清肠温中方内服治疗溃疡性结肠炎的临床疗效及对患者肠黏膜屏障功能的影响

The Clinical Effect of Qingchang Wenzhong Fang in the Treatment of Ulcerative Colitis, as well Its Impact on Patients' Intestinal Mucosa's Barrier Function

目的:探讨清肠温中方治疗溃疡性结肠炎(UC)的临床疗效,以及对肠黏膜屏障功能的影响。方法:前瞻性选取2020年1月至2022年9月我院收治的80例UC患者,按随机数字表法分为研究组与对照组,各40例。研究组给予清肠温中方配方颗粒内服治疗,对照组给予美沙拉嗪肠溶片内服治疗。比较2组治疗效果(中医症候方面疗效和临床总体疗效),治疗前后炎性因子[白细胞介素(IL)-1β、IL-17、IL-23、NOD样受体蛋白3(NLRP3)和半胱氨酸天冬氨酸蛋白酶1(CASP1)]、免疫应答指标[肿瘤坏死因子-α(TNF-α)、β-内咖肽(β-EP)、IL-2和IL-8]、肠黏膜屏障功能指标[二胺氧化酶(DAO)、D-乳酸(D-LA)、尿淀粉酶(UAMY)、细菌脂多糖(LPS)和内毒素],以及不良反应发生情况。结果:中医症候方面疗效及临床总体疗效,研究组均优于对照组,P<0.05。2组治疗后免疫应答指标IL-2水平较治疗前均明显升高;炎性因子指标IL-1β、IL-17、IL-23、NLRP3和CASP1,免疫应答指标TNF-α、β-EP、IL-8及肠黏膜屏障指标DAO、D-LA、UAMY、LPS、内毒素均较治疗前明显降低,P<0.05。治疗后组间比较,研究组IL-2水平更高,其他指标水平均更低,P<0.05。研究组总不良反应发生率低于对照组,P<0.05。结论:清肠温中方内服治疗UC疗效显著,其作用机制可能是通过纠正免疫失衡、缓解炎症反应促进肠黏膜修复实现的。

Objective To investigate the clinical effect of oral Qingchang Wenzhong Fang(a TCM formula, Fang) in the treatment of ulcerative colitis(UC),as well as its impact on the barrier function of intestinal mucosa. Methods Prospectively randomly divided 80 UC patients treated in authors' hospital(2020-01-2022-09) into research group(40 cases, oral Fang) and control group(40 cases, oral mesalazine enteric-coated tablets);then, compared the effects(on TCM symptems) and clinical whole effect;inflammatory factors(IL-1β,IL-17,IL-23,NLRP3 and CASP1),immuno-response norms(TNF-α,β-EP,IL-2 and IL-8),and the barrier function norms(DAO,D-LA,UAMY,LPS and endotoxin) before and after treatment, as well as the status on unward reaction happened between the two groups. Results In the effects and clinical whole effect research group was superior to control group(P<0.05);after treatment in immuno-response norms in both groups IL-2 levels were significantly increased;inflammatory factors norms(IL-1β,IL-17,IL-23,NLRP3 and CASP1) and immuno-response norms(TNF-α,β-EP,IL-8),as well as the barrier norms of intestinal mucosa(DAO,D-LA,UAMY,LPS,and endotoxin) were all decreased than before treatment(P<0.05).But after treatment between the two groups research group's IL-2 level and above rest norms were more significantly higher, and lower than control group's ones(P<0.05).What's more, the incidence of unward reactions of research group was significantly lower than that of control group(P<0.05). Conclusion Tang's effect on UC is great which the mechanism might be arrived by repairing intestinal mucosa through correcting immuno-inbalance and relieving inflammatory responses.