美沙拉秦联合肠胃宁治疗溃疡性结肠炎疗效及对TGF-β1、IGF-1的影响
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摘要
目的探究美沙拉秦联合肠胃宁治疗初发型溃疡性结肠炎疗效及对患者血清细胞因子TGF-β1、IGF-1水平的影响。方法选取来自武汉大学人民医院消化内科就诊并接受治疗的初发型溃疡性结肠炎患者44例,单药治疗组20例仅口服美沙拉秦,联合用药组24例口服美沙拉秦及肠胃宁,对比两组患者临床疗效;选取16例健康人为正常对照组,检测并比较患者治疗前后血清细胞因TGF-β1及IGF-1水平。结果联合用药组经过治疗后总有效率(79.17%)高于单药治疗组(50.00%),差异具有统计学意义(χ~2=4.13,P=0.04)。正常对照组TGF-β1及IGF-1水平分别为(108.50±18.99)ng/L和(255.25±17.41)ng/L;经药物治疗后,联合用药组[(92.46±16.76)ng/L、(221.25±11.56)ng/L]比单药治疗组[(79.45±14.44 ng/L),(181.80±12.12 ng/L)]变化更显著。与治疗前比较,两组患者TGF-β1及IGF-1水平均升高,差异具有统计学意义(单一药物组:t=-4.16,P=0.001;t=-14.22,P=0.000)(联合用药组:t=-8.49,P=0.000;t=-26.7,P=0.000);与单药治疗组相比,治疗后联合用药组患者细胞因子TGF-β1及IGF-1水平升高更显著,差异具有统计学意义(t=2.02,P=0.01;t=2.02,P <0.001)。结论将美沙拉秦与肠胃宁联用能够提高总有效率,患者血清TGF-β1及IGF-1含量更接近正常对照组。
Objective To explore the curative effects and influences of the serum cytokines level in patients with UC after the medication treatment combined salad oxazine with Chang weining.Methods Selecting forty-four patients with UC who came to Renmin Hospital of Wuhan University and accepted medication treatment. Twenty patients were only treated with salad oxazine and other twenty-four patients were treated with salad oxazine and Chang weining, then clinical efficacy was compared between the two groups. In addition, sixteen healthy people were chosen as normal control group, and the serum cytokine level of TGF-β and IGF-1 in two groups were measured before and after treatment with medications. Results After treatments, the total efficiency of combination group(79.17%) was higher than that of single drug treatment group(50.00%), and the difference presented statistically significant(χ~2=4.13, P=0.04). The levels of TGF-β1 and IGF-1 in the normal control group were(108.50±18.99) ng/L and(255.25±17.41) ng/L,respectively. After treatment, the combined drug treatment group [(92.46±16.76) ng/L,(221.25±11.56) ng/L] presented more significant changes than single drug treatment group [(79.45±14.44) ng/L,(181.80±12.12) ng/L]. Compared with the of serum cytokine level before treatment, both TGF-β and IGF-1 levels in two groups were increased, and the difference was statistically significant(single drug treatment group:t=-4.16, P=0.001; t=-14.22, P=0.000)(combined drug treatment group: t=-8.49, P=0.000; t=-26.7,P=0.000). Compared with the single drug treatment group, the level of cytokine in patients with combined drug treatment group was significantly higher, and the difference was statistically significant(t=2.02, P=0.01;t=2.02, P < 0.001). Conclusions The total effective rate was increased by the combination of salad oxazine and Chang weining, and the serum cytokine level of TGF-β1 and IGF-1 of combination group were closer to the normal control group.
Objective To explore the curative effects and influences of the serum cytokines level in patients with UC after the medication treatment combined salad oxazine with Chang weining.Methods Selecting forty-four patients with UC who came to Renmin Hospital of Wuhan University and accepted medication treatment. Twenty patients were only treated with salad oxazine and other twenty-four patients were treated with salad oxazine and Chang weining, then clinical efficacy was compared between the two groups. In addition, sixteen healthy people were chosen as normal control group, and the serum cytokine level of TGF-β and IGF-1 in two groups were measured before and after treatment with medications. Results After treatments, the total efficiency of combination group(79.17%) was higher than that of single drug treatment group(50.00%), and the difference presented statistically significant(χ~2=4.13, P=0.04). The levels of TGF-β1 and IGF-1 in the normal control group were(108.50±18.99) ng/L and(255.25±17.41) ng/L,respectively. After treatment, the combined drug treatment group [(92.46±16.76) ng/L,(221.25±11.56) ng/L] presented more significant changes than single drug treatment group [(79.45±14.44) ng/L,(181.80±12.12) ng/L]. Compared with the of serum cytokine level before treatment, both TGF-β and IGF-1 levels in two groups were increased, and the difference was statistically significant(single drug treatment group:t=-4.16, P=0.001; t=-14.22, P=0.000)(combined drug treatment group: t=-8.49, P=0.000; t=-26.7,P=0.000). Compared with the single drug treatment group, the level of cytokine in patients with combined drug treatment group was significantly higher, and the difference was statistically significant(t=2.02, P=0.01;t=2.02, P < 0.001). Conclusions The total effective rate was increased by the combination of salad oxazine and Chang weining, and the serum cytokine level of TGF-β1 and IGF-1 of combination group were closer to the normal control group.
