枯草杆菌二联活菌肠溶胶囊联合泮托拉唑对UC患者炎性因子、肠黏膜功能及外周血Th17、CD4+CD25+Treg细胞表达的影响

Effects of Bacillus Subtilis Enteric Coated Capsules Combined with Pantoprazole on Inflammatory Factors, Intestinal Mucosal Function and Expression of Th17 and Treg Cells in Peripheral Blood of Patients with UC

目的:观察枯草杆菌二联活菌肠溶胶囊联合泮托拉唑对溃疡性结肠炎(UC)患者炎性因子、肠黏膜功能及外周血Th17、CD4+CD25+Treg细胞表达的影响。方法:研究对象选择2014年7月~2018年9月期间来我院香山路门诊部接受诊治的80例UC患者,随机分为联合组(枯草杆菌二联活菌肠溶胶囊联合泮托拉唑治疗)、对照组(泮托拉唑治疗),各40例。对比两组的疗效、炎性因子、肠黏膜功能及外周血中Th17及CD4+CD25+Treg细胞表达。记录两组治疗期间不良反应发生情况。结果:联合组的临床总有效率为92.50%(37/40),对照组为70.00%(28/40),两组比较差异有统计学意义(P<0.05)。两组不良反应发生率对比无差异(P>0.05)。联合组治疗6个月后血清白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平均明显比对照组低(P<0.05)。联合组治疗6个月后血清D-乳酸含量、二胺氧化酶(DAO)水平均明显比对照组低(P<0.05)。联合组治疗6个月后外周血中Th17细胞表达比对照组低,CD4+CD25+Treg细胞表达比对照组高(P<0.05)。结论:枯草杆菌二联活菌肠溶胶囊联合泮托拉唑治疗UC患者,可有效改善肠道环境,使外周血中的Th17细胞表达降低,CD4+CD25+Treg细胞表达增加,并缓解炎症状态,临床效果满意且安全性好。

Objective: To observe the effect of Bacillus subtilis enteric coated capsules combined with pantoprazole on inflammatory factors, intestinal mucosal function and expression of Th17, Treg cells in peripheral blood of patients with ulcerative colitis(UC).Methods: 80 patients with UC who came to Xiangshan Road outpatient department of our hospital from July 2014 to September 2018 were selected, and were randomly divided into control group(pantoprazole) and combination group(Bacillus subtilis enteric coated capsules combined with pantoprazole), 40 cases in each group. The efficacy, inflammatory factors, intestinal mucosal function and the expression of Th17 and CD4^+CD25^+Treg cells in peripheral blood were compared between the two groups. The incidence of adverse reactions in the two groups was recorded. Results: The clinical total effective rate of the combination group was 92.50%(37/40), and that of the control group was 70.00%(28/40), the difference was statistically significant(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). The levels of serum interleukin-8(IL-8), tumor necrosis factor-α(TNF-α), C-reactive protein(CRP) of the combination group at 6 months after treatment were significantly lower than those of the control group(P<0.05). The levels of serum D-lactic acid and diamine oxidase(DAO) of the combination group at 6 months after treatment were significantly lower than those of the control group(P<0.05). 6 months after treatment, expression of Th17 in the combination group was lower than that of the control group, and the expression of CD4^+CD25^+Treg cells in the combination group were higher than those of the control group(P<0.05). Conclusion: Bacillus subtilis enteric coated capsules combined with pantoprazole in the treatment of patients with UC can effectively improve the intestinal environment, reduce the expression of Th17 cells in peripheral blood, increase the expression of CD4^+CD25^+Treg cells, and reduce the inflammatory state. The clinical effect is satisfactory and the safety is good.