乌梅丸加减治疗溃疡性结肠炎初探

<正>溃疡性结肠炎是一种局限于结肠粘膜及粘膜下层的炎症过程,病变多位于乙状结肠和直肠,也可延伸到降结肠,甚至整个结肠。病史漫长,常反复发作,可见于任何年龄,但20岁～30岁最多见。该病病因至今未明,虽有多     

乌梅丸加减治疗溃疡性结肠炎

目的观察运用乌梅丸加减来治疗溃疡性结肠炎,并观察其临床效果。方法选取55例患者随机分成治疗组与对照组,治疗组对其口服加减乌梅丸,对照组服用诺氟沙星胶囊合黄连素治疗,观察临床疗效。结果治疗组的总有效率达91%,对照组达79%,两组差异具有统计学意义。结论口服加减乌梅丸治疗溃疡性结肠炎疗效良好,无不良反应,医疗费用又低,值得医学界长期推广。     

CX-10对DSS诱导的小鼠溃疡性结肠炎的作用及其机制

目的研究经过化学修饰的穿心莲内酯化合物CX-10对DSS诱导的小鼠溃疡性结肠炎的治疗潜力,并对其可能的作用机制进行初步探究。方法采用DSS灌胃诱导小鼠溃疡性结肠炎。随机分为对照组(灭菌去离子水)、DSS组、DSS+美沙拉嗪(200 mg·kg~(-1))组和DSS+CX-10(50,100,200 mg·kg~(-1))组。在实验期间,每天监测和记录小鼠的临床体征,体质量变化,粪便稠度和便血情况,评价疾病活动指数。评估结肠组织病理学损伤程度。测定结肠组织中的MPO活性及TNF-α和IL-6水平。用Western印迹法检测NF-κB和MAPK信号通路的蛋白表达。结果 DSS成功诱导小鼠溃疡性结肠炎。CX-10组抑制了体质量减轻和结肠缩短,显著降低结肠重量和脾指数,减少了疾病活动指数评分和组织学损伤。CX-10还降低了结肠组织中MPO活性及TNF-α和IL-6的表达,CX-10 200 mg·kg~(-1)组与美沙拉嗪组的治疗效果相当。另外,CX-10可以增加IκBα表达的同时,降低NF-κB P65和p-IκBα的表达,同时下调磷酸化P38-MAPK,磷酸化ERK和磷酸化JNK的含量。说明CX-10对NF-κB和MAPK通路的激活具有抑制效应。结论 CX-10可减轻DSS诱导的小鼠溃疡性结肠炎,可能与其抑制NF-κB和MAPK的活化并抑制相关炎症因子的表达有关,提示CX-10是溃疡性结肠炎的潜在治疗药物。     

姜黄素对TNBS诱导的小鼠溃疡性结肠炎的治疗作用

目的以姜黄素(Cur)和柳氮磺吡啶(SASP)治疗结肠炎模型小鼠,探讨姜黄素在小鼠实验性结肠炎中的抗炎作用及机制。方法用三硝基苯磺酸(TNBS)/乙醇灌肠制备小鼠结肠炎动物模型。模型小鼠分别腹腔注射二甲基亚砜(DMSO)、Cur+DMSO、柳氮磺吡啶+DMSO1周,评价各组小鼠的体质量变化、疾病活动度指数,观察组织学损伤,采用RT-PCR和Western blotting检测结肠组织PPAR-γ和核因子-κB(NF-κB)的表达,并与SASP治疗组相比。结果Cur治疗组小鼠的体重较SASP治疗组恢复快,疾病活动度指数明显降低,组织学损伤轻,结肠组织PPAR-γ表达增高,NF-κB表达减低(P<0.05)。结论姜黄素可能通过PPAR-γ途径负性调节NF-κB的表达,在TNBS诱导的小鼠结肠炎中发挥抗炎作用,其疗效比柳氮磺吡啶显著。     

乌梅丸结合穴位敷贴治疗溃疡性结肠炎42例

目的观察乌梅丸结合穴位敷贴治疗溃疡性结肠炎的疗效。方法采用乌梅丸(乌梅、细辛、干姜、黄连、当归、附子、蜀椒、桂枝、人参、黄柏)结合穴位敷贴(天枢、中脘、足三里)治疗溃疡性结肠炎42例。结果临床有效40例,无效2例,总有效率95.2%。结论乌梅丸结合穴位敷贴治疗溃疡性结肠炎有较好疗效。     

