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目的观察柳氮磺胺吡啶联合培菲康胶囊治疗轻、中度溃疡性结肠炎的临床疗效并探讨其作用机制。方法选择66例轻中度溃疡性结肠炎患者,随机分为联合治疗组(A组)34例,单药治疗组(B组)32例,健康对照组(C组)30例,A组口服柳氮磺胺吡啶同时加服培菲康胶囊,B组口服柳氮磺胺吡啶,疗程4周。2组患者治疗前后的临床症状、结肠镜检查情况进行比较。采用酶联免疫吸附试验(ELISA)检测2组患者治疗前后和30名健康志愿者(C组)血清中白细胞介素-18(IL-18)和白细胞介素-4(IL-4)的水平。结果A组显效率明显高于B组(P<0.05);A和B组治疗前IL-18水平明显高于C组,A组治疗后IL-18的水平与C组无显著差异,而B组仍高与C组;2组患者治疗前IL-4水平与C组差异无统计学意义(P>0.05),治疗后A组与C组比较IL-4水平明显升高(P<0.05);B组与C组差异无统计学意义(P>0.05)。结论柳氮磺胺吡啶联合培菲康胶囊比单独使用柳氮磺胺吡啶治疗轻中度溃疡性结炎具有更好的临床疗效,其可能机制是通过下调IL-18,上调IL-4水平,发挥其治疗作用。
Objective To observe the clinical efficacy of sulfasalazine combined with Peifukang capsule in the treatment of mild and moderate ulcerative colitis and to explore its mechanism. Methods Sixty-six patients with mild-to-moderate ulcerative colitis were randomly divided into the treatment group (group A) 34 cases, monotherapy group B group 32 cases, healthy control group 30 cases, group A oral Sulfasalazine plus serving Peifukang capsule, B group oral sulfasalazine for 4 weeks. Two groups of patients before and after treatment of clinical symptoms, colonoscopy were compared. Serum levels of interleukin-18 (IL-18) and interleukin-4 (IL-4) were measured by enzyme linked immunosorbent assay (ELISA) in two groups before and after treatment and in 30 healthy volunteers (group C) . Results The effective rate of group A was significantly higher than that of group B (P <0.05). The levels of IL-18 in group A and B before treatment were significantly higher than those in group C. The level of IL-18 in group A was not significantly different from that in group C The level of IL-4 in group 2 before treatment was not significantly different from that in group C (P> 0.05). After treatment, the level of IL-4 in group A was significantly higher than that in group C (P <0.05) There was no significant difference between group B and group C (P> 0.05). Conclusions Sulfasalazine combined with Peifukang capsule has better clinical efficacy than sulfasalazine alone in the treatment of mild to moderate ulcerative colitis. The possible mechanism is that down-regulating IL-18 and up-regulating IL-4 level Therapeutic effect.