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目的观察微生态制剂(思连康)辅助治疗活动期溃疡性结肠炎(UC)的疗效和安全性,并进一步探讨微生态制剂对肠黏膜局部细胞因子的影响。方法活动期UC患者86例,随机分为2组,对照组(40例)口服美沙拉嗪,同时用琥珀酸氢化考的松及庆大霉素、蒙脱石散保留灌肠,重度患者加静脉用激素。治疗组(46例)在上述治疗基础上,口服思连康1.5 g,每天3次。治疗6个月后评价2组疗效,主要症状和结肠镜变化情况,免疫组化法检测患者肠黏膜局部细胞因子IL-10、IL-6和IL-18的变化。结果治疗后2组临床表现均有明显好转,且治疗组优于对照组,2组比较差异有统计学意义(P<0.05)。2组治疗后结肠镜表现均有明显改善,治疗组优于对照组;疾病活动指数(DAI)降低(P<0.05),降低幅度治疗组优于对照组(P<0.05)。所有患者均未见明显的不良反应。免疫组化结果显示治疗后肠黏膜细胞因子IL-10的水平升高,治疗组优于对照组,IL-6和IL-18均有降低,IL-6下降治疗组优于对照组,而IL-18的降低2组间差异无统计学意义。结论微生态制剂口服辅助治疗UC疗效明显,并能降低UC的复发,且无不良反应。其机制可能与上调局部肠黏膜抗炎性细胞因子,下调炎性细胞因子有关。
Objective To observe the efficacy and safety of probiotics in the treatment of active ulcerative colitis (UC) and to explore the effect of probiotics on the local cytokines in intestinal mucosa. Methods Eighty-six active UC patients were randomly divided into two groups. The control group (40 patients) was given mesalazine orally. Meanwhile, hydrocortisone acetate and gentamicin were used, With hormones. The treatment group (46 cases) on the basis of the above treatment, oral Salbutamol 1.5 g, 3 times a day. After 6 months of treatment, the curative effect, the main symptoms and the changes of colonoscopy in 2 groups were evaluated. The changes of intestinal mucosal IL-10, IL-6 and IL-18 in intestinal mucosa were detected by immunohistochemistry. Results After treatment, the clinical manifestations of both groups were significantly improved, and the treatment group was better than the control group, the difference between the two groups was statistically significant (P <0.05). The results of colonoscopy in both groups were significantly improved after treatment. The treatment group was better than the control group. The disease activity index (DAI) was decreased (P <0.05), and the decrease in the treatment group was better than that of the control group (P <0.05). All patients showed no obvious adverse reactions. The results of immunohistochemistry showed that the level of IL-10 in the intestinal mucosa increased after treatment, the treatment group was better than the control group, the levels of IL-6 and IL-18 were decreased, the IL-6 decreased group was better than the control group, IL -18 decreased between the two groups was no significant difference. Conclusions The oral administration of probiotics has obvious curative effect on UC and can reduce the recurrence of UC with no adverse reactions. The mechanism may be related to the upregulation of local intestinal mucosal anti-inflammatory cytokines and down-regulation of inflammatory cytokines.