目的 探討芪倍合劑聯(lián)合美沙拉嗪治療活動期潰瘍性結(jié)腸炎的臨床療效和其對Th17、Treg細(xì)胞及其相關(guān)細(xì)胞因子水平的影響。方法 選取2019年1月—2019年12月于新鄉(xiāng)醫(yī)學(xué)院第一附屬醫(yī)院就診的142例活動期潰瘍性結(jié)腸炎患者作為研究對象，將所有患者隨機(jī)分為對照組和觀察組，每組各71例。對照組口服美沙拉嗪腸溶片，1 g/次，4次/d；觀察組在對照組治療的基礎(chǔ)上口服芪倍合劑，50 mL/次，3次/d。兩組療程均為8周。觀察兩組患者的臨床療效，同時比較兩組治療前后的Mayo評分、Baron評分、Th17細(xì)胞、Treg細(xì)胞、Th17/Treg細(xì)胞比值、白細(xì)胞介素（IL）-17、IL-23、轉(zhuǎn)化生長因子（TGF-β）和IL-10水平。結(jié)果 治療后，對照組和觀察組的總有效率分別為81.69%、94.36%，兩組總有效率比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組Mayo評分和Baron評分均顯著降低（P<0.05）；且觀察組Mayo評分和Baron評分顯著低于對照組（P<0.05）。治療后，兩組患者Th17細(xì)胞、Th17/Treg細(xì)胞比值水平均顯著下降，而Treg細(xì)胞顯著升高（P<0.05）。治療后，與對照組相比，觀察組Th17細(xì)胞和Th17/Treg細(xì)胞比值顯著降低，而Treg細(xì)胞顯著升高（P<0.05）。治療后，兩組血清IL-17和IL-23水平顯著降低，而TGF-β和IL-10水平顯著升高（P<0.05）。治療后，觀察組血清IL-17、IL-23水平顯著低于對照組，而TGF-β和IL-10水平顯著高于對照組（P<0.05）。結(jié)論 芪倍合劑聯(lián)合美沙拉嗪對活動期潰瘍性結(jié)腸炎臨床療效較好，治療安全性高，能有效改善患者的臨床癥狀，可能機(jī)制與其能顯著改善Th17/Treg細(xì)胞平衡有關(guān)。

Objective To explore the clinical efficacy and impact of Th17, Treg and its related cytokines levels after Qibei Mixture combined with mesalazine in treatment of active ulcerative colitis. Methods Atotal of 142 active ulcerative colitis patients admitted to the the First Affiliated Hospital of Xinxiang Medical University from January 2019 to December 2019 were selected as the research objects, and all the patients were randomly divided into control group and observation group, with 71 patients in each group. Patients in the control group were po administered with Mesalazine Enteric-coated Tablets, 1 g/time, four times daily. Patients in the observation group were po administered with Qibei Mixture on the basis of control group, 50 mL/time, three times daily. The course of treatment in both groups was eight weeks. After treatment, the clinical efficacy in two groups were observed, the Mayo score, Baron score, Th17 cells, Treg cells, Th17/Treg cells, and the levels of IL-17, IL-23, TGF-β, IL-10 before and after treatment were compared. Results After treatment, the total effective rate of the control group and the observation group was 81.69% and 94.36%, respectively, with statistically significant difference between two groups (P<0.05). After treatment, the Mayo and Baron scores in two groups were significantly reduced (P<0.05). The Mayo and Baron scores in the observation group were significantly lower than those in the control group (P<0.05). After treatment, Th17 cells and Th17/Treg cell ratios in two groups were significantly decreased, while Treg cells were significantly increased (P<0.05). After treatment, the ratio of Th17 cells and Th17/Treg cells in the observation group were significantly lower than those in the control group, while Treg cells was significantly higher than that in the control group (P<0.05). After treatment, the serum levels of IL-17 and IL-23 were significantly decreased, but TGF-β and IL-10 levels were significantly increased (P<0.05). After treatment, the serum levels of IL-17 and IL-23 in the observation group were significantly lower than those in the control group, but the levels of TGF-β and IL-10 were significantly higher than those in the control group (P<0.05). Conclusion Qibei Mixture combined with mesalazine has good clinical efficacy and high safety in treatment of active ulcerative colitis, and can effectively improve the clinical symptoms of patients. The possible mechanism may be related to its ability to significantly improve Th17/Treg cell balance.

R975

河南省科技攻關(guān)項目（192102310315）