大肠湿热型溃疡性结肠炎患者Toll-like受体表达及溃结灵的干预作用Effect of Kuijieling Granule(KG) on Toll-like Receptor and Other Lndexs in the Patient of Ulcerative Colitis of Damp Heat In the Large Intestine Stagnation Type
常东,黄志新,樊亚巍,陶永胜,李辉,何方,张东坡
摘要(Abstract)：
目的观察溃结灵颗粒配合柳氮磺胺吡啶(SASP)对大肠湿热型溃疡性结肠炎(UC)的疗效。方法将活动期UC(大肠湿热证)患者随机分为治疗组予(溃结灵和SASP)和对照组(予SASP),以中医证候疗效、肠黏膜病变、主要症状积分作为观察指标;采用常规免疫组化S-P法检测治疗前后肠黏膜组织内的Toll-like受体2的蛋白表达情况。结果治疗组中医证候疗效、肠黏膜疗效高于对照组;两组腹泻、腹痛、腹胀、脓血便、黏液便、里急后重症状均有明显改善,治疗组多项症状改善较对照组更明显。随着病变组分级程度的增高,患者TLR2的蛋白表达逐渐增强,治疗组治疗后TLR2的蛋白表达明显减少;对照组则无明显变化。结论溃结灵配合SASP有确切的治疗UC作用,其可能是通过抑止TLR4和CD14蛋白表达,减弱CD14和TLR2的协同作用,抑止TLR2依赖的脂蛋白(BLP)信号转导,进而磷酸化激活κB的功能减弱,使损伤的内皮细胞得以修复。
关键词(KeyWords)： 溃疡性结肠炎;大肠湿热型;溃结灵颗粒;中西医结合
基金项目(Foundation): 广东省深圳市科技计划项目(NoJH200507131142A)
作者(Author): 常东,黄志新,樊亚巍,陶永胜,李辉,何方,张东坡
参考文献(References)：
- 1Geng X,taniguchiM,DaiH H,etal.Autoim m unity in ulcerative colitis:hum oraland cellular im m une respocse by tropom yosin in ulcerative colitis[J].W orld J Gastroenterol,2000;6:9
- 2Read RC,W yllie DH.Toll-like receptors and sepsis[J].Curr Opin CritCare,2001,7(5):371
- 3中国中西医结合学会消化系统疾病专业委员会,溃疡性结肠炎中西医结合诊治方案(草案)[S].中国中西医结合杂志,2004,24(11):1052
- 4Powell-Tuck J,Bown RL,Lennardzjones JE.A com parison o-foral prednisolone given as single or m ultiple daily doses for activeproctocolitis[J].Scand J GastRoenterol,1978,13:833～837
- 5中华人民共和国卫生部.中药新药临床研究指导原则(第2辑)[S].1995:211～125
- 6黄志新,劳绍贤,崔怡珍,等.溃结灵颗粒治疗活动性溃疡性结肠炎的临床与实验研究[J].中国中西医结合消化杂志,2003,11(3):141～143
- 7H eum ann D,Roger T.Initialresponses to endotoxins and gram-negtive[J].Clin Chim Acta,2002,323:59～72
- 8Akira S,Takeda K,Kaisho T.Toll2like receptors:criticalpro-teinslinking innate and acquired im m unity[J].Nat Im m unol,2001,8:675～680
- 9Kaisho T,Akira S.Toll-like teceptors and their signaling m echanism in innate im m unity[J].Acta OdontolScand,2001,59:124～130
- 10H irschfeld M M a Y,W eis JH,etal.Cutting Edge:Repu2rifi-action of lipopolysaccharide elim inates signaling through both hum an and m urine TOll2like receptor2[J].Im m unol,2000,165(7):618～622
- 11UnderhillDM,Ozinsky A,H ajjarAM.the Toll2like receptor2is recruited to m acrophage phagosom es and discrim inates between pathogens[J].Nature,1999,401(10):811～815
- 12H em m i H,Takeuchi0,Kawai T,et al.Cutting edge:pre2ferenally the R2stereoisom erofthe m ycoplasm allipopeptide m acrophage2activating lipopeptide22activates im m une cellsthrough a toll2like receptor2and M yD882dependentsignaling pathway[J].Im m uno1,2000,164(1):554～557
- 13常东,黄志新,樊亚巍,等.溃结灵颗粒对大肠湿热型溃疡性结肠炎患者Toll-like受体等指标的影响[J].中国中医药信息杂志,2007,14(12):23～24
- 14liene I,ngallsrR.Toll-like receptors[J].CritCare M ed,2002,30(1):S1～11
- 15常东,劳绍贤,樊亚巍,等.溃结灵颗粒配合柳氮磺胺吡啶治疗大肠湿热型溃疡性结肠炎30例临床观察[J].辽宁中医杂志,2007,34(11):38～40