美沙拉秦联合双歧杆菌嗜酸乳杆菌肠球菌三联活菌治疗溃疡性结肠炎效果及对患者血清sRAGE、Vaspin、炎性因子等影响

Effects of Mesalazine Combined with Triple Live Combined Bifidobacterium, Lactobacillus and Enterococcus on Ulcerative Colitis and Its Influence on Serum sRAGE, Vaspin and Inflammatory Factors of Patients

目的观察美沙拉秦联合双歧杆菌嗜酸乳杆菌肠球菌三联活菌治疗溃疡性结肠炎(ulcerative colitis, UC)的效果及对血清可溶性晚期糖基化终末产物受体(sRAGE)、内脏脂肪特异性丝氨酸蛋白酶抑制剂(Vaspin)、炎性因子等影响。方法选取UC 96例,根据治疗方法不同将其分为研究组(51例)和对照组(45例)两组。研究组在常规治疗基础上采用美沙拉秦联合双歧杆菌嗜酸乳杆菌肠球菌三联活菌进行治疗,对照组在常规治疗基础上仅采用美沙拉秦进行治疗。比较两组治疗2个月后临床效果,治疗前及治疗2个月后血清sRAGE、Vaspin、炎性因子[白细胞介素6(IL-6)、白细胞介素8(IL-8)、肿瘤坏死因子α(TNF-α)]、氧化应激指标[一氧化氮(NO)、过氧化脂质(LPO)、超氧化物歧化酶(SOD)]及便基质金属蛋白酶9(MMP-9)、钙卫蛋白(Cal)、髓过氧化物酶(MPO)水平,以及治疗期间不良反应发生情况。结果治疗2个月后,研究组总有效率为92.16%高于对照组总有效率75.56%,差异有统计学意义(P<0.05)。治疗前,两组血清sRAGE、Vaspin、炎性因子、氧化应激指标及便MMP-9、Cal、MPO水平比较差异均无统计学意义(P>0.05)。治疗2个月后,两组血清sRAGE、Vaspin、IL-6、IL-8、TNF-α、NO、LPO及便MMP-9、Cal、MPO水平均较治疗前降低,血清SOD水平均较治疗前升高;研究组血清sRAGE、Vaspin、IL-6、IL-8、TNF-α、NO、LPO及便MMP-9、Cal、MPO水平均低于对照组,血清SOD水平高于对照组,差异有统计学意义(P<0.01)。治疗期间,研究组出现恶心2例,腹胀加重1例;对照组出现恶心2例。两组出现不良反应者症状均较轻微,未对治疗产生影响,后皆自行缓解。结论美沙拉秦联合双歧杆菌嗜酸乳杆菌肠球菌三联活菌治疗UC效果显著,可减轻患者肠道炎症反应,改善患者免疫功能和肠道黏膜损伤,且安全性良好。

Objective To observe the effects of Mesalazine combined with triple live combined bifidobacterium, lactobacillus and enterococcus on ulcerative colitis(UC) and its influence on the levels of serum soluble receptor for advanced glycation end product(sRAGE), visceral fat-specific serine protease inhibitor(Vaspin) and inflammatory factors. Methods Ninety-six UC patients were selected and divided into the research group(n=51) and the control group(n=45) according to different treatment methods. The research group was given Mesalazine combined with triple live combined bifidobacterium, lactobacillus and enterococcus on the basis of conventional treatment, and the control group was only given Mesalazine on the basis of conventional treatment. The clinical effects at 2 months after treatment, and the serum levels of sRAGE, Vaspin, inflammatory factors [interleukin-6(IL-6), interleukin-8(IL-8), tumor necrosis factor-α(TNF-α)], oxidative stress indexes [nitric oxide(NO), lipid peroxidation(LPO), superoxide dismutase(SOD)] and matrix metalloproteinase-9(MMP-9), calprotectin(Cal) and myeloperoxidase(MPO) in the feces before treatment and at 2 months after treatment, as well as occurrence of adverse reactions during treatment were compared between the two groups. Results At 2 months after treatment, the total effective rate in the research group was significantly higher than that in the control group(92.16% vs. 75.56%)(P<0.05). Before treatment, there were no significant differences in the levels of serum sRAGE, Vaspin, inflammatory factors, oxidative stress indexes and fecal MMP-9, Cal and MPO between the two groups(P>0.05). At 2 months after treatment, the levels of serum sRAGE, Vaspin, IL-6, IL-8, TNF-α, NO, LPO and fecal MMP-9, Cal and MPO in the two groups were all lower than those before treatment, while the level of serum SOD was higher than that before treatment. The levels of serum sRAGE, Vaspin, IL-6, IL-8, TNF-α, NO, LPO and fecal MMP-9, Cal and MPO in the research group were lower than those in the control group(P<0.01), whereas the level of serum SOD was higher than that in the control group(P<0.01). During treatment, 2 cases of nausea and 1 case of worsened abdominal distension occurred in the research group, and 2 cases of nausea appeared in the control group. The symptoms of adverse reactions were mild in both groups, which did not affect the treatment, and all resolved on their own. Conclusion Mesalazine combined with triple live combined bifidobacterium, lactobacillus and enterococcus has significant effects on UC, which can alleviate intestinal inflammatory reactions and improve immune function and intestinal mucosal injury, and it has good safety.