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Article(id=1322925952635904798, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322925862630339452, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.07.015, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339725883, onlineDateStr=2026-10-30, pubDate=1752076800000, pubDateStr=2025-07-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339725883, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339725883, creator=13701087609, updateTime=1793339725883, updator=13701087609, issue=Issue{id=1322925862630339452, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='7', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1752076800000', pubDateStr='2025-07-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339704424, creator='13701087609', updateTime=1793340532184, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929334587105328, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322925862630339452, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929334587105329, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322925862630339452, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=68, endPage=71, ext={EN=ArticleExt(id=1322925952858202911, articleId=1322925952635904798, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Mechanism of Sishen Pill（四神丸）in Regulating Immune Balance and Secreting Inflammatory Cytokines through Th17/Treg Signaling Pathway in Treatment of Ulcerative Colitis, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To study the mechanism of Sishen Pill（四神丸）in regulating immune balance and secreting inflammatory cytokines through Th17/Treg signaling pathway in the treatment of ulcerative colitis.

Methods

A total of 104 patients with ulcerative colitis diagnosed and treated in the hospital from August 2022 to July 2023 were selected and divided into two groups according to the random number table method，with 52 cases in each group. The patients in the control group were routinely treated with Mesalazine，and the observation group was treated with Sishen Pill on the basis of the control group. After 12 weeks of treatment，the efficacy，disease activity index score，immune indexes（Treg cell ratio，Th17 cell ratio and Th17/Treg value），inflammatory cytokines［interleukin（IL）-2，IL-6，IL-10，IL-17］and adverse reactions were observed and compared between the two groups

Results

The markedly effective rate of the observation group was 86.54%（45/52），which was significantly higher than 69.23%（36/52）of the control group，and the difference between the two groups was statistically significant（P<0.05）. After treatment，the disease activity index scores of the two groups were significantly decreased，and the score of the observation group was significantly lower than that of the control group［（2.61±0.72）points vs（3.19±0.84）points］（P<0.05）. After treatment，the proportion of Treg cells in the two groups increased，the proportion of Th17 cells and Th17/Treg value decreased，and the indexes in the observation group were significantly better than those in the control group［（7.61±1.80）%，（6.35±0.41）%，（1.61±0.32）%vs（6.57±1.64）%，（7.67±0.52）%，（1.13±0.28）%］（P<0.05）. After treatment，the levels of IL-2，IL-6 and IL-17 in the two groups decreased，and the level of IL-10 increased. The above indexes in the observation group were significantly better than those in the control group［（5.39±1.13）pg/mL，（5.68±1.41）pg/mL，（53.82±5.20）pg/mL，（2.49±0.37）pg/mL vs（6.45±1.06）pg/mL，（6.62±1.70）pg/mL，（47.19±4.83）pg/mL，（2.98±0.30）pg/mL］（P<0.05）. No serious adverse reactions occurred in both groups.

Conclusion

By regulating the immune balance through Th17/Treg signaling pathway and regulating the secretion of inflammatory cytokines. Sishen Pills can significantly improve the symptoms of ulcerative colitis and play a higher therapeutic value.

, authors=Qihong PAN1, Yang LIU2, Shaofeng WEI3, authorsList=Qihong PAN, Yang LIU, Shaofeng WEI, authorCompany=null, correspAuthors=Shaofeng WEI, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322925954498175785, articleId=1322925952635904798, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=四神丸通过Th17/Treg信号通路调控免疫平衡及其分泌炎性细胞因子治疗溃疡性结肠炎的机制研究, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=
目的

研究四神丸通过辅助性T细胞17（T helper cell 17，Th17）和调节性T细胞（regulatory T cells，Treg）信号通路调控免疫平衡及其分泌炎性细胞因子治疗溃疡性结肠炎的机制。

方法

选取溃疡性结肠炎患者104例，按照随机数表法均分为两组。对照组（52例）常规给予美沙拉嗪治疗，观察组（52例）在对照组基础上增加四神丸治疗。用药12周后，观察并比较两组患者的疗效、疾病活动指数评分、免疫指标（Treg细胞比例、Th17细胞比例和Th17/Treg值）、炎性细胞因子［白细胞介素（interleukin，IL）-2、IL-6、IL-10、IL-17］及不良反应发生情况。

