中西药结合抗乙肝病毒治疗的体会

目的探讨中西药结合消除乙肝病毒复制的疗法．方法乙肝患者和乙肝病毒携带者共123例，均须HBeAg，HBV－DNA（PCR）至少一项阳性．随机分四组，干扰素组为对照组，余三组为治疗组．①α－干扰素组30例，肝功正常14例，肝功异常16例．②猪苓多糖＋乙肝疫苗组31例，肝功正常16例，肝功异常15例．③五灵丸（西安博爱制药厂）组30例，肝功正常15例，肝功异常15例．④猪苓多糖＋乙肝疫苗＋五灵丸组32例，肝功正常13例，肝功异常19例．疗程均为3mo．治疗后复查HBeAg，HBV－DNA（PCR），肝功能等．抗病毒治疗有效指标为HBeAg，HBV－DNA（PCR）全部转阴，采用卡方检验进行比较分析．结果四组之间治疗有效率有显著性差异，x2＝13．877，P＜0．01．其中1组肝功正常者有效1例，肝功异常者有效13例，有效率46．7％2组肝功正常者有效1例，异常者有效8例，有效率29．0％．3组肝功正常者有效0例，异常者有效6例，有效率20％，4组肝功正常者有效2例，异常者有效18例，有效在62．50．2组与1组间P＜0．05，有显著差异．3组与1组间P＜0．05，有显著差异．4组与1组间P＞0．05，差异不明显．肝功正常者58例，有效4例，有效率7．0％，肝功异常者65例，有效45例，有效率69．2％．两组间治疗有效率有显著性差异，x2＝49．69％，P?

Efficacy of Sishen Wan(四神丸) on dinitrobenzene sulfonic acid-induced ulcerative colitis and its effect on toll-like receptor 2/interleukin-1 receptor-associated kinase-4/nuclear factor-κB signal pathway

OBJECTIVE:To investigate the therapeutic effect of Sishen Wan(四神丸,SSW)on ulcerative colitis(UC)induced by dinitrobenzene sulfonic acid and its effect on toll-like receptor 2/interleukin-1 receptor-associated kinase-4/nuclear factor-κB(TLR2/IRAK4/NF-κB)signaling pathway in colonic tissue.METHODS:In this study,120 Sprague–Dawley rats were randomly divided into blank and model groups.The experimental UC model in rats was established by subcutaneous injection of hydrocortisone+senna gavage for 21 d+dinitrobenzene sulfonic acid(DNBS)/ethanol solution enema.The successful model rats were randomly divided into the model group;mesalazine(0.36 g/kg)group;and high-,medium-,and low-dose SSW(24,12,and 6 g/kg)groups.The model and blank groups were gavaged with equal volumes of distilled water once a day for 21 d.The general condition of the rats was observed,and the body mass,fecal properties,and occult blood were recorded for calculating the disease activity index(DAI)score.The colonic tissue of the rats was collected,and its general morphology and pathological form were noted for obtaining the colonic mucosal injury index(CMDI)score.Hematoxylin-eosin staining was used to view the pathological changes of the colon tissue in each group,apoptosis of the cells was detected using terminal deoxynucleotidyl transferase-mediated d UTP nick-end labeling staining,and quantitative real-time polymerase chain reaction was used to measure the expressions of TLR2,myeloid differentiation primary response gene 88(My D88),IRAK4,and NF-κB p65 mRNA in the colon tissue.The expressions of TLR2,My D88,IRAK4,and NF-κB p65 protein were detected using western blotting and immunohistochemistry assay,and the levels of interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)in the colon tissue were determined using enzyme linked immunosorbent assay.RESULTS:Compared with the blank group,the general condition of the model group was relatively poor.The DAI and CMDI scores of the model group increased significantly(P<0.01),the glands and intestinal mucosa disappeared partially,and several inflammatory cells infiltrated and gathered in the mucosal layer and base layer of the rats in the model group.Furthermore,the cell apoptosis and expression levels of TLR2,My D88,IRAK4,and NF-κB p65 mRNA and protein in the colon tissue of rats in the model group increased significantly(P<0.01).The levels of IL-1βand TNF-αincreased significantly in the colon tissue of rats in the model group(P<0.01).After treatment with SSW,compared with the model group,the general condition of the UC rats improved.Moreover,the DAI and CMDI scores of the UC rats decreased significantly(P<0.05),and the pathological changes in the colon tissue of the UC rats tended to be normal.The cell apoptosis and expression levels of TLR2,My D88,IRAK4,and NF-κB p65 mRNA and protein in the colon tissue of the UC rats decreased gradually(P<0.01),and the levels of IL-1βand TNF-αdecreased significantly(P<0.01).CONCLUSION:SSW can improve the general condition and alleviate the intestinal mucosal injury of UC model rats.Additionally,SSW can inhibit the TLR2/IRAK4/NF-κB signaling pathway,but further studies are required to confirm it.