基于糖萼损伤研究金银花水煎液治疗溃疡性结肠炎的作用机制

Study on the mechanism of honeysuckle decoction in the treatment of ulcerative colitis based on glycocalyx injury

目的观察金银花水煎液对溃疡性结肠炎患者糖萼损伤的影响,研究金银花水煎液治疗溃疡性结肠炎可能的作用机制。方法选取2018年12月—2020年1月连云港市第一人民医院收治的溃疡性结肠炎患者180例,采用随机数字表法分为对照组及观察组各90例,对照组给予美沙拉嗪治疗,观察组在对照组治疗基础上联合金银花水煎液治疗,2组均治疗28 d。测定2组患者治疗前后糖萼损伤标志物[多配体蛋白聚糖-1(SDC-1)、硫酸乙酰肝素(HS)、透明质酸(HA)]水平、糖萼厚度、糖萼损伤因子[金属蛋白酶-9(MMP-9)、硫酸乙酰肝素酶(HPA-1)]、炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)、γ-干扰素(IFN-γ)]及氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)、环氧化酶(COX-2)]水平,比较2组治疗效果。结果观察组患者治疗后SDC-1、HS、HA、MMP-9、HPA-1水平均显著低于治疗前及对照组治疗后(P均<0.05),糖萼厚度显著高于治疗前及对照组治疗后(P均<0.05),对照组患者治疗前后上述指标比较差异均无统计学意义(P均>0.05)。与治疗前比较,2组患者治疗后TNF-α、IFN-γ、MDA及COX-2水平均显著降低(P均<0.05),IL-10水平及SOD活性显著升高(P均<0.05);治疗后观察组TNF-α、IFN-γ、MDA及COX-2水平显著低于对照组(P均<0.05),IL-10水平及SOD活性显著高于对照组(P均<0.05)。观察组患者治疗总有效率为88.9%(80/90),显著高于对照组的76.7%(69/90),差异有统计学意义(P<0.05)。结论金银花水煎液可有效提高溃疡性结肠炎患者临床治疗有效率,其作用机制可能与降低炎性因子水平、改善高氧化应激状态,抑制患者糖萼损伤有关。

Objective It is to observe the effect of honeysuckle decoction on glycocalyx injury in patients with ulcerative colitis(UC),and to study the possible mechanism of honeysuckle decoction in the treatment of this disease.Methods A total of 180 patients with UC admitted to the First People’s Hospital of Lianyungang from December 2018 to January 2020 were selected and divided into the control group and the observation group by random number table,with 90 cases in each group.The control group was treated with mesalazine,the observation group was treated with honeysuckle decoction based on the control group,both groups were treated for 28 days.The levels of glycocalyx injury markers[Syndecan-1(SDC-1),heparan sulfate(HS),hyaluronic acid(HA)],glycocalyx thickness,glycocalyx injury factors[metalloproteinase-9(MMP-9),heparanase-1(HPA-1)],inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-10(IL-10),γ-interferon(IFN-γ)]and oxidative stress indicators[superoxide dismutase(SOD),malondialdehyde(MDA),cyclooxygenase(COX-2)]were detected before and after treatment,and the treatment effects were compared between the two groups.Results The levels of SDC-1,HS,HA,MMP-9 and HPA-1 were significantly lower and the thickness of glycocalyx was significantly higher in the observation group after treatment than those before treatment and those in the control group after treatment(P<0.05),there was no statistically significant difference in the above indicators in the control group before and after treatment(P>0.05).Compared with before treatment,the levels of TNF-α,IFN-γ,MDA and COX-2 were significantly reduced(P<0.05),and IL-10 levels and SOD activity were significantly increased after treatment in the two groups(P<0.05);the levels of TNF-α,IFN-γ,MDA and COX-2 were significantly lower(P<0.05),and the levels of IL-10 and SOD activity were significantly higher in the observation group than those in the control group after treatment(P<0.05).The effective rate of treatment in the observation group was 88.9%(80/90),which was significantly higher than that 76.7%(69/90)in the control group(P<0.05).Conclusion Honeysuckle decoction can effectively improve the clinical treatment efficiency of patients with UC,and its mechanism of action may be related to reducing the level of inflammatory factors,improving the state of high oxidative stress,and inhibiting glycocalyx injury.