参苓白术散联合美沙拉嗪对溃疡性结肠炎儿童和青少年炎症因子与免疫功能的影响

Effect of Shenlingbaizhu Powder Combined with Mesalamine on Inflammatory Factors and Immune Function in Children and Adolescents with Ulcerative Colitis

目的探讨参苓白术散联合美沙拉嗪对溃疡性结肠炎少儿炎症因子与免疫功能的影响。方法溃疡性结肠炎少儿62例,按数字表法随机分为对照组与治疗组,各31例。对照组口服美沙拉嗪,每次20 mg·kg^(-1),每天4次。治疗组在对照组基础上口服参苓白术散,每次3.0或6.0 g,每天3次。两组疗程均为2个月。比较两组治疗前后炎症因子水平,T细胞亚群水平(CD_3^+、CD_4^+、CD_8^+、CD_4^+/CD_8^+),免疫球蛋白水平,中医证候评分及治疗有效率。结果治疗后,治疗组白细胞介素(IL)-6、IL-17及肿瘤坏死因子-α(TNF-α)水平低于对照组,IL-10水平高于对照组(P<0.05);治疗组CD_3^+、CD_8^+水平明显低于对照组,CD_4^+水平、CD_4^+/CD_8^+比值明显高于对照组(P<0.05);治疗组IgA、IgM水平下降程度明显大于对照组(P<0.05);治疗组腹痛、腹泻、脓血便、里急后重积分及总积分均显著低于对照组;治疗组和对照组治疗有效率分别为93.55%,74.19%(P<0.05)。结论参苓白术散联合美沙拉嗪治疗少儿溃疡性结肠炎有利于调节炎症因子水平,降低炎症反应,平衡T细胞数量,降低免疫球蛋白水平,提升肠道黏膜的免疫功能,促进溃疡愈合,从而改善中医证候,提高临床疗效。

Objective To investigate the effects of Shenlingbaizhu powder combined with mesalazine on inflammatory factors and immune function in children and adolescents with ulcerative colitis. Methods Sixty-two children with ulcerative colitis were randomly divided into control group and treatment group (31 children each) according to random number table method. The control group received oral Mesal amine, 20 mg·kg^-1 each time, 4 times a day. The treatment group was given Shenlingbaizhu powder on the basis of the control group, 3.0 or 6.0 g each time, 3 times a day. Both groups were treated for 2 months. The levels of inflammatory factors, T cell subsets(CD3 ^+,CD4^+,CD + 8 and CD4 ^+/CD8^+), immunoglobulin levels, Traditional Chinese Medicine (TCM) syndrome scores and treatment effectiveness were compared between the two groups. Results After treatment, the levels of interleukin (IL)-6, IL-17 and tumor necrosis factor-α(TNF-α) in the treatment group were lower than those in the control group, and the level of IL-10 was higher than the control group ( P <0.05). The levels of CD 3 ^+ and CD 8^+ in the treatment group were significantly lower than those in the control group, and the ratio of CD + 4 and CD 4^+/CD 8 ^+was significantly higher than the control group ( P <0.05). The level of IgA and IgM in the treatment group was significantly lower than the control group( P < 0.05). After treatment, abdominal pain, diarrhea, pus and bloody stool, tenesmus points and total scores in the treatment group were significantly lower than the control group ( P <0.05). The efficacy of the treatment group and the control group were 93.55% and 74.19%, respectively( P <0.05). Conclusion Shenlingbaizhu powder combined with mesalamine in the treatment of in children and adolescents with ulcerative colitis is beneficial to improve clinical efficacy, which regulate the level of inflammatory factors, reduce the inflammatory response, balance the number of T cells, reduce the level of immunoglobulin, improve the immune function of intestinal mucosa, promote ulcer healing, and improve TCM syndromes.