| Objective:To observe the clinical therapeutic effect of combination of mesalazine and Jianpihuashi decoction taking Shenling Baizhu Powder as the foundation prescription in treating mild-to-moderate ulcerative colitis on dampness stagnancy due to spleen deficiency, and survey the functions of Jianpihuashi decoction on the ERK1/2 signal pathway of ulcerative colitis model rats colonic mucosa; Explore the possible mechanism of action and provide basis for the therapeutic effect and mechanism of traditional Chinese medicine on ulcerative colitis.Method:Clinical research:Adopting the randomized controlled method,40 cases of standard mild-to-moderate ulcerative colitis on dampness stagnancy due to spleen deficiency patients were divided into the treatment group and control group with 20 cases respectively. Both groups took orally mesalazine sustained release particle 1g every time and 4 times per day and the treatment group additionally took Jianpihuashi decoction. Compared two groups of patients with the comprehensive therapeutic effect, efficacy with TCM, efficacy under endoscopy and the improvement of the Chinese medicine symptom complex score and Sutherland DAI between two groups before and after therapy after 8 weeks.Experimental research:Adopting random method,45 rates were divided into normal control group, model control group, Jianpihuashi decoction group and positive control group. Apart from the normal control group, other groups adopted trinitro-benzene-sulfonic acid derivative method to make rat ulcerative colitis models, and through intragastric administration, gave water decoction of Jianpihuashi decoction to the Jianpihuashi decoction group; gave salazosulfapyridine aqueous solution to the positive control group, and gave equal volume of distilled water to the normal control group and model control group. After 10 days’ pharmacy, observed the structural changes of the rate colon tissues with the method of HE staining and detected the expression of ERK1/2 in the rate colon tissues with the method of Westernblot.Results:The results of clinic study show that:after the treatment, the Chinese medicine symptom complex score of both groups had obvious decrease (P<0.01), the score after the treatment of the treatment group was lower than the control group (P<0.05), and the efficacy with TCM was also better than the control group (P<0.05). The Sutherland DAI score of other cases had obvious differences (P<0.05), and the DAI score treatment group after the treatment was lower than the control group (P<0.01). The efficacy under endoscopy has no difference between two groups(P>0.05),but the treatment group effective rate 75.0% was higher than the 50.0% of the control group, it was deemed that the effects of the both groups were same. The general short-term effect rate of the treatment group was 95.00%, which was higher than the 75.00% of the control group (P>0.05). It was confirmed that the effects of the both groups had no differences.The experimental research results show that:Compared with normal control group, model control group had different degree of active UC histological pathology, such as congestion, edema, chronic inflammatory cell infiltration, mucosal necrosis, ulcers. The mucosa inflammatory cell infiltration of Jianpihuashi decoction group and positive control group had different degree of ease compared with model control group.The colonic mucosa ERK1/2 of the rates in model control group increased obviously than those in the normal control group (P<0.01). The relative transcript level of the positive control group and ERK1 of Jianpihuashi decoction group had decrease comparing with the model control group (P<0.05), and in the respect of ERK2 expression, there was no obvious difference with the model control group (P>0.05). Jianpihuashi decoction group had no advantage than the positive control group in the respect of ERK1/2 expression (P>0.05).Conclusion:The Jianpihuashi decoction combining with mesalazine can well improve the clinical symptoms and DAI of mild-to-moderate ulcerative colitis patients,but has no obvious effect on the Mucosal lesions under colonoscopy in short-term, the mode of action of which may be through the ERK signal pathway.ERK play an anti-inflammatory action and promote the ulcer repair. |
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