康复新液联合美沙拉嗪对溃疡性结肠炎活动期患者HMGB1、MCP-1、SOCS-3和Beclin1表达的影响

目的探讨康复新液联合美沙拉嗪对溃疡性结肠炎（UC）活动期患者高迁移率族蛋白B1（HMGB1）、单核细胞趋化蛋白-1（MCP-1）、细胞因子信号传导抑制蛋白-3（SOCS-3）和Beclin1表达的影响。 方法选择2019年2月至2021年2月亳州市人民医院UC活动期患者120例，按1∶1比例随机分为对照组和治疗组，各60例。2组患者均给予补液、营养支持、纠正电解质和酸碱平衡紊乱等基础治疗。对照组口服美沙拉嗪肠溶片1 g/次，4 次/d，连续治疗2周。治疗组在美沙拉嗪肠溶片基础上给予康复新液，30 ml加入150 ml 0.9%生理盐水稀释并加温至37℃后灌肠，每次灌肠时间20～30 min，每日2次，连续治疗2周。比较2组治疗效果、主要症状积分、肠道黏膜病变程度（改良Mayo评分和Geboes指数）、HMGB1、MCP-1、SOSC-3、Beclin1水平及炎症性肠病问卷（IBDQ）评分。 结果治疗组UC活动期患者治疗总有效率显著高于对照组（93.33% vs 78.33%，P＜0.05）。治疗前2组症状积分差异无统计学意义（P＞0.05），治疗后2组各症状积分均显著降低（P＜0.05），且治疗组显著低于对照组（P＜0.05）。治疗前2组改良Mayo评分和Geboes指数差异无统计学意义（P＞0.05），治疗后2组指标均降低（P＜0.05），且治疗组显著低于对照组（P＜0.05）。治疗前2组血清HMGB1、MCP-1、SOSC-3和Beclin1水平、蛋白表达水平差异无统计学意义（P＞0.05），治疗后2组HMGB1、MCP-1、Beclin1水平均下降，SOSC-3水平均升高，且治疗组各指标水平显著优于对照组（P＜0.05）。治疗前2组IBDQ评分差异无统计学意义（P＞0.05），治疗后2组评分均升高（P＜0.05），且治疗组显著高于对照组（P＜0.05）。 结论康复新液联合美沙拉嗪对UC活动期患者治疗效果显著，机制可能与HMGB1、MCP-1、Beclin1的下调及SOSC-3的上调有关。

Effect of Kangfuxin solution combined with mesalazine on expression of HMGB1, MCP-1, SOCS-3, and Beclin1 in patients with active ulcerative colitis

ObjectiveTo investigate the effect of Kangfuxin solution combined with mesalazine on the expression of high mobility group protein B1 (HMGB1), monocyte chemoattractant protein-1 (MCP-1), suppressor of cytokine signaling 3 (SOCS-3), and Beclin1 in patients with active ulcerative colitis (UC). MethodsA total of 120 UC patients with active UC treated at Bozhou People's Hospital from February 2019 to February 2021 were selected and randomly divided into either a control group or a treatment group at a ratio of 1∶1, with 60 cases in each group. Patients in both groups were given basic treatment such as fluid rehydration, nutritional support, and correction of electrolyte and acid-base balance disorders. Both groups were given mesalazine enteric-coated tablets (1 g/time, 4 times/day for 2 weeks). The treatment group was additionally given Kangfuxin solution (30 ml diluted with 150 mL 0.9% normal saline, heated to 37℃ before enema, 20 to 30 min for each enema, twice a day, for consecutive 2 weeks). Treatment efficacy, scores of major symptoms, severity of intestinal mucosal lesions (modified Mayo Mayo score and Geboes index), and levels of HMGB1, McP-1, SOSC-3, Beclin1, and IBDQ scores were compared between the two groups. ResultsThe total effective rate in the treatment group was significantly higher than that of the control group (93.33% vs 78.33%, P＜0.05). Before treatment, there was no statistical significance in the symptom scores between the two groups (P＞0.05); after treatment, the symptom scores of the two groups were both significantly decreased (P＜0.05), and they were significantly lower in the treatment group than in the control group (P＜0.05). Before treatment, there was no significant difference in the modified Mayo Risk score and Geboes index between the two groups (P＞0.05); after treatment, the modified Mayo risk score and Geboes index decreased in both groups (P＜0.05), and they were significantly lower in the treatment group than in the control group (P＜0.05). Before treatment, there were no significant differences in serum and tissue protein expression levels of HMGB1, MCP-1, SOSC-3, and Beclin1 between the two groups (P＞0.05); after treatment, the levels of HMGB1, MCP-1, and Beclin1 decreased, while the levels of SOSC-3 increased in both groups, and these indexes in the treatment group were significantly better than those of the control group (P＜0.05). Before treatment, there was no significant difference in IBDQ score between the two groups (P＞0.05); after treatment, the score increased in both groups (P＜0.05), and it was significantly higher in the treatment group than in the control group (P＜0.05). ConclusionKangfuxin solution combined with mesalazine has significant therapeutic effects in patients with active UC. The mechanism may be related to the down-regulation of HMGB1, MCP-1, and Beclin1 levels and up-regulation of SOSC-3 levels.