乌梅丸对2,4,6-三硝基苯磺酸诱导的溃疡性结肠炎大鼠的作用机制研究

目的 研究乌梅丸对2,4,6-三硝基苯磺酸(TNBS)诱导的溃疡性结肠炎(UC)大鼠的作用机制.方法 大鼠结肠灌注含50％乙醇的TNBS溶液复制UC模型.造模次日,按照体重将造模成功大鼠随机分为5组:模型组、阳性对照组和低、中、高3个剂量实验组,每组8只.另取8只正常大鼠作为正常组.阳性对照组大鼠灌胃0.5 g·kg-...     

乌梅丸联合5-氨基水杨酸治疗溃疡性结肠炎的临床研究

目的探讨乌梅丸联合5-氨基水杨酸治疗溃疡性结肠炎的临床疗效。方法选取2014年3月—2015年7月仙桃市中医医院消化内科收治的溃疡性结肠炎患者76例,按治疗方法不同分为对照组和治疗组,每组各38例。对照组口服5-氨基水杨酸肠溶片,2片/次,3次/d。治疗组在对照组治疗基础上口服乌梅丸,6丸/次,3次/d。两组患者均连续治疗6周。观察两组的临床疗效,比较治疗前后两组中医症状评分、血清炎性因子包括IL-6、IL-8、IL-10、TNF-α水平变化,同时比较两组肠道菌群的变化情况。结果治疗后,对照组和治疗组的总有效率分别为78.95%、94.74%,两组比较差异有统计学意义(P0.05)。两组患者中医症状评分、IL-6、IL-8及TNF-α均降低,IL-10显著升高,同组治疗前后差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度优于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组患者双歧杆菌和乳酸菌均显著升高,大肠杆菌显著降低,同组治疗前后差异具有统计学意义(P0.05);且治疗组这些观察指标的改善程度优于对照组,两组比较差异有统计学意义(P0.05)。结论乌梅丸联合5-氨基水杨酸肠溶片治疗溃疡性结肠炎具有较好的临床疗效,可降低患者临床中医症状评分,改善血清炎症细胞因子水平,促进肠道菌群恢复,具有一定的临床推广应用价值。     

溃疡性结肠炎患者的骨密度分析

目的：探讨溃疡性结肠炎（ UC）患者的骨密度变化情况。方法选取我院2012年1月－2014年12月收治的UC患者100例作为观察组,健康体检者60例作为对照组。超声检测2组L1～L4骨密度（ BMD）。结果观察组患者骨密度降低56例（56％）,骨量减少37例（37％）,骨质疏松7例（7％）。观察组患者的骨密度及T值均低于对照组,差异均有统计学意义（P＜0．05）。结论 UC患者可引起BMD降低而发生骨质疏松。     

乌梅汤治疗寒热错杂型溃疡性结肠炎35例

目的观察乌梅汤治疗寒热错杂型溃疡性结肠炎的临床效果。方法将70例溃疡性结肠炎患者随机分为对照组与治疗组,每组各35例,对照组采用西药柳氮磺毗啶进行治疗,治疗组用中药乌梅汤加减,两组治疗周期均为半年,治疗结束后评定疗效。结果治疗结束后,治疗组临床总有效率为88．57％,完全缓解20例,对照组临床总有效率为74．29％,完全缓解11例,两组完全缓解人数差异有统计学意义（P〈0.05）。结论乌梅汤治疗寒热错杂型溃疡性结肠炎的临床疗效显著,尤其对于病程较长的患者完全治愈率高,值得在临床推广应用。     