结果

观察组愈显率为86.54%（45/52），显著高于对照组69.23%（36/52），两组间差异有统计学意义（P<0.05）；观察组、对照组总有效率分别为98.08%（51/52）、90.38%（47/52），差异无统计学意义（P>0.05）。治疗后，两组患者的疾病活动指数评分均显著下降，观察组显著低于对照组［（2.61±0.72）分vs（3.19±0.84）分］（P<0.05）。治疗后，两组患者Treg细胞比例升高，Th17细胞比例和Th17/Treg值降低，观察组各指标显著优于对照组［（7.61±1.80）%、（6.35±0.41）%、（1.61±0.32）vs（6.57±1.64）%、（7.67±0.52）%、（1.13±0.28）］（P<0.05）。治疗后，两组患者IL-2、IL-6、IL-17水平降低，IL-10水平升高，观察组上述各指标显著优于对照组［（5.39±1.13）pg/mL、（5.68±1.41）pg/mL、（53.82±5.20）pg/mL、（2.49±0.37）pg/mL vs（6.45±1.06）pg/mL、（6.62±1.70）pg/mL、（47.19±4.83）pg/mL、（2.98±0.30）pg/mL］（P<0.05）。两组均无严重不良反应发生。

结论

四神丸能够通过Th17/Treg信号通路调控免疫平衡，调节其分泌炎性细胞因子水平，进而显著改善溃疡性结肠炎症状，发挥更高的治疗价值。

, authors=潘琦虹1, 刘洋2, 魏韶锋3, authorsList=潘琦虹, 刘洋, 魏韶锋, authorCompany=null, correspAuthors=魏韶锋, authorNote=

潘琦虹（1984-），男，福建南安人，副教授，博士，研究方向：中药药理。

, correspAuthorsNote=
魏韶锋（1984-），男，河北邢台人，副教授，博士，研究方向：药剂学教学与新药开发。E-mail：。
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潘琦虹（1984-），男，福建南安人，副教授，博士，研究方向：中药药理。

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潘琦虹（1984-），男，福建南安人，副教授，博士，研究方向：中药药理。

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组别例数痊愈显效有效无效愈显总有效
观察组5216（30.77）29（55.77）6（11.54）1（1.92）45（86.54）51（98.08）
对照组5212（23.08）24（46.15）11（21.15）5（9.62）36（69.23）47（90.38）
χ2值4.5221.592
P值0.0360.207
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两组溃疡性结肠炎患者疗效比较

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组别例数痊愈显效有效无效愈显总有效
观察组5216（30.77）29（55.77）6（11.54）1（1.92）45（86.54）51（98.08）
对照组5212（23.08）24（46.15）11（21.15）5（9.62）36（69.23）47（90.38）
χ2值4.5221.592
P值0.0360.207
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组别例数治疗前治疗后t值P值
观察组527.82±1.452.61±0.7224.543<0.001
对照组527.40±1.563.19±0.8417.542<0.001
t值1.4223.129
P值0.1580.002
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两组溃疡性结肠炎患者治疗前后Mayo评分比较（±s）

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组别例数治疗前治疗后t值P值
观察组527.82±1.452.61±0.7224.543<0.001
对照组527.40±1.563.19±0.8417.542<0.001
t值1.4223.129
P值0.1580.002
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组别例数Treg细胞比例/（%）Th17细胞比例/（%）Th17/Treg值
治疗前治疗后治疗前治疗后治疗前治疗后
观察组524.10±1.257.61±1.80*11.20±1.796.35±0.41*3.24±0.521.61±0.32*
对照组523.97±1.196.57±1.64*10.71±1.387.67±0.52*3.36±0.451.13±0.28*
t值0.5433.3421.56314.3741.2588.140
P值0.5880.0010.1210.0010.211<0.001
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两组溃疡性结肠炎治疗前后Treg细胞比例、Th17细胞比例和Th17/Treg值比较（±s）

