标题：盐酸小檗碱片联合美沙拉嗪治疗溃疡性结肠炎对患者T淋巴细胞亚群及肠道黏膜屏障功能的影响

      作者：曹竣植，童敏思，祝毛玲，王保才，史惠惠，臧意，马静，李力    曹竣植，童敏思，祝毛玲，王保才，史惠惠，臧意，马静，李力同济大学附属杨浦医院(上海市杨浦区中心医院)消化科，上海 200090

      卷次： 2023年34卷9期

      【摘要】 目的 探讨盐酸小檗碱片联合美沙拉嗪治疗溃疡性结肠炎对患者T淋巴细胞亚群及肠道黏膜屏障功能的影响。方法 选择2021年1月至2022年2月同济大学附属杨浦医院收治的90例溃疡性结肠炎患者作为研究对象，按照随机数表法分为观察组与对照组各45例。对照组患者给予美沙拉嗪治疗，观察组患者在对照组治疗的基础上联合盐酸小檗碱片治疗，两组患者均持续治疗3个月。比较两组患者治疗3个月后的临床疗效、症状改善时间，并比较治疗前、治疗3个月后两组患者的T淋巴细胞亚群CD3+、CD4+、CD4+/CD8+及血清二胺氧化酶(DAO)、D-乳酸(D-LA)水平以及治疗期间的不良反应发生情况。结果 治疗后，观察组患者的临床治疗总有效率为95.56%，明显高于对照组的80.00%，差异有统计学意义(P<0.05)；观察组患者的腹痛、腹泻、脓血便、里急后重改善时间分别为(2.49±0.32) d、(2.19±0.30) d、(2.01±0.36) d、(1.95±0.32) d，明显短于对照组的(4.12±0.57) d、(3.96±0.45) d、(4.07±0.52) d、(3.82±0.43) d，差异均有统计学意义(P<0.05)；治疗后，观察组患者的CD3+、CD4+、CD4+/CD8+分别为(68.20±5.61)%、(43.61±4.02)%、1.86±0.23，明显高于对照组的(62.67±5.25)%、(38.43±3.64)%、1.51±0.20，差异均有统计学意义(P<0.05)；治疗后，观察组患者的血清DAO、D-LA水平分别为(3.97±0.52) IU/mL、(3.16±0.38) mmol/L，明显低于对照组的(5.38±0.61) IU/mL、(4.47±0.59) mmol/L，差异均有统计学意义(P<0.05)；两组患者治疗期间均未发生明显不良反应。结论 盐酸小檗碱片联合美沙拉嗪治疗溃疡性结肠炎的疗效显著，且能有效改善T淋巴细胞亚群、肠道黏膜屏障功能，具有临床应用价值。
      【关键词】 溃疡性结肠炎；美沙拉嗪；盐酸小檗碱片；T淋巴细胞亚群；肠道黏膜屏障功能
      【中图分类号】 R574.62 【文献标识码】 A 【文章编号】 1003—6350（2023）09—1225—04

Effects of berberine hydrochloride tablets combined with mesalazine on T lymphocyte subsets and intestinalmucosal barrier function in patients with ulcerative colitis.
CAO Jun-zhi, TONG Min-si, ZHU Mao-ling, WANGBao-cai, SHI Hui-hui, ZANG Yi, MA Jing, LI Li. Digestive Department, Yangpu Hospital Affiliated to Tongji University(Shanghai Yangpu District Central Hospital), Shanghai 200090, CHINA
【Abstract】 Objective To investigate the effect of berberine hydrochloride tablets combined with mesalazineon T lymphocyte subsets and intestinal mucosal barrier function in patients with ulcerative colitis. Methods Ninety pa-tients with ulcerative colitis admitted to Yangpu Hospital Affiliated to Tongji University from January 2021 to February2022 were selected as the research objects, which were randomly divided into an observation group and a control group,with 45 cases in each group. Patients in the control group were treated with mesalazine, and those in the observationgroup were treated with berberine hydrochloride tablets combined with mesalazine, both for 3 months. The clinical effi-cacy and symptom improvement time at 3 months after treatment were compared between the two groups, and the chang-es of CD3+, CD4+, CD4+/CD8+, serum diamine oxidase (DAO), and D-lactic acid (D-LA) levels before and at 3 monthsafter treatment, and occurrence of adverse reactions during treatment were compared. Results After treatment, the totaleffective rate of clinical treatment in the observation group was 95.56%, which was significantly higher than 80.00% ofthe control group (P<0.05); the improvement time of abdominal pain, diarrhea, purulent and bloody stool, and tenesmusin the observation group was (2.49±0.32) d, (2.19±0.30) d, (2.01±0.36) d, (1.95±0.32) d, which were significantly short-er than (4.12±0.57) d, (3.96±0.45) d, (4.07±0.52) d, (3.82±0.43) d in the control group (P<0.05). After treatment, CD3+,CD4+, CD4+/CD8+ in the observation group were (68.20±5.61)%, (43.61±4.02)%, 1.86±0.23, which were significantlyhigher than (62.67±5.25)%, (38.43±3.64)%, 1.51±0.20 in the control group (P<0.05); after treatment, the serum DAOand D-LA levels in the observation group were (3.97±0.52) IU/mL and (3.16±0.38) mmol/L, which were significantlylower than (5.38±0.61) IU/mL and (4.47±0.59) mmol/L in the control group (P<0.05). There were no obvious adverse re-actions between the two groups during treatment. Conclusion Berberine hydrochloride tablets combined with mesala-zine in the treatment of ulcerative colitis has a significant effect, which can effectively improve T lymphocyte subsetsand intestinal mucosal barrier function, and has high clinical application value.
      【Key words】 Ulcerative colitis; Mesalazine; Berberine hydrochloride tablets; T lymphocyte subsets; Intestinalmucosal barrier function