柴芍六君颗粒配合经肠镜植入益生菌治疗溃疡性结肠炎临床观察

目的:基于NLRP-6探讨双歧杆菌三联活菌胶囊制剂经肠镜喷洒于右半结肠单次给药治疗溃疡性结肠炎的可行性及作用机理。方法:将36例溃疡性结肠炎患者随机分为两组各18例,治疗组口服柴芍六君颗粒配合经肠镜下植入益生菌,对照组给予口服美沙拉嗪颗粒剂,疗程为12周,观察肠镜下Baron评分、肠道菌群变化及NLRP-6表达变化。结果:两组总有效率相当,治疗组为83.3%,对照组为77.8%,无统计学差异(P﹥0.05);治疗前两组肠镜下Baron评分积分值分别为(5.30±1.46)、(5.15±1.51),治疗12周后为(3.35±1.37)、(3.73±1.71),差异有统计学意义(P﹤0.05),治疗后两组间比较无明显差异(P﹥0.05)。两组治疗12周后肠杆菌、肠球菌较治疗前减少,双歧杆菌、乳酸杆菌增多,有统计学差异;治疗后两组间比较有统计学差异(P﹤0.05)。治疗后两组NLRP-6基因及免疫组化阳性细胞表达数均降低,治疗后组内及组间比较有统计学差异(P﹤0.05)。结论:口服柴芍六君颗粒配合经肠镜下植入益生菌可增加优势菌群(双歧杆菌、乳酸杆菌),减少致病菌群(肠杆菌、肠球菌),调节NLRP-6基因表达,从而有效治疗溃疡性结肠炎。

Efficiency observation of modified Chaishao Liujun granules and probiotics of endoscopic implantation on ulcerative colitis

Objective:To observe the curative effect and mechanism of modified Chaishao Liujun granules and probiotics of endoscopic implantation on ulcerative colitis. Methods:36 cases of patients with ulcerative colitis were randomly divided into two group,18 cases in each group. The treatment group was treated with oral modified Chaishao Liujun granules and probiotics of endoscopic implantation,while the control group was treated with oral modified Chaishao Liujun granules and mesalazine granules.The course of treatment was 12 weeks. Endoscopic Baron score,TCM symptom score,change of intestinal flora and change of NLRP-6 expression were observed. The curative effects of two groups were evaluated. Results:The total effective rates of two groups was similar,83.3% in treatment group and 77.8% in control group,and with no statistical difference(P>0.05). Before treatment,in treatment group and control group,the values of endoscopic Baron score were respectively(5.30±1.46)and(5.15±1.51),after 12 weeks of treatment respectively(3.35±1.37)and(3.73±1.71);while compared between two groups after treatment,there was no significant difference(P>0.05). After 12 weeks of treatment in both groups,enterobacter and enterococcus were less than before treatment,bifidobacterium and lactobacillus were more,there were statistical differences;compared between two groups after treatment,there was a statisticallysignificant difference(P<0.05).After treatment in both groups,the expressions of NLRP-6 gene and positive cells of immunohistochemistry decreased;compared within same group and between two groups after treatment,there were statistically significant differences(P<0.05). Conclusion:Probiotics of endoscopic implantation can increase dominantmicroflora(bifidobacterium and lactobacillus),decrease pathogenic bacteria(enterobacter and enterococcus)and regulate the expressions of NLRP-6 gene,so as to effectively treat ulcerative colitis.