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组别例数Treg细胞比例/（%）Th17细胞比例/（%）Th17/Treg值
治疗前治疗后治疗前治疗后治疗前治疗后
观察组524.10±1.257.61±1.80*11.20±1.796.35±0.41*3.24±0.521.61±0.32*
对照组523.97±1.196.57±1.64*10.71±1.387.67±0.52*3.36±0.451.13±0.28*
t值0.5433.3421.56314.3741.2588.140
P值0.5880.0010.1210.0010.211<0.001
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组别例数IL-2IL-6IL-10IL-17
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
观察组5210.77±1.805.39±1.13*8.90±2.255.68±1.41*38.45±4.1153.82±5.20*3.85±0.892.49±0.37*
对照组5211.03±1.946.45±1.06*9.03±1.966.62±1.70*39.02±3.9647.19±4.83*3.79±0.922.98±0.30*
t值0.7094.9340.3143.0690.7206.7370.3387.418
P值0.480<0.0010.7540.0020.473<0.0010.736<0.001
), ArticleFig(id=1322925958826697556, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322925952635904798, language=CN, label=表4, caption=

两组溃疡性结肠炎患者治疗前后血清IL-2、IL-6、IL-10、IL-17水平比较（±s）

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组别例数IL-2IL-6IL-10IL-17
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
观察组5210.77±1.805.39±1.13*8.90±2.255.68±1.41*38.45±4.1153.82±5.20*3.85±0.892.49±0.37*
对照组5211.03±1.946.45±1.06*9.03±1.966.62±1.70*39.02±3.9647.19±4.83*3.79±0.922.98±0.30*
t值0.7094.9340.3143.0690.7206.7370.3387.418
P值0.480<0.0010.7540.0020.473<0.0010.736<0.001
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组别例数嗳气腹泻胃烧灼感尿黄合计
观察组520（0.00）1（1.92）2（3.85）1（1.92）4（7.69）
对照组523（5.77）2（3.85）1（1.92）0（0.00）6（11.54）
χ2值0.443
P值0.506
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两组溃疡性结肠炎患者不良反应情况比较

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组别例数嗳气腹泻胃烧灼感尿黄合计
观察组520（0.00）1（1.92）2（3.85）1（1.92）4（7.69）
对照组523（5.77）2（3.85）1（1.92）0（0.00）6（11.54）
χ2值0.443
P值0.506
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四神丸通过Th17/Treg信号通路调控免疫平衡及其分泌炎性细胞因子治疗溃疡性结肠炎的机制研究
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潘琦虹 1 , 刘洋 2 , 魏韶锋 3
中华中医药学刊 | 国家项目点击 2025,43(7): 68-71
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中华中医药学刊 |国家项目点击 2025 , 43 (7) : 68 -71
四神丸通过Th17/Treg信号通路调控免疫平衡及其分泌炎性细胞因子治疗溃疡性结肠炎的机制研究
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潘琦虹（1984-），男，福建南安人，副教授，博士，研究方向：中药药理。

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潘琦虹（1984-），男，福建南安人，副教授，博士，研究方向：中药药理。

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潘琦虹1, 刘洋2, 魏韶锋3
作者信息
  • 1.南昌医学院中医学院，江西 南昌 330025
  • 2.南昌医学院组织部，江西 南昌 330025
  • 3.南昌医学院药学院，江西 南昌 330025
通讯作者:
魏韶锋（1984-），男，河北邢台人，副教授，博士，研究方向：药剂学教学与新药开发。E-mail：。
作者简介:

潘琦虹（1984-），男，福建南安人，副教授，博士，研究方向：中药药理。

Mechanism of Sishen Pill（四神丸）in Regulating Immune Balance and Secreting Inflammatory Cytokines through Th17/Treg Signaling Pathway in Treatment of Ulcerative Colitis
Qihong PAN1, Yang LIU2, Shaofeng WEI3
Affiliations
  • 1.School of Traditional Chinese Medicine，Nanchang Medical College，Nanchang 330025，Jiangxi，China
  • 2.Organization Department of Nanchang Medical College，Nanchang 330025，Jiangxi，China
  • 3.School of Pharmacy，Nanchang Medical College，Nanchang 330025，Jiangxi，China
出版时间: 2025-07-10 doi: 10.13193/j.issn.1673-7717.2025.07.015
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摘要
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目的

