Jiedu Shenghua Decoction Combined With Mesalazine On The Repair Of Colonic Mucosa In Patients With Ulcerative Colitis And The Regulation On T Cell Subsets

Objective:To evaluate the repair of colonic mucosa of Jiedu Shenghua Decoction combined with mesalazine in the treatment of patients with ulcerative colitis of large intestine damp-heat syndrome.Observe its clinical efficacy and its regulatory effect on T cell subsets.Methods:A self-controlled clinical study before and after treatment included 33 patients with ulcerative colitis with large intestine damp-heat syndrome,which including 13 cases of type E1(rectal type)and 20 cases of type E2(left colonic type).Type E1 was given Jiedu Shenghua Decoction orally combined with mesalazine suppository,and type E2 was given Jiedu Shenghua Decoction combined with mesalazine enteric-coated tablets,both of the treatment courses were 12 weeks.Compare the endoscopic Baron score before and after treatment of type E1 and type E2,respectively.The histopathological Geboes scores before treatment of each intestinal segment were compared.The histopathological Geboes scores before and after treatment of each intestinal segment were compared.The decrease in histopathological Geboes scores of each intestinal segment after treatment of E1 and E2 were compared respectively.Observetheclinicalefficacy,lesionrange,Mayo score,traditional Chinese medicine(TCM)symptom score before and after treatment.Observe the levels of peripheral blood CD4~+,CD8~+,CD4~+/CD8~+in T cell subsets before and after treatment.The safety was evaluated simultaneously.Results:After 12 weeks of treatment,The Baron score of rectum after treatment was significantly lower than that before treatment of type E1(P<0.01).The Baron score of rectum,sigmoid colon and descending colon after treatment were significantly lower than that before treatment of type E2(P<0.01).Type E1 histopathology Geboes scores of each intestinal segment before treatment were ranked from high to low:rectum>sigmoid colon>descending colon,transverse colon,ascending colon.After treatment,the Type E1 histopathology Geboes scores of rectum,sigmoid colon,descending colon,transverse colon,and ascending colon were all decreased significantly(P<0.01).The descending range of histopathology Geboes scores of each intestinal segment of type E1 were ranked as high out of low:rectum>sigmoid colon>descending colon,transverse colon,ascending colon.Type E2histopathology Geboes scores of each intestinal segment before treatment were ranked from high to low:rectum>sigmoid colon>descending colon>transverse colon>ascending colon.After treatment,the Type E2 histopathology Geboes scores of rectum,sigmoid colon,descending colon,transverse colon,and ascending colon were all decreased significantly(P<0.01).The descending range of histopathology Geboes scores of each intestinal segment of type E2were ranked as high out of low:rectum>sigmoid colon>descending colon>transverse colon>ascending colon.The total effective rate of the treatment was 93.9%.The range of lesions after treatment was narrower than before(P<0.05).Mayo score was significantly lower than before treatment(P<0.01).After treatment,the main symptom scores in TCM symptom scores were significantly lower than before treatment,and the difference was statistically significant(P<0.01);the minor symptom scores in burning pain in anus,dry or bitterness mouth,and anorexia compared with before treatment,the difference was Statistical significance(P<0.01,P<0.05),The levels of peripheral blood CD4~+and CD4~+/CD8~+ratio were significantly lower than before treatment(P<0.01).The level of peripheral blood CD8~+was higher than before treatment(P<0.05).Conclusion:The lesions of ulcerative colitis type E1 and type E2 have not involved the whole colon,but the normal intestinal segment(Baron score=0)under endoscopy still has different degrees of inflammation in histopathology.Taking mucosal healing as the main end point of curative effect evaluation,multi-segment and multi-point biopsy of the whole intestine can be used for pathological evaluation to accurately evaluate the deep healing of intestinal mucosa.The treatment of Jiedu Shenghua Decoction combined with mesalazine fully exerts the advantages of integrated traditional Chinese and Western medicine.The two take advantages and complement of each other which play a synergistic and detoxification role at the same time.The two take advantage of each other’s strengths,complement each other’s advantages,increase efficiency and reduce toxicity,accelerate induction of remission,regulate immune function,and promote the repair and deep healing of colonic mucosa.