白及多糖对溃疡性结肠炎的作用研究

目的:研究白及多糖(BSPS)对溃疡性结肠炎(UC)的作用。方法:小鼠均分为6组,即对照(等容生理盐水)、模型(等容生理盐水)、柳氮磺胺吡啶(SASP,370mg.kg-1)和BSPS高、中、低剂量(320、160、80mg.kg-1)组,ig给药,每天1次,连续10d。恶唑酮诱导复制UC模型后观察小鼠疾病活动指数(DAI)、结肠指数、结肠组织大体评分和病理评分,并检测结肠组织白细胞介素(IL)-10、肿瘤坏死因子(TNF)-α和核因子(NF)-κB的水平。结果:与模型组比较,BSPS高、中剂量组小鼠DAI、结肠指数、结肠组织大体评分、病理评分和TNF-α、NF-κB水平均显著降低(P<0.05或P<0.01),IL-10显著升高(P<0.05)。结论:BSPS具有促进UC模型小鼠肠黏膜修复、抑制机体炎症和恢复免疫平衡的作用,其作用机制可能与抑制TNF-α和NF-κB,上调IL-10水平有关。     

Protective effect of taurohyodeoxycholic acid from Pulvis Fellis Suis on trinitrobenzene sulfonic acid induced ulcerative colitis in mice

Ulcerative colitis is a nonspecific inflammatory disorder characterized by oxidative and nitrosative stress, leucocyte infiltration and up-regulation of pro-inflammatory cytokines. The aim of this study is to evaluate the effect of taurohyodeoxycholic acid (THDCA) isolated from Pulvis Fellis Suis on acute ulcerative colitis model induced by trinitrobenzene sulfonic acid (TNBS) in mice. The efficacy of THDCA was studied by macroscopical and histological scoring systems as well as myeloperoxidase (MPO) activity. Serum levels, including tumor necrosis factor (TNF)-α and interleukin (IL)-6 were assayed by enzyme-linked immunoassay. The expression of cyclooxygenase (COX)-2 in the colons was assessed by immunohistochemical analysis. Treatment with THDCA in doses of 25, 50 and 100 mg/kg/day and sulfasalazine in a dose of 500 mg/kg/day used as reference for 7 consecutive days after the induction of colitis, significantly decreased colonic MPO activity, TNF-α, IL-6 serum levels and the expression of COX-2 in colon compared with TNBS induced ulcerative colitis model group. Moreover, THDCA attenuated the macroscopic colonic damage and the histopathological changes induced by TNBS. All the effects of these parameters were comparable to that of the standard sulfasalazine, especially at the highest dose level. The results suggested that THDCA from Pulvis Fellis Suis has a protective effect in TNBS-induced ulcerative colitis which might be due to its anti-inflammatory activities, and that it may have therapeutic value in the setting of inflammatory bowel disease.     

基于HPLC-Q-Orbitrap-MS槐白皮水提物的化学成分测定及其对溃疡性结肠炎的治疗作用研究

目的 分析槐白皮水提物的化学成分,探讨其对溃疡性结肠炎的治疗作用及机制.方法 采用高效液相色谱-四级杆/静电场轨道阱高分辨质谱(HPLC-Q-Orbitrap-MS)技术对槐白皮水提物的化学成分进行定性鉴定,与数据库(mzCloud、mzVault、ChemSpider)检索比对.42只♂ BALB/c小鼠随机分为正常...     

Plumbagin inhibits LPS-induced inflammation through the inactivation of the nuclear factor-kappa B and mitogen activated protein kinase signaling pathways in RAW 264.7 cells

Plumbagin (PL) has been reported to exhibit anti-carcinogenic, anti-inflammatory and analgesic activities, but little is known about its mechanism. In this study, we investigated the anti-inflammatory property of PL and its mechanism of action. Although no significant cytotoxicity of PL was observed over the concentration range tested, PL (2.5–7.5 μM) significantly and dose-dependently suppressed the secretion of pro-inflammatory mediators and inhibited the expression of TNF-α, IL-1β, IL-6 and iNOS in LPS-stimulated RAW 264.7 cells. Furthermore, PL consistently suppressed the activity of iNOS in LPS-induced RAW 264.7 cells. To elucidate the mechanism underlying the anti-inflammatory activity of PL, we assessed the effects of PL on the MAPK pathway and the activity and expression of NF-κB. These experiments demonstrated that PL significantly reduced the luciferase activity of an NF-κB promoter reporter and p65 nuclear translocation. The LPS-induced phosphorylation of MAP kinases was also attenuated by PL; significant changes were observed in the levels of phosphorylated ERK1/2, JNK and p38 MAPK. Additionally, MAPK inhibitors confirmed the inhibitory effect of PL on the MAPK pathway. Taken together, these data suggest that PL exerts its anti-inflammatory effects by down-regulating the expression of pro-inflammatory mediators through inhibition of NF-κB and MAPK signaling in LPS-stimulated RAW 264.7 cells.     

