Clinical Efficacy of Thalidomide Combined with Prednisone in the Treatment of Ulcerative Colitis and its Impact on Intestinal Barrier Function and Inflammatory Indicators in Patients
JIANG Ruihong, GUO Nannan, WANG Haili, et al
Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou Henan 450000
Abstract:【Objective】To investigate the clinical efficacy of thalidomide combined with prednisone in the treatment of ulcerative colitis (UC) and its effects on intestinal barrier function and inflammatory indicators in patients.【Methods】A retrospective analysis was conducted on the clinical data of 92 UC patients admitted to our hospital l from April 2021 to March 2023. According to the treatment plan, they were divided into the control group (treated with prednisone in addition to conventional treatment) and the observation group (treated with thalidomide in addition to the control group), with 46 patients in each group. After 8 weeks of treatment, the efficacy, disease-related scores (Mayo endoscopic score, UC endoscopic severity index (UCEIS) score), intestinal barrier function related indicators [diamine oxidase (DAO), blood lactate (LAC), bacterial lipopolysaccharide (LPS), D-lactate (D-LA)], inflammation related indicators [Toll like receptor 4 (TLR-4), nuclear factor kappa B (NF-κB), soluble late glycation end product receptor (sRAGE)], and adverse reactions were compared between the two groups.【Results】The total effective rate of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). After treatment, the Mayo score and UCEIS score of both groups were lower than before treatment, and the observation group was lower than the control group, with statistical significance (P<0.05); The levels of serum DAO, LAC, LPS, and D-LA in both groups were lower than before treatment, and the observation group was lower than the control group, with statistical significance (P<0.05); The levels of NF-κB, TLR-4, and sRAGE in both groups were lower than before treatment, and the observation group was lower than the control group, with statistically significant differences (P<0.05). There was no statistically significant difference in the total effective rate of adverse reactions between the two groups (P>0.05).【Conclusion】The combination of thalidomide and prednisone has a good therapeutic effect on UC, which can reduce intestinal mucosal inflammation, improve intestinal barrier function, and is relatively safe.
姜瑞红, 郭南南, 王海丽, 郑璐. 沙利度胺联合强的松治疗溃疡性结肠炎的临床疗效及对患者肠屏障功能、炎症指标的影响[J]. 医学临床研究, 2024, 41(8): 1209-1211.
JIANG Ruihong, GUO Nannan, WANG Haili, et al. Clinical Efficacy of Thalidomide Combined with Prednisone in the Treatment of Ulcerative Colitis and its Impact on Intestinal Barrier Function and Inflammatory Indicators in Patients. JOURNAL OF CLINICAL RESEARCH, 2024, 41(8): 1209-1211.
[1] 刘润利,周铖,杜晓泉.溃疡性结肠炎的分期治疗[J].中国中西医结合消化杂志,2021,29(1):67-71.
[2] 陆伟,陈红斗,王梦雷,等.1例重度溃疡性结肠炎糖皮质激素抵抗患者的环孢素转换治疗[J].中国现代应用药学,2021,38(2):232-236.
[3] 贾燕,杨善兵,张丽敏,等.环磷酰胺联合沙利度胺治疗难治性克罗恩病的探索性研究[J].胃肠病学和肝病学杂志,2023,32(2):142-145.
[4] 贾福运,高望.基于Toll样受体4/核因子-κB信号通路中医药干预溃疡性结肠炎作用机制的研究进展[J].环球中医药,2022,15(9):1729-1735.
[5] 张冬梅,张雅明,夏泽华.清肠愈疡汤口服及中药灌肠对溃疡性结肠炎患者血清I-FABP、sRAGE和p-ANCA水平的影响[J].西部中医药,2021,34(3):14-18.
[6] 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疗共识意见(2017年)[J].中国中西医结合消化杂志,2018,26(2):105-122.
[7] DU L, HA C. Epidemiology and Pathogenesis of Ulcerative Colitis[J].Gastroenterol Clin North Am,2020,49(4):643-654.
[8] 夏守兵,许春杰,蒋春晖,等.溃疡性结肠炎及其恶性并发症的生物信息学分析和潜在治疗药物筛选[J].上海交通大学学报(医学版),2020,40(3):317-325.
[9] 徐秋实,张润丰,唐颢,等.糖皮质激素抵抗急性重度溃疡性结肠炎的序贯拯救治疗研究现状[J].中华医学杂志,2021,101(24):1942-1945.
[10] 郭晓鹤,蒯君,朱艳丽,等.沙利度胺联合美沙拉嗪和强的松治疗难治性溃疡性结肠炎疗效观察[J].新乡医学院学报,2021,38(6):585-588.
[11] 曹立军,贺学强,戴璞,等.沙利度胺联合糖皮质激素治疗难治性克罗恩病初探[J].现代消化及介入诊疗,2022,27(2):196-200.
[12] 周海娟,陈刚,李枝锦.清热愈疡汤对大肠湿热型溃疡性结肠炎患者炎性因子、内毒素及肠黏膜屏障的影响[J].广州中医药大学学报,2023,40(3):563-569.
[13] ZHOU Y D, DOU F F, SONG H W, et al. Anti-ulcerative effects of wogonin on ulcerative colitis induced by dextran sulfate sodium via Nrf2/TLR4/NF-κB signaling pathway in BALB/c mice[J].Environ Toxicol,2022,37(4):954-963.
[14] 吴可,苏鹏飞,佟延新.美沙拉秦联合双歧杆菌嗜酸乳杆菌肠球菌三联活菌治疗溃疡性结肠炎效果及对患者血清sRAGE、Vaspin、炎症因子等影响[J].临床误诊误治,2020,33(2):37-42.