甘草泻心汤对溃疡性结肠炎患者血浆IL-17、IL-23水平的影响

目的 观察甘草泻心汤对溃疡性结肠炎（UC）患者血浆白介素17（IL-17）、白介素23（IL-23）水平的影响，探讨甘草泻心汤治疗UC的可能机制。方法 将60例UC患者随机分为对照组及治疗组各30例，对照组予以柳氮磺吡啶口服治疗，治疗组在对照组的基础上配合甘草泻心汤治疗，疗程8周。观察治疗前后临床症状的改善情况，进行临床疗效评定，采用Mayo评分系统评估疾病活动度，采用IBDQ量表进行生活质量评分。同时采集2组患者外周静脉血，应用酶联免疫吸附法（ELISA）检测IL-17、IL-23的水平。结果 治疗组临床疗效总有效率达93.3%，明显优于对照组(总有效率80%，P＜0.05）；治疗后2组Mayo评分均下调（P<0.01），治疗组评分明显低于对照组（P＜0.01）；2组IBDQ评分均升高（P<0.05~0.01），治疗组IBDQ量表中肠道症状、全身症状、情感功能、社会功能及总分均高于对照组（P＜0.05~0.01）。治疗后，UC患者血浆IL-17、IL-23均下调(P<0.01)，与对照组相比，治疗组的IL-17、IL-23下调更显著（P＜0.01）。结论 甘草泻心汤联合柳氮磺吡啶治疗UC，可显著改善临床症状，提高生活质量；甘草泻心汤下调UC患者血浆IL-17、IL-23水平，参与免疫调节，可能是其治疗本病的机制之一。 

Effects of Gancao Xiexin Decoction on Serum Levels of IL-17 and IL-23 in Patients with Ulcerative Colitis

OBJECTIVE To explore the treatment mechanism of Gancao Xiexin Decoction on patients with ulcerative colitis(UC) by observing the serum levels of interleukin-17(IL17)， interleukin-23(IL23) before and after the treatment. METHODS 60 patients with UC were randomly divided into control group and treatment group， with 30 patients in each group. Patients in the control group were given oral sulfasalazine， while those in the treatment group were given Gancao Xiexin Decoction combined with sulfasalazine. After 8 weeks treatment， the clinical efficacy evaluation was done. To be specific， the disease activity score was calculated according to Mayo Score， and the quality of life was measured by IBD Questionnaire(IBDQ) before and after the treatment. Besides， peripheral venous blood samples of patients in both groups were collected and the serum levels of IL17， IL23 were measured with enzyme-linked immunosorbent assay(ELISA). RESULTS The total effective rate of the treatment group was 93.3%， which was evidently superior to that of 80% in the control group(P<0.05); The Mayo score of both groups went down after the treatment(P<0.01)， and the score of the treatment group was much lower than that in the control group(P<0.01). The symptom scores such as intestinal tract symptom， constitutional symptom， emotional capability， social competence as well as the total scores of the IBDQ in the treatment group were higher than those in the control group(P<0.05~0.01). The serum levels of IL17、IL23 in both group declined after the treatment， while the decrease in the treatment group was more obvious compared with the control group(P<0.01). CONCLUSION Gancao Xiexin Decoction combined with sulfasalazine shows significant efficacy in improving the clinical symptoms and life quality of patients with UC. One of the action mechanisms of Gancao Xiexin Decoction in treating UC might be its effective role in decreasing the serum levels of IL17， IL23 and participating in immune regulation.