微生态制剂对溃疡性结肠炎的治疗效果及作用机制研究

目的探讨微生态制剂对溃疡性结肠炎（UC）的治疗效果及其作用机制。方法前瞻性入组2007年5月至2010年6月间新乡医学院第一附属医院收治的60例UC患者。按随机数字表法分为金双歧组、畅美组和联合组（金双歧联合畅美），每组各20例。分别予以金双歧2．0g口服、2次／d，畅美1．0g口服、3次／d，及两种药物联合应用，疗程为24个月。治疗前及治疗后24个月对各组患者进行临床症状评分、内镜分级评分以及结肠炎性反应评分；并通过免疫组织化学染色和酶联免疫双抗体夹心法分别检测结肠黏膜及血清中的白细胞介素IO（IL-10）含量。结果联合组患者治疗后24个月，临床症状评分（12．5±2．1比2．3±0．8，P=O．016）、内镜分级评分（3．02±0．17比0．25±0．13，P=O．032）和炎性反应评分（2．63±0．19比0．77±0．16，P=O．028）均显著优于治疗前；而金双歧组和畅美组治疗前后各项评分的差异均无统计学意义（均P〉O．05）。联合组患者治疗24个月时，IL．10在结肠黏膜中的阳性表达率[85％（17／20）比55％（11／20），P=O．038]和在血清中的表达水平f（17．4±2．2）ng／L比（12．8±2．2）ng／L，P=O．015]均显著高于治疗前；而金双歧组和畅美组治疗前后IL．10表达水平的差异均无统计学意义（均P〉O．05）。结论金双歧联合畅美治疗UC疗效肯定，其治疗作用可能与促进IL-10表达升高有关。

Efficacy of probiotics on ulcerative colitis and its mechanism

Objective To evaluate the efficacy of probiotics on the treatment outcomes of ulcerative colitis, and explore its possible mechanism. Methods According to the table of random number, 60 ulcerative colitis patients in our hospital were enrolled prospectively and divided into 3 groups： Golden Bifid group, Changmei group, combination group （Golden＋ Changmei）. Patients in Golden Bifid group received Golden Bifid 2.0 g, bid, those in Changmei group received Changmei 1.0 g, tid, and those in combination group received the above two drugs for 24 months. The clinical symptom score, colon mucosa inflammation score and endoscopic grade score were calculated and compared. IL-10 in mueosa and serum was determined by immunohistochemistry and double- antibody sandwich ELISA. Results In combined group after 24 months of treatment, clinical symptom score （12.5＋2.t vs. 2.3＋0.8, P=0.O16）, endoscopic classification score （3.02＋0.17 vs. 0.25~0.13, P= 0.032）, inflammatory reaction score （2.63~0.19 vs. 0.77＋0.16, P=0.028） were significantly higher than those before treatment. While the scores differences of before and after treatment in Gold Bifid group and Changmei group were not statistically significant（P〉0.05）. IL-10 in serum C（17.4~2.2） ng/L vs. （12.8~2.2） ng/L, P=0.015] and colon mueosa [85%（17/20） vs. 55%（11/20）, P=0.026% in combination group were significantly higher than those before treatment. The differences in IL-10 expression level before and after treatment were not statistically significant in the Gold Bifid group and Changmei group （P〉0.05）. Conclusion Golden Bifid combined with Changmei as microbial ecological agents has a positive efficacy on mild to moderate ulcerative colitis, which may be associated with the up-regulation of IL-IO expression.