研究四神丸通过辅助性T细胞17（T helper cell 17，Th17）和调节性T细胞（regulatory T cells，Treg）信号通路调控免疫平衡及其分泌炎性细胞因子治疗溃疡性结肠炎的机制。

方法

选取溃疡性结肠炎患者104例，按照随机数表法均分为两组。对照组（52例）常规给予美沙拉嗪治疗，观察组（52例）在对照组基础上增加四神丸治疗。用药12周后，观察并比较两组患者的疗效、疾病活动指数评分、免疫指标（Treg细胞比例、Th17细胞比例和Th17/Treg值）、炎性细胞因子［白细胞介素（interleukin，IL）-2、IL-6、IL-10、IL-17］及不良反应发生情况。

结果

观察组愈显率为86.54%（45/52），显著高于对照组69.23%（36/52），两组间差异有统计学意义（P<0.05）；观察组、对照组总有效率分别为98.08%（51/52）、90.38%（47/52），差异无统计学意义（P>0.05）。治疗后，两组患者的疾病活动指数评分均显著下降，观察组显著低于对照组［（2.61±0.72）分vs（3.19±0.84）分］（P<0.05）。治疗后，两组患者Treg细胞比例升高，Th17细胞比例和Th17/Treg值降低，观察组各指标显著优于对照组［（7.61±1.80）%、（6.35±0.41）%、（1.61±0.32）vs（6.57±1.64）%、（7.67±0.52）%、（1.13±0.28）］（P<0.05）。治疗后，两组患者IL-2、IL-6、IL-17水平降低，IL-10水平升高，观察组上述各指标显著优于对照组［（5.39±1.13）pg/mL、（5.68±1.41）pg/mL、（53.82±5.20）pg/mL、（2.49±0.37）pg/mL vs（6.45±1.06）pg/mL、（6.62±1.70）pg/mL、（47.19±4.83）pg/mL、（2.98±0.30）pg/mL］（P<0.05）。两组均无严重不良反应发生。

结论

四神丸能够通过Th17/Treg信号通路调控免疫平衡，调节其分泌炎性细胞因子水平，进而显著改善溃疡性结肠炎症状，发挥更高的治疗价值。

溃疡性结肠炎  /  四神丸  /  Th17/Treg信号通路  /  免疫功能  /  炎性细胞因子
Objective

To study the mechanism of Sishen Pill（四神丸）in regulating immune balance and secreting inflammatory cytokines through Th17/Treg signaling pathway in the treatment of ulcerative colitis.

Methods

A total of 104 patients with ulcerative colitis diagnosed and treated in the hospital from August 2022 to July 2023 were selected and divided into two groups according to the random number table method，with 52 cases in each group. The patients in the control group were routinely treated with Mesalazine，and the observation group was treated with Sishen Pill on the basis of the control group. After 12 weeks of treatment，the efficacy，disease activity index score，immune indexes（Treg cell ratio，Th17 cell ratio and Th17/Treg value），inflammatory cytokines［interleukin（IL）-2，IL-6，IL-10，IL-17］and adverse reactions were observed and compared between the two groups

