摘要
目的探讨芪倍合剂联合美沙拉嗪治疗活动期溃疡性结肠炎的临床疗效和其对Th17、Treg细胞及其相关细胞因子水平的影响。方法选取2019年1月—2019年12月于新乡医学院第一附属医院就诊的142例活动期溃疡性结肠炎患者作为研究对象,将所有患者随机分为对照组和观察组,每组各71例。对照组口服美沙拉嗪肠溶片,1 g/次,4次/d;观察组在对照组治疗的基础上口服芪倍合剂,50 mL/次,3次/d。两组疗程均为8周。观察两组患者的临床疗效,同时比较两组治疗前后的Mayo评分、Baron评分、Th17细胞、Treg细胞、Th17/Treg细胞比值、白细胞介素(IL)-17、IL-23、转化生长因子(TGF-β)和IL-10水平。结果治疗后,对照组和观察组的总有效率分别为81.69%、94.36%,两组总有效率比较差异具有统计学意义(P<0.05)。治疗后,两组Mayo评分和Baron评分均显著降低(P<0.05);且观察组Mayo评分和Baron评分显著低于对照组(P<0.05)。治疗后,两组患者Th17细胞、Th17/Treg细胞比值水平均显著下降,而Treg细胞显著升高(P<0.05)。治疗后,与对照组相比,观察组Th17细胞和Th17/Treg细胞比值显著降低,而Treg细胞显著升高(P<0.05)。治疗后,两组血清IL-17和IL-23水平显著降低,而TGF-β和IL-10水平显著升高(P<0.05)。治疗后,观察组血清IL-17、IL-23水平显著低于对照组,而TGF-β和IL-10水平显著高于对照组(P<0.05)。结论芪倍合剂联合美沙拉嗪对活动期溃疡性结肠炎临床疗效较好,治疗安全性高,能有效改善患者的临床症状,可能机制与其能显著改善Th17/Treg细胞平衡有关。
Objective To explore the clinical efficacy and impact of Th17, Treg and its related cytokines levels after Qibei Mixture combined with mesalazine in treatment of active ulcerative colitis. Methods Atotal of 142 active ulcerative colitis patients admitted to the the First Affiliated Hospital of Xinxiang Medical University from January 2019 to December 2019 were selected as the research objects, and all the patients were randomly divided into control group and observation group, with 71 patients in each group. Patients in the control group were po administered with Mesalazine Enteric-coated Tablets, 1 g/time, four times daily. Patients in the observation group were po administered with Qibei Mixture on the basis of control group, 50 mL/time, three times daily. The course of treatment in both groups was eight weeks. After treatment, the clinical efficacy in two groups were observed, the Mayo score, Baron score, Th17 cells, Treg cells, Th17/Treg cells, and the levels of IL-17, IL-23, TGF-β, IL-10 before and after treatment were compared. Results After treatment, the total effective rate of the control group and the observation group was 81.69% and94.36%, respectively, with statistically significant difference between two groups(P < 0.05). After treatment, the Mayo and Baron scores in two groups were significantly reduced(P < 0.05). The Mayo and Baron scores in the observation group were significantly lower than those in the control group(P < 0.05). After treatment, Th17 cells and Th17/Treg cell ratios in two groups were significantly decreased, while Treg cells were significantly increased(P < 0.05). After treatment, the ratio of Th17 cells and Th17/Treg cells in the observation group were significantly lower than those in the control group, while Treg cells was significantly higher than that in the control group(P < 0.05). After treatment, the serum levels of IL-17 and IL-23 were significantly decreased, but TGF-β and IL-10 levels were significantly increased(P < 0.05). After treatment, the serum levels of IL-17 and IL-23 in the observation group were significantly lower than those in the control group, but the levels of TGF-β and IL-10 were significantly higher than those in the control group(P < 0.05). Conclusion Qibei Mixture combined with mesalazine has good clinical efficacy and high safety in treatment of active ulcerative colitis, and can effectively improve the clinical symptoms of patients. The possible mechanism may be related to its ability to significantly improve Th17/Treg cell balance.
作者
杜学芳
马尚超
张彩凤
张超群
李光艳
张兰芳
张利利
郭晓鹤
顾莉莉
杨妮
司玉静
DU Xuefang;MA Shangchao;ZHANG Caifeng;ZHANG Chaoqun;LI Guangyan;ZHANG Lanfang;ZHANG Lili;GUO Xiaohe;GU Lili;YANG Ni;SI Yujing(Department of Gastroenterology,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453000,China)
出处
《药物评价研究》
CAS
2020年第11期2254-2258,共5页
Drug Evaluation Research
基金
河南省科技攻关项目(192102310315)。
