标题：致康胶囊联合美沙拉嗪治疗轻中度溃疡性结肠炎疗效观察

      作者：温彪，孙敬平    (成都医学院第一附属医院消化内科，四川 成都 610500)

      卷次： 2017年28卷23期

      【摘要】 目的 观察致康胶囊联合美沙拉嗪治疗溃疡性结肠炎的疗效，同时通过对患者血清促炎细胞因子(TNF-α，IL-1β和 IL-6)和抗炎介质(IL-10)的检测，探讨治疗作用的相关机制。方法 选择2013年1月至2016年12月在我院门诊就诊确诊为轻中度溃疡性结肠炎的患者98例。按随机数表法分为两组，每组49例。观察组给予致康胶囊口服3粒/次，3次/d，并美沙拉嗪肠溶片1.0 g/次，4次/d；对照组给予美沙拉嗪肠溶片1.0 g/次，4次/d；两组疗程均为 4周。治疗前和治疗后分别检测患者TNF-α、IL-1β、IL-6和 IL-10，同时观察和比较两组患者的症状改善情况。结果 观察组治疗总有效率为 91.84%，对照组为 75.51%，两组比较差异有统计学意义(P<0.05)。治疗 4 周后，观察组 TNF-α，IL-1β，IL-6水平分别为(79.22±20.43) ng/L、(16.51±12.72) ng/L、(100.15±24.12) ng/L，较治疗前的 (102.55±20.23) ng/L、(31.26±27.63) ng/L、(123.06±25.34) ng/L显著降低，也明显低于对照组治疗后的(97.35±18.39) ng/L、(21.62±14.33) ng/L、(119.01±20.13) ng/L，差异均有统计学意义(P<0.05)。而治疗后观察组患者的 IL-10水平为(59.15±7.94) ng/L，明显高于同组治疗前的(21.99±5.14) ng/L和对照组治疗后的(42.51±6.99) ng/L，差异均有统计学意义(P<0.05)。结论 致康胶囊联合美沙拉嗪治疗溃疡性结肠炎疗效优于单用美沙拉嗪，其通过降低促炎因子TNF-α、IL-1β和 IL-6水平，升高抗炎因子 IL-10水平，减轻炎症反应程度。
      【关键词】 溃疡性结肠炎；致康胶囊；美沙拉嗪；促炎细胞因子；抗炎细胞因子
      【中图分类号】 R574.62 【文献标识码】 A 【文章编号】 1003—6350（2017）23—3820—03

Clinical effect of Zhikang Capsule combined with Mesalazine in the treatment of mild-to-moderate ulcerativecolitis.
WEN Biao, SUN Jing-ping. Department of Gastroenterology, the First Affiliated Hospital of Chengdu MedicalCollege, Chengdu 610500, Sichuan, CHINA
【Abstract】 Objective To observe the curative effect of Zhikang Capsule combined with Mesalazine in thetreatment of ulcerative colitis, and to explore the mechanism of treatment by detecting the serum levels of proinflamma-tory cytokines (TNF-α, IL-1β and IL-6) and anti-inflammatory mediators (IL-10) in patients. Methods A total of 98patients with mild-to-moderate ulcerative colitis in our hospital from January 2013 to December 2016 were enrolled andrandomly divided into two groups. The observation group (49 cases) received Zhikang Capsule (orally, 3 tablets/time,3 times/day) and Mesalazine enteric-coated tablets (1.0 g/time, 4 times/day). The control group (49 cases) received Me-salazine (1.0 g/time, 4 times/day). The two groups were treated for 4 weeks. The levels of TNF-α, IL-1β, IL-6 andIL-10 were measured before and after treatment, and the symptoms of the two groups were observed and compared.Results The effective rate of treatment was 91.84% in the observation group and 75.51% in the control group (P<0.05).After treatment for 4 weeks, the levels of TNF-α, IL-1β and IL-6 in the observation group were (79.22±20.43) ng/L,(16.51±12.72) ng/L, (100.15±24.12) ng/L, significantly lower than (102.55±20.23) ng/L, (31.26±27.63) ng/L, (123.06±25.34) ng/L before treatment in the observation group and the corresponding (97.35±18.39) ng/L, (21.62±14.33) ng/L,(119.01±20.13) ng/L in the control group (P<0.05). The level of IL-10 in the observation group was (59.15±7.94) ng/L,significantly higher than (21.99 ± 5.14) ng/L before treatment in the observation group and the corresponding (42.51 ±6.99) ng/L in the control group (P<0.05). Conclusion Zhikang Capsule combined with Mesalazine for the treatment ofulcerative colitis is better than Methadiazine alone, which can reduce the degree of inflammatory response by reducingthe levels of proinflammatory cytokines TNF-α, IL-1β and IL-6 and increasing anti-inflammatory factor IL-10.
      【Key words】 Ulcerative colitis; Zhikang Capsule; Misalazine; Proinflammatory cytokines; Anti-inflammatory factor·临床经验·doi:10.3969/j.issn.1003-6350.2017.23.012