Results

The markedly effective rate of the observation group was 86.54%（45/52），which was significantly higher than 69.23%（36/52）of the control group，and the difference between the two groups was statistically significant（P<0.05）. After treatment，the disease activity index scores of the two groups were significantly decreased，and the score of the observation group was significantly lower than that of the control group［（2.61±0.72）points vs（3.19±0.84）points］（P<0.05）. After treatment，the proportion of Treg cells in the two groups increased，the proportion of Th17 cells and Th17/Treg value decreased，and the indexes in the observation group were significantly better than those in the control group［（7.61±1.80）%，（6.35±0.41）%，（1.61±0.32）%vs（6.57±1.64）%，（7.67±0.52）%，（1.13±0.28）%］（P<0.05）. After treatment，the levels of IL-2，IL-6 and IL-17 in the two groups decreased，and the level of IL-10 increased. The above indexes in the observation group were significantly better than those in the control group［（5.39±1.13）pg/mL，（5.68±1.41）pg/mL，（53.82±5.20）pg/mL，（2.49±0.37）pg/mL vs（6.45±1.06）pg/mL，（6.62±1.70）pg/mL，（47.19±4.83）pg/mL，（2.98±0.30）pg/mL］（P<0.05）. No serious adverse reactions occurred in both groups.

Conclusion

By regulating the immune balance through Th17/Treg signaling pathway and regulating the secretion of inflammatory cytokines. Sishen Pills can significantly improve the symptoms of ulcerative colitis and play a higher therapeutic value.

