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目的:观察木瓜三萜联合美沙拉嗪对溃疡性结肠炎( ulcerative colitis,UC)临床疗效、炎症因子及肠黏膜屏障保护因子的影响.方法:将入选的90例UC患者随机分为对照组和治疗组,每组各45例.对照组口服给予美沙拉嗪1. 0 g,治疗组在给予美沙拉嗪的同时加服木瓜三萜0. 375 g,每天3次,疗程8周.比较两组患者的临床疗效、不良反应发生率,计算临床症状体征积分、疾病活动指数( disease activity index,DAI)评分、结肠镜积分及病理组织学评分,检测外周血中 TNF-α、IL-1β、IL-6、IFN-γ、IL-4、IL-10含量及结肠黏膜中髓过氧化物酶( MPO)活性和结肠黏膜中闭锁小带蛋白1(ZO1)、钙粘附蛋白E(E-cadherin)、紧密连接蛋白(occludin)、黏蛋白2(MUC2)、肠三叶因子( TFF3) mRNA 表达.结果: UC 患者治疗后,治疗组的总有效率(86. 67% )明显高于单用美沙拉嗪(66. 67% )对照组,不良反应的发生率明显低于对照组(P<0. 01);临床症状体征积分、DAI评分、结肠镜积分及病理组织学评分明显低于对照组(P <0. 05或 P <0. 01);血液中 TNF-α、IL- 1β、IL-6、IFN-γ含量和结肠黏膜中MPO活性较对照组明显降低,IL-4、IL-10 含量较对照组明显升高(P<0. 05或 P <0. 01);结肠黏膜中 ZO1、E-cadherin、occludin、 MUC2、 TFF3 mRNA 表达较对照组明显上调(P <0. 05或P <0. 01).结论:木瓜三萜与美沙拉嗪联用对UC患者有良好的治疗效果和较低不良反应,抑制促炎因子产生、恢复促炎和抗炎因子之间的平衡及上调肠黏膜屏障保护因子表达可能是其发挥对UC治疗作用的机制之一.“,”AIM: To investigate the clinical effect Muguasantie combined with mesalazine on the clinical efficacy, inflammatory and intestinal barrier protective factors of ulcerative colitis. METHODS:Ninety patients with ulcerative colitis were randomly divided into the control group and treatment group, with 45 cases in each group. The control group was given mesalazine 1. 0 g each time, while the treat-ment group was given mesalazine plus Muguasantie 0. 375 g each time, 3 times a day for 8 consecutive weeks. The clinical efficacy, the adverse reaction incidence, clinical symptom and sign score, disease activity index ( DAI) score, colonoscopy score and histopathology score of the two groups were com-pared; the contents of tumor necrosis factor ( TNF)-α, interleukin (IL)-1β, IL-6, interferon(IFN)-γ, IL-4, IL-10 in the peripheral blood, and myeloper-oxidase ( MPO) activity, locked small band protein 1 ( ZO1 ) , calcium adhesion protein E ( E-cadher-in) , occludin, mucin 2 ( MUC2 ) , and intestinal trifolium factor ( TFF3) mRNA expressions in colon-ic mucosa were detected, respectively. RESULTS:After treatment, the total effective rate of the treat-ment group (86. 67% ) was significantly higher than that of the control group (66. 67% ) , and the inci-dence of adverse reactions was significantly lower than that of the control group ( P < 0. 01 ) ; the symptom and sign score, the DAI score, colonosco-py score and histopathology score were significantly lower than those of the control group ( P<0. 05 or P<0. 01, respectively); the contents of TNF-α, IL-1β, IL-6, IFN-γ in the peripheral blood, and MPO activity in colonic mucosa were significantly lower, and IL-4 and IL-10 was significantly higher than those of the control group ( P <0. 05 or P <0. 01, respectively); the mRNA expressions of ZO1, E-cadherin, occludin, MUC2 and TFF3 in the colonic mucosa were significantly up-regulated than those of the control group ( P <0. 05 or P <0. 01, respec-tively ) . CONCLUSION: Muguasantie combined with mesalazine has good therapeutic effect and low-er side effect on patients with ulcerative colitis. Its mechanism is related to inhibiting the productions of pro-inflammatory factors, restoring the balance be-tween pro-inflammatory and anti-inflammatory factors and up-regulating the expression of intestinal muco-sal barrier protective factors.