盐酸小檗碱片联合美沙拉嗪治疗远端溃疡性结肠炎疗效及血清细胞因子水平分析

Efficacy and serum cytokine levels of berberine hydrochloride tablets combined with mesalazine in treatment of patients with distal ulcerative colitis

目的探讨远端溃疡性结肠炎患者盐酸小檗碱片联合美沙拉嗪治疗的疗效及血清细胞因子水平。方法选取2019年6月—2021年5月周口市中心医院远端溃疡性结肠炎患者98例,将采用美沙拉嗪治疗的49例作为对照组,将采用美沙拉嗪联合盐酸小檗碱片治疗的49例作为研究组,比较两组治疗前、治疗4周后血清细胞因子[肿瘤坏死因子-α(TNF-α)、干扰素-γ(INF-γ)、转化生长因子-β(TGF-β)、二胺氧化酶(DAO)]水平、临床疗效及不良反应发生率。结果研究组治疗总有效率(93.88%)高于对照组(77.55%)(P<0.05);组内采用配对t检验显示,治疗4周后DAI、Baron评分低于治疗前(P<0.05);组间采用独立样本t检验显示,两组治疗前DAI、Baron评分无显著差异(P>0.05);研究组治疗4周后DAI、Baron评分较对照组低(P<0.05);治疗4周后研究组DAI、Baron内镜评分低于对照组(P<0.05);治疗4周后研究组血清TNF-α、INF-γ、DAO、TGF-β水平低于对照组(P<0.05);治疗4周后血清TNF-α、INF-γ、DAO、TGF-β水平低于治疗前(P<0.05);组间采用独立样本t检验显示,两组治疗前血清TNF-α、INF-γ、DAO、TGF-β水平无显著差异(P>0.05);研究组治疗4周后血清TNF-α、INF-γ、DAO、TGF-β水平较对照组低(P<0.05);研究组不良反应发生率(6.12%)与对照组(4.08%)比较,两组差异无统计学意义(P>0.05)。结论盐酸小檗碱片、美沙拉嗪联合应用于远端UC患者疗效确切,可抑制炎症因子释放,促进肠道黏膜修复,保护肠黏膜屏障,在减轻病变程度,确保治疗安全性方面具有积极意义。

Objective To investigate the effect of berberine hydrochloride tablets combined with mesalazine in the treatment of distal ulcerative colitis and the level of serum cytokines.Methods Totally 98 patients with distal ulcerative colitis in our hospital from June 2019 to May 2021 were selected and divided into groups according to the simple random number table method.The generated random allocation sequence and grouping scheme were put into sequentially coded,sealed and opaque envelopes.After the researchers determined that the subjects were qualified,the envelopes were opened in sequence and the subjects were assigned into the corresponding groups,namely the study group and the control group 49 cases in each group.The control group was treated with mesalazine,and the study group was treated with berberine hydrochloride tablets on the basis of the above.The clinical efficacy,the incidence of adverse reactions,and the levels of serum cytokines[tumor necrosis factor-α(TNF-α),interferon-γ(INF-γ),transforming growth factor-β(TGF-β),diamine oxidase(DAO)]before and 4 weeks after treatment were compared between the two groups.Result The total effective rate in the study group was 93.88%higher than 77.55%in the control group(P<0.05).Paired t test showed that DAI and Baron scores were lower after 4 weeks of treatment than before(P<0.05).Independent sample t test between the two groups showed no significant difference in DAI and Baron scores before treatment(P>0.05).The DAI and Baron scores of the study group were lower than those of the control group after 4 weeks of treatment(P<0.05).After 4 weeks of treatment,DAI and Baron endoscopic scores in the study group were lower than those in the control group(P<0.05).After 4 weeks of treatment,the levels of TNF-α,INF-γ,DAO and TGF-βin the study group were lower than those in the control group(P<0.05).After 4 weeks of treatment,the serum LEVELS of TNF-α,INF-γ,DAO and TGF-βwere lower than those before treatment(P<0.05).Independent sample t test between the two groups showed that there were no significant differences in serum TNF-α,INF-γ,DAO and TGF-βlevels between the two groups before treatment(P>0.05).The levels of TNF-α,INF-γ,DAO and TGF-βin the study group were lower than those in the control group after 4 weeks of treatment(P<0.05).The incidence of adverse reactions was 6.12%in the study group and 4.08%in the control group(P>0.05).Conclusion Berberine hydrochloride tablets combined with mesalazine in the treatment of patients with distal UC has definite curative effect.It can inhibit the release of inflammatory factors,promote intestinal mucosal repair,protect intestinal mucosal barrier,and has positive significance in reducing the degree of lesions and ensuring the safety of treatment.