参苓白术颗粒联合美沙拉嗪对溃疡性结肠炎患者Th17/Treg细胞平衡的影响以及疗效分析

The effect of Shenling Baizhu granule combined with mesalazine on Th17/Treg balance in patients with ulcerative colitis and its clinical efficacy

[目的]观察参苓白术颗粒联合美沙拉嗪对溃疡性结肠炎(UC)患者Th17/Treg细胞平衡的影响,以及分析临床疗效。[方法]收集本院2017年1月~2018年10月诊治的UC患者132例,数字表法将132例UC患者随机分为对照组和观察组。对照组美沙拉嗪肠溶片口服,每次1.0 g,3次/d,疗程12周;观察组:在对照组基础上加用参苓白术颗粒开水冲服,1袋/次,3次/d,疗程12周。流式细胞仪检测外周血Th17和Treg细胞比例,ELISA法检测患者外周血IL-6和TNF-α表达的使用。[结果]观察组治疗后Th17细胞比例为(8.54±1.26)%,显著低于对照组的(10.45±1.52)%(P<0.05),观察组治疗后Treg细胞比例为(6.38±1.12)%,显著高于对照组的(5.46±1.03)%(P<0.05)。治疗后观察组IL-6和TNF-α分别为(18.28±4.24)μg/mL和(34.23±5.14)μg/mL(P<0.01),显著低于对照组的(26.34±5.81)μg/mL和(47.14±8.63)μg/mL(P<0.01)。治疗后观察组肠镜镜检的充血水肿率、糜烂率和溃疡率分别为24.24%、15.15%和7.58%,显著低于对照组的42.42%、28.79%和16.67%(P<0.05)。观察组治疗有效率为92.42%(61/66),显著高于对照组的75.76%(50/66)(P<0.05)。观察组复发率为4.91%(3/61),显著低于对照组的32.00%(16/50)(P<0.05)。[结论]参苓白术颗粒调节了UC患者Th17/Treg平衡,抑制炎症反应,疗效显著,患者复发率低。

[Objective] To observe the influence of Shenling Baizhu granule combined with mesalazine on Th17/Treg balance in patients with ulcerative colitis(UC)and its clinical efficacy.[Methods]132 UC patients were selected in our Hospital from January 2017 to October 2018.The patients were divided into control group and observation group by digital table method.The control group was orally token mesalazine enteric-coated tablets(1.0 g/time,3 times/d for 12 weeks).The observation group,on the basis of control group,was added Shenling Baizhu granules(1 bag/time,3 times/day,for 12 weeks).Th17 and Treg cells were detected by Flow Cytometry.The expression of IL-6 and TNF-α was detected by ELISA analysis.[Results]After treatment,the percentage of Th17 cells in observation group(8.54±1.26)% was lower than that in control group(10.45±1.52)%(P<0.05).The percentage of Treg cells was in observation group(6.38±1.12)% was higher than that in control group(5.46±1.03)%(P<0.05).After treatment,the IL-6 and TNF-α in observation group(18.28±4.24μg/mL and 34.23±5.14μg/mL)was lower than thatin control group\[(26.34±5.81)μg/mL and(47.14±8.63)μg/mL\](P<0.01).The detection rate of hyperemia edema,erosion,and ulceration in observation group(24.24%,15.15%,and 7.58%)was lower than that in control group(42.42%,28.79%,and 16.67%)(P<0.05).The clinic effective rate in observation(92.42%)was higher than that in control group(75.76%)(P<0.05).The recurrence rate in observation(4.91%)was lower than that in control group(32.00%)(P<0.05).[Conclusion]Shenling Baizhu granule decreased Th17 cells and increased Treg cells to inhibit inflammation in UC patients,with remarkable curative effect.The recurrence rate was low by Shenling Baizhu granule treatment.