本文選題：潰瘍性結(jié)腸炎 + IL-17細胞��； 參考：《北京中醫(yī)藥大學》2014年碩士論文

【摘要】：研究目的： 本課題運用中藥血竭地榆合劑對血瘀腸絡型UC患者進行局部保留灌腸,聯(lián)合美沙拉秦口服,分別對治療前后患者腸黏膜愈合情況進行評分,檢測Th17細胞相關(guān)細胞因子IL-17在血清中的表達濃度,探討血竭地榆合劑局部保留灌腸治療血瘀腸絡型UC在促進黏膜愈合與緩解中醫(yī)證候方面的優(yōu)勢,根據(jù)血清IL-17濃度分析其對腸黏膜愈合的影響。 研究方法： 診斷標準參照2012年中華醫(yī)學會消化病學分會炎癥性腸病學組制定的《炎癥性腸病診斷與治療的共識意見(2012年·廣州)》及2010年中國中西醫(yī)結(jié)合學會消化系統(tǒng)疾病專業(yè)委員會制定的《潰瘍性結(jié)腸炎中西醫(yī)結(jié)合診療指南》,選取24位血瘀腸絡型潰瘍性結(jié)腸炎患者納入試驗,隨機分為血竭地榆合劑灌腸聯(lián)合美沙拉秦口服治療組、美沙拉秦口服對照組(各12例)。予患者疾病活動指數(shù)評分、腸鏡下腸黏膜分級,并給予中醫(yī)證候量化分級。 兩組基礎(chǔ)治療均口服美沙拉秦緩釋顆粒劑1.0g,每日3次,4周為一個療程。 取治療后患者外周血清,采用酶聯(lián)免疫吸附法(ELISA)檢測Th17細胞分泌的相關(guān)細胞因子IL-17的濃度； 治療前后采用Rachmilewitz計分法對患者腸黏膜進行腸鏡下評分； 將治療前后患者予疾病活動指數(shù)評分、中醫(yī)證候量化分級。 所得數(shù)據(jù)整理后進行統(tǒng)計學分析,觀察血竭地榆合劑局部保留灌腸對血瘀腸絡型UC的臨床療效,探討UC患者腸黏膜愈合度與血清IL-17濃度之間的關(guān)系。研究結(jié)果： IL-17濃度比較：治療組IL-17濃度15.88±1.87pg/ml,對照組22.03±2.32pg/ml,有統(tǒng)計學意義(P0.05),治療組IL-17濃度低于對照組； 腸鏡下黏膜Rachmilewitz積分比較：治療組3.58±1.83,對照組7.33±1.67,有統(tǒng)計學意義(P0.05),治療組腸黏膜愈合情況優(yōu)于對照組； 疾病活動指數(shù)比較：治療組積分2.00±1.64,對照組4.25±1.66,有統(tǒng)計學意義(P0.05),治療組療效優(yōu)于對照組； 中醫(yī)證候量化分級積分比較：治療組8.00±2.70,對照組16.75±4.39,有統(tǒng)計學意義(P0.05),治療組中醫(yī)證候療效優(yōu)于對照組。 研究結(jié)論： 血竭地榆合劑局部保留灌腸治療血瘀腸絡型潰瘍性結(jié)腸炎臨床有效,血竭地榆合劑灌腸聯(lián)合美沙拉秦口服治療效果要優(yōu)于單純口服美沙拉秦制劑治療。治療組IL-17濃度低于對照組,差異有統(tǒng)計學意義,證實血竭地榆合劑灌腸能有效降低IL-17在UC發(fā)展進程中的表達。推斷IL-17濃度與UC患者腸黏膜愈合度相關(guān),IL-17降低可減緩腸黏膜損傷進程,促進病變局部炎性細胞因子的平衡,促使黏膜愈合。
[Abstract]:Objective: to evaluate the healing of intestinal mucosa of patients with blood stasis and intestinal collaterals by local retention enema with traditional Chinese medicine Deiyu mixture, combined with mezalazin oral administration, before and after treatment. To detect the expression of Th17 cytokine IL-17 in serum, and to explore the advantages of local retention enema of Dieyu mixture in promoting mucosal healing and relieving TCM syndrome in the treatment of blood stasis and intestinal collaterals type UC. According to the concentration of serum IL-17, the effect of IL-17 on intestinal mucosal healing was analyzed. Methods: the diagnostic criteria were based on the consensus opinion on diagnosis and treatment of inflammatory bowel disease (Guangzhou, 2012) formulated by the inflammatory enteropathy group of the Chinese medical association of digestive diseases in 2012 and the Chinese traditional and western medicine in 2010 The "guidelines for the diagnosis and treatment of Ulcerative Colitis" developed by the Professional Committee on Digestive Diseases of the Society selected 24 patients with ulcerative colitis with blood stasis and intestinal collaterals. The rats were randomly divided into two groups: the control group (n = 12) and the control group (n = 12). The patients were evaluated with disease activity index, intestinal mucosa under enteroscopy, and TCM syndromes were quantified. Two groups of basic treatment were orally Medalazine sustained release granules 1.0 g, 3 times a day for 4 weeks as a course of treatment. The concentration of IL-17 secreted by Th17 cells was detected by enzyme-linked immunosorbent assay (Elisa), and the intestinal mucosa was evaluated by Rachmilewitz scoring method before and after treatment. Patients before and after treatment with disease activity index score, TCM syndromes quantitative grading. To observe the clinical effect of local retention enema of Deiyu mixture on UC with blood stasis and intestinal collaterals, and to explore the relationship between the degree of intestinal mucosal healing and the concentration of serum IL-17 in patients with UC. Results: the concentration of IL-17 was 15.88 鹵1.87pg / ml in the treatment group and 22.03 鹵2.32pg / ml in the control group (P0.05). The concentration of IL-17 in the treatment group was lower than that in the control group. Comparison of mucosal Rachmilewitz score under enteroscopy: the treatment group (3.58 鹵1.83) and the control group (7.33 鹵1.67) had statistical significance (P0.05). The healing of intestinal mucosa in the treatment group was better than that in the control group. Disease activity index comparison: the treatment group score 2.00 鹵1.64, the control group 4.25 鹵1.66, has statistical significance (P0.05), the treatment group is better than the control group; Comparison of TCM syndromes quantitative grading integral: the treatment group 8.00 鹵2.70, the control group 16.75 鹵4.39, there was statistical significance (P0.05), the treatment group TCM syndrome efficacy is better than the control group. Conclusion: local retention enema with Xue Deiyu mixture is effective in treating ulcerative colitis with blood stasis and collaterals. The concentration of IL-17 in the treatment group was lower than that in the control group, and the difference was statistically significant. It was proved that the enema of Diyu mixture could effectively reduce the expression of IL-17 in the development of UC. It is inferred that the decrease of IL-17 concentration associated with the degree of intestinal mucosal healing in UC patients can slow down the process of intestinal mucosal injury, promote the balance of inflammatory cytokines and promote mucosal healing.
【學位授予單位】：北京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R574.62

