| Objective and Significance: Ulcerative Colitis is an refractory disease of digestive system with it’s etiology and pathogenesis not very clear, available western regimen is quite limited in satisfying patients’ needs because of limitation in efficacy, side effects and lacking comprehensive therapeutic effects. On the other hand, Traditional Chinese Medicine (TCM) is clinically effective in treating this problem and with good safetyrecords as well, while different disease names, sophisticated syndrome types and variable medication regimen are it’s insufficiency that made clinical application very difficult. Therefore, unified TCM disease names, establishing relative fixed regimen could make it easier to be mastered, contribute to generalized clinical application. Because the clinical manifestation, endoscopic features and pathological signs of ulcerative colitis resemble carbuncle in TCM, we suggest that ulcerative colitis pertains to Internal Carbuncle, and can be named as Intestinal Carbuncle, and put forward the theory of treating ulcerative colitis in internal carbuncle theory, clearing away heat and eliminating dampness, diminishing carbuncle and promoting the wound healing in active stage, Shenbai Enema Prescription is formulated accordingly. Since 95% of ulcerative colitis take place at rectum or left half of the colon, diseased area distributed continuously, we use Enema as the main administration route to reduce the side effects or toxic effects.To investigate the clinical efficacy and the effects of Shenbai Enema Prescription to intestinal mucosal capillaropathy, experimental and clinical studies were conducted, and further, from the aspect of molecule medicine for first time, we have exploited the possible acting mechanism of Shenbai Enema Prescription to the pathological change of microvasculature with animal models of ulcerative colitis.Methods: For clinical research, 44 patients were divided into research group and control group randomizely, 22 were intervened by Shenbai Enema Prescription, others received SASP enema, 9 patients in research group and 6 patients in control group had been examined by endoscopy before and after treatment, endoscopic features, pathological signs and pathological change of microvasculature of intestinal mucosa were compared. For experimental study, rats were randomizely divided into blank control group, western drug control group, model group, experimental group, altogether four groups. No intervention was administered to blank control group, DSS ulcerative colitis rats model were made for the other three groups, rats in experimental group received Shenbai Enema Prescription for two weeks, rats in western drug control group received SASP enema for two weeks, no intervention to the model group. Two weeks later, pathological change of colon mucosa and pathological change of microvasculature of intestinal mucosa were compared, VEGF, PDGF of rats colon mucosa were checked with Elisa method.Results: Result of clinical research, clinical symptoms improved in research group, superior to that of control group, P＜0.01; clinical effective rate in research group is 100%, superior to that of control group, P＜0.01. Among those received endoscope, recovery rate is 22.22% in research group compared with 0 in control group, even there is no significancebetween the two group with respect to overall effective rate, P＞0.05; while histological grade and pathologic change of micromusculature in research group are markably improved after treatment when compared with that of before treatment, with both P＜0.01, there is no significance in control group with the two index, both P＞0.05. Result of animal study, pathological change of colon mucosa and pathological change of microvasculature of intestinal mucosa in experimental group improved obviously, superior to model group, while no significance compared with western drug control group. VEGF, PDGF of rats’ colon mucosa elevated evidently in model group while decreased markably in experimental group, there is statistical significance.Conclusion: Formulated according to the theory of internal carbuncle theory, Shenbai Enema Prescription could markably improve clinical symptoms for patients with ulcerative colitis, promote intestinal mucosa recovery and the healing of ulceration, and improvecapillaropathy of intestinal mucosa as well. Expression of VEGF and PDGF of colon mucosa increasing in rats model of ulcerative colitis indicates that both are more specific indicators of capillaropathy of ulcerative colitis. Shenbai Enema Prescription could lower the expression of VEGF and PDGF which maybe the target of the prescription to capillaropathy of ulcerative colitis. |
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