中药保留灌肠治疗溃疡性结肠炎效果观察

目的:探讨中药保留灌肠治疗溃疡性结肠炎(Ulcerative colitis,UC)的疗效.方法:将74例UA患者随机分为两组,对照组36例采用柳氮磺吡啶(SASP)口服加思密达保留灌肠治疗;治疗组38例采用SASP口服加中药保留灌肠治疗.观察两组患者临床疗效及治疗前后结肠镜病理学改变,用酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)检测两组UC患者血清TNF-α、IL-β含量.结果:治疗组总有效率为94.7%,对照组总有效率为77.8%(P＜0.05),治疗组治疗前后结肠镜病理学改变优于对照组.对照组治疗后血清TNF-α及IL-1水平分别(32.5±3.6)、(43.6±5.1)ng/L,治疗组治疗后血清TNF-α及IL-β水平分别为(22.3±3.1)、(33.4±3.8)ng/L(P＜0.05).结论:中药保留灌肠治疗UA疗效显著.     

Suppression of NF-kappaB activation by curcumin leads to inhibition of expression of cyclo-oxygenase-2 and matrix metalloproteinase-9 in human articular chondrocytes: Implications for the treatment of osteoarthritis

Pro-inflammatory cytokines such as interleukin-1beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha) play a key role in the pathogenesis of osteoarthritis (OA). Anti-inflammatory agents capable of suppressing the production and catabolic actions of these cytokines may have therapeutic potential in the treatment of OA and a range of other osteoarticular disorders. The purpose of this study was to examine the effects of curcumin (diferuloylmethane), a pharmacologically safe phytochemical agent with potent anti-inflammatory properties on IL-1beta and TNF-alpha signalling pathways in human articular chondrocytes maintained in vitro. The effects of curcumin were studied in cultures of human articular chondrocytes treated with IL-1beta and TNF-alpha for up to 72h. Expression of collagen type II, integrin beta1, cyclo-oxygenase-2 (COX-2) and matrix metalloproteinase-9 (MMP-9) was monitored by western blotting. The effects of curcumin on the expression, phosphorylation and nuclear translocation of protein components of the NF-kappaB system were studied by western blotting and immunofluorescence, respectively. Treatment of chondrocytes with curcumin suppressed IL-1beta-induced NF-kappaB activation via inhibition of IkappaBalpha phosphorylation, IkappaBalpha degradation, p65 phosphorylation and p65 nuclear translocation. Curcumin inhibited the IL-1beta-induced stimulation of up-stream protein kinase B Akt. These events correlated with down-regulation of NF-kappaB targets including COX-2 and MMP-9. Similar results were obtained in chondrocytes stimulated with TNF-alpha. Curcumin also reversed the IL-1beta-induced down-regulation of collagen type II and beta1-integrin receptor expression. These results indicate that curcumin has nutritional potential as a naturally occurring anti-inflammatory agent for treating OA through suppression of NF-kappaB mediated IL-1beta/TNF-alpha catabolic signalling pathways in chondrocytes.     

美沙拉嗪治疗溃疡性结肠炎的疗效

目的 探讨美沙拉嗪治疗溃疡性结肠炎的临床疗效与安全性.方法 溃疡性结肠炎患者84例随机均分为两组,分别在支持治疗的基础上,观察组加用美沙拉嗪治疗,每日口服3次,1.0 g/次;对照组加用柳氮磺胺吡啶常规治疗;疗程为8周.比较两组临床疗效和治疗前后外周血C反应蛋白(CRP)、IL-6和TNF-α变化,记录治疗期的不良反应.结果 观察组的总有效率为97.6％,明显高于对照组的81.0％ (P＜0.05).治疗后两组外周血CRP和炎性细胞因子IL6和TNF-α水平均明显下降,且观察组的改变更为明显(P＜0.05).两组的不良反应发生率相仿(4.8％vs.9.5％)(P＞0.05).结论 美沙拉嗪治疗溃疡性结肠炎的临床疗效优于柳氮磺胺吡啶,能够明显改善患者体内的炎性状态.