ulcerative colitis  /  Sishen Pill（四神丸）  /  Th17/Treg signaling pathway  /  immune function  /  inflammatory cytokines
潘琦虹, 刘洋, 魏韶锋. 四神丸通过Th17/Treg信号通路调控免疫平衡及其分泌炎性细胞因子治疗溃疡性结肠炎的机制研究. 中华中医药学刊, 2025 , 43 (7) : 68 -71 . DOI: 10.13193/j.issn.1673-7717.2025.07.015
Qihong PAN, Yang LIU, Shaofeng WEI. Mechanism of Sishen Pill（四神丸）in Regulating Immune Balance and Secreting Inflammatory Cytokines through Th17/Treg Signaling Pathway in Treatment of Ulcerative Colitis[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (7) : 68 -71 . DOI: 10.13193/j.issn.1673-7717.2025.07.015
正文
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溃疡性结肠炎是一种慢性炎症性疾病，其具有反复发作、缓急交替的发病特点，大部分患者确诊后终身患病，给患者个人及其家庭带来沉重负担，影响患者生活质量[1-2]。据报道，近年来我国溃疡性结肠炎的发病率和患病率呈快速上升趋势，已成为临床常见病[3]。《中成药治疗溃疡性结肠炎临床应用指南》[4]中指出溃疡性结肠炎是中医药治疗的优势病种，中成药是中医药的重要组成部分，但其在临床应用方面仍存在大量盲目用药和不规范用药的情况，还需要不断探索安全、有效的用药方案。中医则强调五脏一体，认为溃疡性结肠炎发病与脾肺肝肾功能失调有关[5]。现代研究表明，中药应用于溃疡性结肠炎能够多靶点、多环节、多途径发挥治疗作用[6-7]。调控辅助性T细胞17（T helper cell 17，Th17）和调节性T细胞（regulatory T cells，Treg）平衡是中医药治疗溃疡性结肠炎的重要靶点[8]。本研究探究四神丸通过Th17/Treg信号通路调控免疫平衡及其分泌炎性细胞因子治疗溃疡性结肠炎的机制，报道如下。
1　资料与方法
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1.1　一般资料
选取2022年8月—2023年7月医院诊治的溃疡性结肠炎患者104例，纳入标准：均符合《溃疡性结肠炎中西医结合诊疗指南（草案）》[9]中西医诊断标准及中医寒热错杂证诊断标准，成年患者，具备正常的交流能力且知情、自愿参与研究；排除标准：其他胃肠道器质性病变患者，严重心肝肾功能不全患者，近1个月免疫抑制剂、激素或微生态制剂等用药史患者，妊娠期/哺乳期女性。按照随机数表法均分为两组。对照组52例，男32例，女20例；年龄21～63岁，平均（42.76±6.10）岁；病程1～10年，平均（4.92±1.54）年；左半结肠16例，直肠乙状结肠29例，全结肠7例。观察组52例，男30例，女22例；年龄20～61岁，平均（42.29±5.91）岁；病程1～9年，平均（4.75±1.43）年；左半结肠15例，直肠乙状结肠27例，全结肠10例。两组患者性别、年龄、病程、病变部位进行比较，差异均无统计学意义（P>0.05），具有可比性。研究内容通过医院所属医学伦理委员会审核并批准进行。
1.2　方法
对照组患者常规给予美沙拉嗪治疗，美沙拉嗪（生产企业：黑龙江天宏药业股份有限公司；批准文号：国药准字H20103359；规格：0.25 g×24片）2片/次，3次/d，用药12周。
观察组在对照组基础上增加四神丸治疗，美沙拉嗪用药及用法完全同对照组，四神丸（生产企业：山西华康药业股份有限公司；批准文号：国药准字Z14020017；规格：产品规格：9 g×6袋）9 g/次，1～2次/d，用药12周。
1.3　观察指标
（1）疗效：临床症状消失，经结肠镜检查黏膜病变基本正常，溃疡糜烂处呈愈合状态为痊愈；临床症状消失，经结肠镜检查黏膜仅有轻微炎症为显效；临床症状基本消失，经结肠镜检查黏膜病变有较大改善为有效；临床症状及结肠镜检查所示黏膜病变均无显著变化甚至恶化为无效[10]。以痊愈、显效计算愈显率，以痊愈、显效、有效计算总有效率。（2）疾病活动指数评分：采用改良梅奥（Mayo）评分系统评估患者排便次数、便血、内镜发现和医师总体评价四方面内容，根据患者具体情况每个方面的内容依次对应0、1、2、3分，评分为项评分之和，评分范围0～12分，分值越高、症状越严重[9]。（3）免疫指标：取患者晨起空腹静脉血5 mL进行肝素钠抗凝，离心处理后弃上清液-80℃保存，使用特定的抗体标记细胞表面标志物，进行细胞渗透固定、PDS冲洗后细胞浆染色，采用全自动流式细胞分析仪检测获取Treg细胞比例、Th17细胞比例和Th17/Treg值。（4）炎性细胞因子：取患者空腹静脉血离心处理后取上清液采用酶联免疫吸附试剂盒检测白细胞介素（interleukin，IL）-2、IL-6、IL-10、IL-17。（5）不良反应发生情况：观察是否有嗳气、腹泻、恶心呕吐、胃烧灼感、尿黄等不良反应。
1.4　统计学方法
数据分析工具应用SPSS 22.0统计学软件，计数资料用例（%）表示，进行χ2 检验，计量资料经Shapiro-wilk检验呈正态分布、用表示，进行t检验，P<0.05表示差异有统计学意义。
2　结果
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2.1　疗效比较
