双歧杆菌三联活菌对溃疡性结肠炎患者辅助性T细胞17/调节性T细胞平衡的调节作用

Regulating effect of Bifidobacterium triple viable capsules on helper T cell 17/regulatory T cell balance in patients with ulcerative colitis

目的探讨双歧杆菌三联活菌对溃疡性结肠炎(UC)患者辅助性T细胞17(Th17)/调节性T细胞(Treg)平衡的调节作用。方法将116例UC患者分为对照组和观察组,每组58例。2组患者均采用美沙拉嗪肠溶片治疗,2片/次,4次/d。观察组在此基础上联用双歧杆菌三联活菌胶囊治疗,2粒/次,3次/d。2组患者均连续治疗8周。比较2组患者的临床疗效、肠道菌群、外周血Treg与Th17水平、Th17/Treg值、不良反应情况。结果观察组的总有效率为94.83%,高于对照组的82.76%,差异有统计学意义(P<0.05)。治疗后,观察组乳酸菌属、双歧杆菌属数量多于对照组,大肠埃希菌、梭菌属、拟杆菌属数量少于对照组,差异有统计学意义(P<0.05)。治疗后,观察组外周血Treg水平高于对照组,Th17水平和Th17/Treg低于对照组,差异有统计学意义(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论双歧杆菌三联活菌治疗UC可有效提高临床疗效,调节Th17/Treg平衡可能是其作用机制之一。

Objective To investigate the effect of Bifidobacterium triple viable capsules on the balance of helper T cell 17(Th17)/regulatory T cell(Treg)in patients with ulcerative colitis(UC).Methods A total of 116 patients with UC were divided into control group(n=58)and observation group(n=58).The patients in two groups were treated with Mesalazine enteric coated tablets according to the guidelines,2 tablets per time,4 times a day.Based on the above treatment,the patients in observation group were treated with Bifidobacterium triple viable capsules,2 capsules per time,3 times daily.The patients in two groups were all treated for 8 weeks.The clinical efficacy,intestinal flora,the proportion of of Treg and Th17 cells in peripheral blood,ratio of Th17 to Treg and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 94.83%,which was higher than 82.76%of the control group(P<0.05).After treatment,the number of Lactobacillus and Bifidobacterium in the observation group was more than that in the control group,while the number of Escherichia coli,Clostridium and Bacteroides was less than that in the control group(P<0.05).After treatment,the proportion of Treg cells in peripheral blood of the observation group was higher than that of the control group,and the proportion of Th17 cells was higher,while the ratio of Th17 to Treg were lower than that of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Bifidobacterium triple viable bacteria can effectively improve the clinical efficacy of UC,and regulating Th17/Treg balance may be one of its mechanisms.