美沙拉嗪结合锡类散灌肠治疗溃疡性结肠炎的效果及对患者免疫功能和细胞因子的影响

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摘要目的探讨美沙拉嗪结合锡类散灌肠治疗溃疡性结肠炎（UC）的效果及对患者免疫功能和细胞因子的影响。方法选取2018年1月至2021年1月在江苏大学附属武进医院诊治的76 例UC 患者作为研究对象，按随机数字表法将其分为对照组和研究组，每组各38 例。对照组给予美沙拉嗪治疗，研究组在对照组的基础上给予锡类散治疗，两组疗程均为8 周。比较两组的临床疗效、辅助性T 细胞（Th17）、调节性T 细胞（Treg）、T 细胞亚群（CD4+、CD8+、CD4+/CD8+）、自然杀伤细胞（NK）水平、免疫球蛋白（Ig）A、IgG、IgM 水平、血清白细胞介素（IL）-10、IL-18、IL-6、IL-4、肿瘤坏死因子-α（TNF-α）水平及不良反应发生情况。结果研究组患者的治疗总有效率为92.11%，高于对照组的68.42%，差异有统计学意义（P＜0.05）；研究组治疗后的Th17 表达水平低于对照组，差异有统计学意义（P＜0.05）；研究组治疗后的Treg 表达水平高于对照组，差异有统计学意义（P＜0.05）；研究组治疗后的CD4+、CD4+/CD8+、NK 水平均高于对照组，CD8+水平低于对照组，差异有统计学意义（P＜0.05）；研究组治疗后的IgA、IgG、IgM 水平均低于对照组，差异有统计学意义（P＜0.05）；研究组治疗后的IL-10、IL-4 水平均高于对照组，差异有统计学意义（P＜0.05）；研究组治疗后的IL-18、IL-6、TNF-α 水平均低于对照组，差异有统计学意义（P＜0.05）；两组患者的不良反应总发生率比较，差异无统计学意义（P＞0.05）。结论美沙拉嗪结合锡类散灌肠可提升UC 患者的临床治疗效果，改善UC 患者的免疫功能，减轻炎症反应，对免疫指标和细胞因子均产生不同程度的影响，且安全性较高。

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关键词 ：美沙拉嗪, 锡类散灌肠, 溃疡性结肠炎, 疗效, 免疫功能, 细胞因子

Abstract：Objective To explore the effect of Mesalazine combined with Tin Powder enema in the treatment of ulcerative colitis (UC) and its influence on the immune function and cytokines of patients. Methods A total of 76 patients with UC who were diagnosed and treated in Wujin Hospital Affiliated to Jiangsu University from January 2018 to January 2021 were selected as the research subjects. According to the random number table method, they were divided into a control group and a study group, with 38 cases in each group. The control group was treated with Mesalazine, and the study group was treated with Tin Powder enema on the basis of the control group. The clinical efficacy, helper T cells (Th17) and regulatory T cells (Treg), T cell subsets (CD4+, CD8+, CD4+/CD8+), natural killer cell (NK) levels, immunoglobulin (Ig) A, IgG, IgM levels, serum interleukin (IL)-10, IL-18, IL-6, IL-4, and tumor necrosis factor-α(TNF-α) and the occurrence of adverse reactions were compared between the two groups. Results The total effective rate of study group was 92.11%, which was higher than that of control group (68.42%), and the difference was statistically significant (P＜0.05). The expression level of Th17 in the study group after treatment was lower than that in the control group, and the difference was statistically significant (P＜0.05). The expression level of Treg in the study group after treatment was higher than that in the control group, and the difference was statistically significant (P＜0.05). After treatment, CD4+, CD4+/CD8+ and NK levels in the study group were higher than those in the control group, while CD8+level in the study group was lower than that in the control group, the differences were statistically significant (P＜0.05).The levels of IgA, IgG and IgM in the study group after treatment were lower than those in the control group, and the differences were statistically significant (P＜0.05). The levels of IL-10 and IL-4 in the study group after treatment were higher than those in the control group, with statistical significances (P＜0.05). The levels of IL-18, IL-6 and TNFα in the study group after treatment were lower than those in the control group, the differences were statistically significant (P＜0.05). There was no significant difference in the total incidence of adverse reactions between the two groups(P＞0.05). Conclusion Mesalamine combined with Tin Powder enema can enhance the clinical treatment effect in patients with UC, improve the immune function, reduce inflammation, and have varying degrees of impact on immune indicators and cytokines, and it is safer.

Key words： Mesalazine Tin Powder enema Ulcerative colitis Curative effect Immune function Cytokines

通讯作者: 贺明洁（1988-），女，汉族，硕士，主要从事消化系统疾病治疗方面的研究

引用本文:

蔡怡;贺明洁; 罗培培. 美沙拉嗪结合锡类散灌肠治疗溃疡性结肠炎的效果及对患者免疫功能和细胞因子的影响[J]. 中国当代医药, 2022, 29(2): 60-64.
CAI Yi ;HE Mingjie;LUO Peipei. Effect of Mesalamine combined with Tin Powder enema in the treatment of ulcerative colitis and its influence on the immune function and cytokines of patients. 中国当代医药, 2022, 29(2): 60-64.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2022/V29/I2/60

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