观察组愈显率为86.54%，显著高于对照组（69.23%），两组间差异有统计学意义（P<0.05）；观察组、对照组总有效率分别为98.08%、90.38%，差异无统计学意义（P>0.05）。见表1。
2.2　疾病活动指数评分比较
治疗前两组疾病活动指数Mayo评分差异无统计学意义（P>0.05），治疗后，两组患者的Mayo评分均显著下降，观察组显著低于对照组（P<0.05）。见表2。
2.3　Treg细胞比例、Th17细胞比例和Th17/Treg值比较
治疗前，两组患者Treg细胞比例、Th17细胞比例和Th17/Treg值差异无统计学意义（P>0.05）；治疗后，两组患者Treg细胞比例升高，Th17细胞比例和Th17/Treg值降低，观察组各指标显著优于对照组（P<0.05）。见表3。
2.4　炎症因子比较
治疗前两组血清IL-2、IL-6、IL-10、IL-17水平差异无统计学意义（P>0.05）。治疗后，两组患者IL-2、IL-6、IL-17水平下降，IL-10水平升高，观察组上述各项指标显著优于对照组（P<0.05）。见表4。
2.5　不良反应情况比较
观察组、对照组不良反应发生率分别为7.69%、11.54%，差异无统计学意义（P>0.05），并且两组出现不良反应的患者均症状轻微、不影响继续治疗，无严重不良反应发生。见表5。
3　讨论
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溃疡性结肠炎属中医学“久痢”“下利”“久泄”等范畴，如《诸病源候论·久赤白痢候》曰：“久赤白涮者，是冷热不调，热乘于血，血渗肠间，与津液相杂而下，甚者肠虚不复，故赤白连滞，久不塞也。”其属本虚标实，脾虚为本，水湿为标。湿为阴邪，则损伤阳气，脾虚及肾，导致脾肾两虚，气机郁滞导致血脉瘀阻，郁久化热、湿热内蕴，损伤肠络，血败肉腐。临床多见寒热错杂证，表现为腹部冷痛、大便不成形、下肢发凉，望诊舌质淡红，舌苔薄黄或黄白相间，触诊脉沉细，治宜清热散寒[11-13]。
中医疗法和西医疗法各有优势，在溃疡性结肠炎治疗实践中可以优势互补，提高疗效和安全性[14]。本研究中观察组在对照组应用美沙拉嗪治疗的基础上增加四神丸用药，溃疡性结肠炎患者愈显率更高。四神丸药物成分肉豆蔻、补骨脂、五味子、吴茱萸、大枣，其中，君药补骨脂辛苦大温，补命火、散寒邪；臣药肉豆蔻温暖脾胃、涩肠止泻，吴茱萸温中散寒、除湿燥脾；佐药五味子酸能涩精、收敛固涩；使药大枣补益脾胃；诸药共同发挥温肾暖脾、涩肠止泻的治疗作用[15-17]。
相关研究实践中发现调控辅助性T细胞/调节性T细胞平衡紊乱可有效治疗溃疡性结肠炎[18]。程念等[19]研究表明四神丸可通过改善炎症性肠病动物模型能量代谢水平，调节免疫状态平衡，维持免疫耐受，从而有效治疗炎症性肠病。Th17和Treg被认为是许多自身免疫性疾病发展的主要致病Th细胞群之一，Th17细胞可产生特异性炎症因子，在诱导炎症过程中起着重要的作用[20-22]。本研究结果显示，观察组Treg细胞比例、Th17细胞比例和Th17/Treg值以及炎性细胞因子IL-2、IL-6、IL-10、IL-17均显著改善，优于对照组。说明四神丸能够通过Th17/Treg信号通路调控免疫平衡，调节其分泌炎性细胞因子水平。现代药理学研究提示，四神丸可能是通过影响能量代谢、分化方向，或者影响肠黏膜中的蛋白表达，来实现对肠黏膜免疫系统中Th17/Treg平衡调节，调控Th17/Treg信号通路、改善其分泌炎性因子水平，达到对溃疡性结肠炎的治疗作用[23-25]。
综上所述，四神丸能够通过Th17/Treg信号通路调控免疫平衡，调节其分泌炎性细胞因子水平，进而显著改善溃疡性结肠炎症状，发挥更高的治疗价值。
基金
收起
  • 国家自然科学基金地区科学基金项目(82060799)
  • 教育部“春晖计划”合作科研项目(HZKY20220396)
  • 江西省教育科学“十四五”规划项目(23YB331)
  • 南昌医学院博士科研启动基金项目(NYB220066)
文献
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参考文献 引证文献
排序方式：
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2025年第43卷第7期
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doi: 10.13193/j.issn.1673-7717.2025.07.015
  • 首发时间：2026-10-30
  • 出版时间：2025-07-10
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基金
国家自然科学基金地区科学基金项目(82060799)
教育部“春晖计划”合作科研项目(HZKY20220396)
江西省教育科学“十四五”规划项目(23YB331)
南昌医学院博士科研启动基金项目(NYB220066)
作者信息
    1.南昌医学院中医学院，江西 南昌 330025
    2.南昌医学院组织部，江西 南昌 330025
    3.南昌医学院药学院，江西 南昌 330025

通讯作者:

魏韶锋（1984-），男，河北邢台人，副教授，博士，研究方向：药剂学教学与新药开发。E-mail：。
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https://castjournals.cast.org.cn/joweb/zhzyyxk/CN/10.13193/j.issn.1673-7717.2025.07.015
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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