【參考文獻】

相關(guān)期刊論文 前10條

1 歐陽博文;黎奕房;何家鳴;鄭建凱;陳延;;益氣托毒活血中藥復方對潰瘍性結(jié)腸炎大鼠腸道黏膜屏障的影響[J];貴陽醫(yī)學院學報;2013年03期

2 陸為民;周曉波;徐丹華;;國醫(yī)大師徐景藩教授論治潰瘍性結(jié)腸炎的經(jīng)驗[J];中華中醫(yī)藥雜志;2014年01期

3 姜睿;熊明芳;;從濕論治潰瘍性結(jié)腸炎驗案3則[J];江西中醫(yī)藥;2011年10期

4 呂明,劉曉艷;推拿三步九法結(jié)合針灸治療慢性潰瘍性結(jié)腸炎46例[J];遼寧中醫(yī)雜志;2005年09期

5 朱磊;沈洪;劉麗;;清腸化濕方干預治療對潰瘍性結(jié)腸炎急性活動期小鼠結(jié)腸組織黏膜修復及COX-2表達影響的實驗研究[J];遼寧中醫(yī)雜志;2013年11期

6 高偉;司雁菱;吳瑜;;潰瘍性結(jié)腸炎患者結(jié)腸黏膜中IL-10、IL-13表達變化及意義[J];山東醫(yī)藥;2010年11期

7 趙曉霞;郭勝;李寶鶴;虎勤;;芍藥湯對潰瘍性結(jié)腸炎大鼠ICAM-1、TNF-α、IL-10影響的實驗研究[J];中國中醫(yī)藥科技;2008年03期

8 張興源;;鄭紅斌教授治療潰瘍性結(jié)腸炎經(jīng)驗[J];陜西中醫(yī)學院學報;2013年03期

9 梁秀云;;潰瘍性結(jié)腸炎患者血清TNF-α與內(nèi)毒素水平檢測及臨床意義[J];臨床和實驗醫(yī)學雜志;2013年09期

10 朱芳麗;劉蕾;張曉嵐;;潰瘍性結(jié)腸炎易感基因的研究進展[J];世界華人消化雜志;2011年21期

，

本文編號：2095342