng Pingkui decoction combined with acupuncture can significantly relieve the clinical symptoms and signs and inhibit the intestinal mucosal inflammatory lesions in patients with chronic ulcerative colitis.The mechanism may be related to the improvement of intestinal dysbacteriosis,and promotion of immune balance of Th17/Treg cells,thus to inhibit the inflammatory response.