引文
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[14]Dubash AD,Kam CY,Aguado BA,et al.Plakophilin-2 loss promotes TGF-β1/p38 MAPK-dependent fibrotic gene expression in cardiomyocytes[J].J Cell Biol,2016,212(4):425-438.
[15]王俊珊,刘占举,郑萍,等.胰岛素样生长因子与炎症性肠病活动度和病变范围的相关性[J].上海医学,2010,33(1):104-106.
[16]Zatorski H,Marynowski M,Fichna J.Is insulin-like growth factor1(IGF-1)system an attractive target inflammatory bowel diseases?Benefits and limitation of potential therapy[J].Pharmacological Reports,2016,68(4):809-815.
[2]刘笃佳,王媛媛,马旭.溃疡性结肠炎的流行病学研究进展[J].中国烧伤创疡杂志,2017,29(3):214-217.
[3]Wang YN,Li J,Zheng WY,et al.Clinical characteristics of ulcerative colitis related colorectal cancer in Chinese patients[J].J Dig Dis,2017,18(12):684-690.
[4]Yoshino T,Nakase H,Takagi T,et al.Risk factors for developing colorectal cancer in Japanese patients with ulcerative colitis:a retrospective observational study-CAPITAL(Cohort and Practice for IBD total management in Kyoto-Shiga Links)study I[J].BMJ Open Gastroenterol,2016,3(1):e000122.
[5]Caini S,Bagnoli S,Palli D,et al.Total and cancer mortality in a cohort of ulcerative colitis and Crohn′s disease patients:The Florence inflammatory bowel disease study,1978-2010[J].Dig Liver Dis,2016,48(10):1162-1167.
[6]张声生,沈洪,郑凯,等.溃疡性结肠炎中医诊疗专家共识意见(2017)[J].中华中医药杂志,2017,32(8):3585-3589.
[7]中华医学会消化病学分会炎症性肠病学组.炎症性肠病诊断与治疗的共识意见(2012年·广州)[J].胃肠病学,2012,51(12):763-781.
[8]中华医学会病理学分会消化病理学组筹备组.中国炎症性肠病组织病理诊断共识意见[J].中华病理学杂志,2014,43(4):268-274.
[9]张娜,周璐,曹晓沧,等.初发型溃疡性结肠炎患者的长期随访(附37例病例分析)[J].天津医科大学学报,2012,18(1):89-92.
[10]李军祥,谭祥,毛堂友.溃疡性结肠炎中西医结合治疗策略[J].中国中西医结合杂志,2017,37(4):398-400.
[11]干丹,韩昌鹏.中西医结合治疗溃疡性结肠炎的研究进展[J].现代中西医结合杂志,2017,26(26):2958-2961.
[12]胥靖域,顾三元,王菊,等.TGF-β1与溃疡性结肠炎的相关性研究[J].实用中西医结合临床,2013,13(7):1-3.
[13]李苁,黄德强.TGF-β在炎症性肠病肠纤维化中的作用[J].实用临床医学,2017,18(5):104-107.
[14]Dubash AD,Kam CY,Aguado BA,et al.Plakophilin-2 loss promotes TGF-β1/p38 MAPK-dependent fibrotic gene expression in cardiomyocytes[J].J Cell Biol,2016,212(4):425-438.
[15]王俊珊,刘占举,郑萍,等.胰岛素样生长因子与炎症性肠病活动度和病变范围的相关性[J].上海医学,2010,33(1):104-106.
[16]Zatorski H,Marynowski M,Fichna J.Is insulin-like growth factor1(IGF-1)system an attractive target inflammatory bowel diseases?Benefits and limitation of potential therapy[J].Pharmacological Reports,2016,68(4):809-815.