参苓白术散联合美沙拉嗪治疗溃疡性结肠炎的疗效及对NLRP3炎症小体的影响

doi:10.12092/j.issn.1009-2501.2018.03.013

摘要/Abstract

摘要：

目的:探讨参苓白术散联合美沙拉嗪治疗溃疡性结肠炎（ulcerative colitis,UC）的临床疗效及对NOD样受体-3(Nod-like receptor pyrin domain 3,NLRP3)炎症小体的影响。方法:入选UC患者100例，随机分为对照组和观察组，各50例。对照组给予美沙拉嗪1.0 g qid，观察组给予美沙拉嗪1.0 g qid+参苓白术散6.0 g tid。疗程8周。比较两组患者的临床疗效；检测肠黏膜中NLRP3、凋亡相关斑点样蛋白（apoptosis-associated speck-like protein containing CARD,ASC）、天冬氨酸特异性半胱氨酸蛋白酶（caspase）-1 mRNA表达水平；检测外周血血清中C-反应蛋白(C-reactive protein,CRP)、血沉(erythrocyte sedimentation rate,ESR)、白细胞介素-1β(interleukin-1β,IL-1β)、白细胞介素-18(interleukin-18,IL-18)的情况。结果:治疗后，观察组的临床症状改善总有效率（86.00%）显著优于对照组（73.00%），差异有统计学意义（P<0.05）。观察组肠黏膜NLRP3、ASC、caspase-1 mRNA表达(4.08±0.85、3.75±0.91、3.86±0.93)较对照组(5.26±0.96、4.66±0.95、4.97±0.99)明显降低，差异有统计学意义(P<0.05)。观察组血清中CRP、ESR、IL-1β、IL-18［（6.74±2.45） mg/L、（11.63±4.58） mm/h、（44.27±8.58） pg/mL、（263.37±60.34） pg/mL］较对照组［（15.32±5.68） mg/L、（18.45±5.12） mm/h、（51.11±9.26） pg/mL、（371.18±61.25） pg/mL］明显降低，差异有统计学意义(P<0.05)。结论:参苓白术散联合美沙拉嗪治疗UC具有良好的临床疗效，其作用机制可能与抑制NLRP3炎症小体的形成，进而抑制炎症反应有关。

关键词: 参苓白术散, 溃疡性结肠炎, 临床疗效, NLRP3炎症小体

Abstract:

AIM: To investigate the clinical effect of Shenlingbaizhu powder combined with mesalazine in the treatment of ulcerative colitis (UC) and the influence of Nod-like receptor pyrin domain 3 (NLRP3) inflammasome. METHODS: One hundred patients with UC were randomly divided into control group and observation group, fifty cases in each group. The control group was given mesalazine 1.0 g qid, while the observation group was given Shenlingbaizhu powder 6.0 g tid combined with mesalazine 1.0 g qid. The course of treatment was eight weeks. The clinical efficacy of the two groups was compared; the expression levels of NLRP3, apoptosis-associated speck-like protein containing CARD (ASC) and caspase-1mRNA were detected; The levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-1 beta (IL-1β) and interleukin-18 (IL-18) in serum was detected. RESULTS: After treatment, the total effective rate of the clinical symptoms of observation group (86%) was significantly better than that of control group (73%), the difference was statistically significant (P<0.05). The expression of NLRP3, ASC, caspase-1 mRNA in observation group (4.08±0.85, 3.75±0.91, 3.86±0.93) were more lower than those of control group (5.26±0.96, 4.66±0.95, 4.97±0.99), and the difference was statistically significant (P<0.05). The levels of CRP, ESR, IL-1 beta and IL-18 in observation group (6.74±2.45,11.63±4.58,44.27±8.58, 263.37±60.34) were more lower than those of control group (15.32±5.68,18.45±5.12,51.11±9.26, 371.18±61.25), and the difference was statistically significant (P<0.05). CONCLUSION: Shenlingbaizhu powder combined with mesalazine in the treatment of UC has good clinical curative effect, the mechanism may be related with the inhibition of NLRP3 inflammasome and inflammation.

Key words: Shenlingbaizhu powder, ulcerative colitis, curative effect, NLRP3 inflammasome

中图分类号:

R574.62

周桃梅，杨上文，汪剑波. 参苓白术散联合美沙拉嗪治疗溃疡性结肠炎的疗效及对NLRP3炎症小体的影响[J]. 中国临床药理学与治疗学, 2018, 23(3): 319-324.

ZHOU Taomei, YANG Shangwen, WANG Jianbo. Effects of Shenlingbaizhu powder combined with mesalazine in the treatment of ulcerative colitis and the influence of NLRP3 inflammasome[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2018, 23(3): 319-324.

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