摘要
目的 系统评价中药灌肠对活动期溃疡性结肠炎(UC)肠黏膜及炎性因子的影响.方法 选择中国期刊全文数据库(CNKI)、万方数据库(Wanfang)、中国科技期刊数据库(VIP)及PubMed数据库,全面检索关于中药灌肠治疗活动期UC的临床随机对照试验(RCT).筛选出符合纳入标准的文献,并进行数据提取和质量评价,运用RevMan5.4软件进行数据统计分析.结果 最终纳入22篇文献,共计2 087例患者.Meta分析结果显示中药灌肠组患者Baron内镜评分、Mayo疾病活动指数评分、黏膜组织Geboes指数评分显著低于对照组(P＜0.05);肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞介素-1β(IL-1β)、白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)显著低于对照组(P＜0.05);转化生长因子-β1(TGF-β1)、白细胞介素-10(IL-10)及临床有效率显著高于对照组(P＜0.05).结论 中药灌肠治疗UC可提高临床总有效率,激活IL-10及TGF-β1的表达水平,沉默TNF-α、hs-CRP、IL-1β、IL-4、IL-6、IL-8等促炎因子,减少炎症浸润,修复受损的肠道黏膜.
Abstract
Objective:To systematically evaluate the effects of traditional Chinese medicine(TCM)enema on in-testinal mucosal protection and inflammatory factors in active ulcerative colitis(UC).Methods:Randomized con-trolled trials(RCTS)on the treatment of active UC were searched by China National Knowledge Infrastructure(CNKI),Wanfang,VIP and PubMed.The literatures eligible for inclusion were screened out,data extraction and quality evaluation were carried out,and statistical analysis was carried out using RevMan 5.4 software.Results:A total of 22 literatures with a total of 2 087 patients were included.The results of meta-analysis showed that the Baron endoscopy score,Mayo disease activity index score and mucosal Geboes index score of patients in the TCM enema group were significantly lower than those in the control group(P＜0.05);levels of TNF-α,hs-CRP,IL-1β,IL-4,IL-6,IL-8 were significantly lower than those in control group(P＜0.05);levels of TGF-β1,IL-10 and the clinical effective rate were significantly higher than those in control group(P＜0.05).Conclusion:TCM enema in the treatment of UC can improve the total clinical effective rate,activate the expression levels of IL-10 and TGF-β1,silence pro-inflammatory factors such as TNF-α,hs-CRP,IL-1β,IL-4,IL-6 and IL-8,reduce inflammatory in-filtration,and repair the damaged intestinal mucosa.
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万方数据