| Objective:This study aims to observe the clinical effect of TCM enema recipe combined with mesalazine on ulcerative colitis in various stages,to understand whether the combination of Chinese and western medicine has synergistic effect.Through test the expression levels of IL-4,IL-10 and IL-13 in patients' serum,and observe the effect of TCM enema recipe on colonic pathology and IL-6?TGF-? in rats,to explore the possible effective mechanism of combining Chinese and western methods in the treatment of ulcerative colitis.Method:A total of 60 patients with active stage of ulcerative colitis with TCM for dysentery,syndrome of damp heat syndrome,patients using the randomized controlled method 60 patients were divided into combined treatment group 30 cases,western medicine group 30 cases.Combined treatment group treated with Chinese medicine enema Method with Mesalazine SR Granules,while western medicine treatment group treated with SASP and Mesalazine SR Granules,sustained release granules for 24 weeks.All cases were from The first affiliated hospital of nanjing university of Chinese medicine.After the treatment,the clinical efficacy was compared,the serum IL-4,IL-10 and IL-13 values were determined by ELISA before and after the treatment,and the changes were analyzed and the possible mechanism of action was discussed.The effect of traditional Chinese medicine enema recipe on IL-6?TGF-? was observed by ELISA.Results:Clinical part:the main symptom disappearance rate and TCM syndrome efficacy of the treatment group were better than that of the control group(P<0.05).The symptom disappearance rates(76.7%,85.7%,85.2%,86.7%)of patients in the TCM enema group were higher than those in the Sulfasalazine group(50.0%,53.6%,55.6%,60.0%),with statistically significant differences(P<0.05).There were no statistically significant differences in clinical efficiency,clinical remission rate,endoscopic response rate,mucosal healing rate,and Mayo score difference before and after treatment between the two groups(P>0.05).No adverse events occurred in either group.Compared with before treatment,the serum levels of IL-4,IL-10 and IL-13 in UC patients in the two groups were significantly increased after treatment,with statistical significance(P<0.05),and the differences between the two groups before and after treatment of IL-4?IL-10 and IL-13 were statistically significant(P<0.05),and the combination of Chinese and western medicine group was superior to the western medicine group alone.Experimental part:the increase in body mass of rats in the TCM enema group was better than that of the model group,and the gross morphology and histopathology of the colon were significantly better than that of the model group,resulting in a decrease in IL-6 level and an increase in TGF-? level,which was statistically significant compared with the model group(P<0.05).Conclusions:The efficacy of Chinese medicine enema combined with western medicine in the treatment of active and remission period UC patients is positive,which can obviously improve the symptoms of the patients and promote the healing of the colon mucosa.The mechanism of action may play a role in inhibiting the expression of anti inflammatory factors IL-4,IL-10 and IL-13 in the serum of UC patients. |
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