谷参肠安对溃疡性结肠炎黏膜细胞因子的影响

目的观察谷参肠安（复方谷氨酰胺肠溶胶囊）口服治疗活动期溃疡性结肠炎（UC）的疗效及安全性，并进一步探讨其对肠黏膜细胞因子的影响。方法活动期UC患者76例，随机分为2组。对照组（36例）口服柳氮磺胺吡啶（或美沙拉嗪），同时用琥珀酸氢化考的松及庆大霉素、蒙脱石散保留灌肠，每晚1次；治疗组（40例）在上述治疗基础上，121服谷参肠安胶囊0．6g，每天3次。治疗2个月后评价2组疗效，主要症状和结肠镜变化情况，免疫组化法检测患者肠黏膜局部细胞因子IL—10和IL-18的变化。结果治疗后两组临床表现均明显好转，且治疗组优于对照组，2组比较，差异有统计学意义（P〈0．05）。疾病活动指数（DAI）降低（P〈0．05），降低幅度治疗组优于对照组（t=5．05，P〈0．01）；治疗后黏膜细胞因子IL-10的水平升高，IL-18降低，治疗组均优于对照组（P〈0．05）。结论谷参肠安口服并联合琥珀酸氢化考的松及庆大霉素保蜜灌肠治疗活动期UC近期疗效明显优于只用琥珀酸氢化考的松及庆大霉素保留灌肠，且无明显不良反应。

Effect of Glutamine Entero-soluble Capsule on Mucosal Cytokine of Patients with Ulcerative Colitis

[ Objective ] To observe the therapeutic effect and safety of compound glutamine entero-soluble capsule （ CGC ） on active ulcerative colitis （UC）, and to investigate its effects on the cytokines in mucosa. [ Methods] Totally 76 patients with active UC were randomly assigned to the treatment group（40 patients ） and the control group（ 36 patients）. Besides the basic treatment of oral taking salicylazosulfapyridine or mesalazine, the control group was treated by retention enema with Hydrocortisone succinate plus Gentamicin and Montmorillonite Powder for once each night. The patients in the treatment group were treated by oral administration of CGC, 0.6 g each time, thrice a day. The efficacy of treatment such as the clinical symptom, colon mucosa inflammation changes and the expressions of IL-10 and IL-18 in mucosa of patients were evaluated with immunohistochemistry 2 months after treatment. [ Results] After the treatment, clinical manifestation of all patients had improved, treatment group was better than control group, the difference was signifieant between 2 groups （ P 〈 0.05 ）. The disease active index （ DAI ） decreased after the treatment in both 3 groups （ P 〈 0.05 ）, reduction of DAI in the treatment group were superior to that in the control group （ t = 5.05, P 〈 0.01 ）. The expressions of IL- 10 in mucosa increased, while the expression of IL-18 decreased, especially in experiment group （ P 〈0.05）. [ Conelusion]The effect of combination treatment of glutamine entero-soluble capsule, hydrocortisone, gentamicin and retention enema is better than that of single use of hydrocortisone or gentamiein with retention enema, and with no adverse reaction.