挑治法治疗Ⅰ、Ⅱ期内痔疗效观察

Observations on the Efficacy of Picking Therapy for Stage 1 and 2 Internal Hemorrhoids

目的观察挑治法治疗Ⅰ、Ⅱ期内痔的临床疗效。方法将30例Ⅰ、Ⅱ期内痔患者随机分为挑治组和太宁栓组,每组15例。同时纳入15例正常志愿者对照组,共3组。挑治组采用痔点挑治法治疗;太宁栓组用太宁栓塞肛治疗。观察两组临床症状积分,采用荧光定量PCR法和双抗体夹心ABC-ELISA法检测3组血清Toll样受体4(TLR4)、核因子-κB(NF-κB)p65 mRNA以及白细胞介素-12(IL-12)、干扰素-α(IFN-α)含量变化,并比较两组临床疗效。结果挑治组患者出血、肛门坠胀、水肿症状积分明显优于太宁栓组,差异有统计学意义(P<0.05)。挑治组血清TLR4 mRNA和NF-κB p65 mRNA扩增倍数明显高于太宁栓组,差异有统计学意义(P<0.05),与正常组比较差异无统计学意义(P>0.05)。挑治组血清IL-12和IFN-α含量均明显高于太宁栓组,差异有统计学意义(P<0.05);与正常组比较,差异无统计学意义(P>0.05)。挑治组总有效率为86.7%,显著高于太宁栓组的60.0%(P<0.05)。结论挑治法可能通过挑治刺激作为配体与TLR4结合后,通过其介导的通路激活NF-κB,NF-κB活化并转位到胞核,使得IFN-α、IL-12的分泌增多,单核细胞的分裂增殖增强,从而诱导机体的获得性免疫机能来发挥作用的。

Objective To observe the clinical efficacy of picking therapy for stage 1 and 2 internal hemorrhoids.Method Thirty patients with stage 1 or 2 internal hemorrhoids were randomized to picking therapy and titanoreine suppository groups,with 15 cases in each group.Fifteen normal volunteers constituted a control group.There were a total of three groups.The picking therapy group received hemorrhoidal point picking therapy and the titanoreine suppository group,insertion of titanoreine suppository into the rectum.The clinical symptom score was recorded in the two groups.Serum TLR4 and NF-kBp65 contents were measured by fluorescent quantitative PCR and IL–12 and IFN-acontents,by double antibody sandwich ABC-ELISA.The clinical therapeutic effects were compared between the two groups.Result The bleeding,anal downbearing distention and edema scores were significantly lower in the picking therapy group than in the titanoreine suppository group with a statistically significant difference(P<0.05).Serum TLR4 mRNA and NF-kBp65 mRNA expanding folds were significantly higher in the picking therapy group than in the titanoreine suppository group with a statistically significant difference(P<0.05)and had no statistically significant differences compared with the control group(P>0.05).Serum IL–12 and IFN-acontents were significantly higher in the picking therapy group than in the titanoreine suppository group with a statistically significant difference(P<0.05)and had no statistically significant differences compared with the control group(P>0.05).The total efficacy rate was 86.7%in the picking therapy group,which was higher than 60.0%in the control group(P<0.05).Conclusion Picking therapy may produce an effect by it as a ligand combining with TLR4 and activating NF-kB through its mediated pathway and activated NF-kB being transposed to the cell nucleus,which increase IFN-aand IL–12 secretion and cell division and proliferation to induce bodily acquired immunity.