Objective To observe the therapeutic effect of heat-clearing and dampness-removing therapy combined with Bifico for ulcerative colitis ( UC) induced by trinitrobenzene sulfonic acid ( TNBS), and to explore its influence on tumor necrosis factor alpha ( TNF-α) and interleukin-10 ( IL-10) in rats. Methods Forty female adult Sprague-Dawley rats were evenly randomized into five groups, namely normal control group, model group, Bifico (175 mg/kg) group, Chinese medicine group(enema with Changdiqing 3.6/kg and oral use of Changyanling Recipe l) , and Chinese medicine plus Bifico group. After treatment, the damage of colonic mucous membrane was evaluated, and expression levels of IL-10 and TNF-α in colonic mucosa were observed through immunohistochemical assay. Results The degree of colonic mucosal injury was severer and the inflammation was more obvious in the model group than those in the normal control groups ( P<0.01) , and the above changes were relieved to various degrees in the medication group ( P<0.01 compared with those in the model group) . Chinese medicine plus Bifico group had better effect on reducing colonic mucosa damage index ( CMDI) and inflammation, and on promoting the healing of colonic mucosa than Bifico group and Chinese medicine group (P<0.05 ) . The expression level of TNF-α in the colonic mucosa was markedly increased while that of IL-10 was markedly decreased in the model group ( P<0.01 compared with those in the normal control group) . The medication groups could counteract the above changes in the colonic mucosa ( P<0.01 compared with those in the model group) . The combination group and Chinese medicine group had better effect on decreasing TNF-α expression level and on increasing IL-10 expression level than Bifico group ( P<0.05) . Conclusion IL-10 and TNF-α play an important role in the pathogenesis and development of ulcerative colitis. Chinese medicine combined with Bifico has satisfactory therapeutic effect on UC rats, and its mechanism may be related with the increase of IL-10 expression level and with the decrease of TNF-α expression level.%【目的】探讨清热祛湿法联合培菲康对2，4，6-三硝基苯磺酸(TNBS)诱导的溃疡性结肠炎(UC)大鼠的疗效，以及对结肠组织中白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)水平的影响。【方法】选用成年雌性SD大鼠40只，随机分为正常组、模型组、培菲康组（剂量为175 mg/kg）、中药组（肠涤清3.6 g/kg灌肠+肠炎清1号方10 g/kg灌胃）、中药+培菲康组。经不同处理和治疗后，观察各组结肠黏膜损伤程度；采用免疫组织化学染色观察各组结肠组织中IL-10、 TNF-α的表达水平。【结果】与正常组比较，模型组结肠黏膜损伤程度最严重，炎症反应最明显（P<0.01）；与模型组比较，各治疗组结肠黏膜损伤程度和炎症反应均显著减轻（P<0.01）；各治疗组间比较，中药联合培菲康组可显著降低大鼠结肠黏膜损伤指数（CMDI），能有效抑制炎症反应，促进肠黏膜愈合（P<0.05）。与正常组比较，模型组结肠黏膜TNF-α表达水平显著增加(P<0.01)， IL-10表达水平显著降低（P<0.01）；与模型组比较，各治疗组可显著降低结肠黏膜TNF-α表达水平(P<0.01)，增加IL-10表达水平（P<0.01）；各治疗组间比较，中药联合培菲康组、中药组可显著降低结肠黏膜TNF-α表达水平，增加IL-10表达水平，其作用优于培菲康组（P<0.05）；中药联合培菲康组作用优于中药组，差异有统计学意义（P<0.05）。【结论】清热利湿法联合培菲康对溃疡性结肠炎大鼠有良好的治疗作用，其作用机制可能与增加IL-10表达水平、降低TNF-α表达水平有关。
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