Clinical Research Of Qingchang Decoction Combined With Mesalazine On Active Ulcerative Colitis Patients With Heat And Blood Stasis

Objective Research the clinical effect and mechanism of Qingchang Decoction combined with mesalazine on active ulcerative colitis patients.Methods From October 2018 to December 2019,60 patients of active ulcerative colitis with active blood and blood stasis from Zhangjiagang Hospital affiliated to Nanjing University of Chinese Medicine are randomly divided into treatment group and control group.The treatment group is treated with Qingchang Decoction combined with mesalazine,while the control group is treated with mesalazine only.Course of treatment for 3 months,observe the Mayo score,TCM clinical symptom score,Mayo endoscopic subscore,mucosal healing rate,the quality of life with the IBDQ questionnaire,immunohistochemical expression of TRAF6、p65 and immunofluorescence staining of TLR4 in mucosal tissues of two groups of patients before and after treatment.SPSS 24.0 is used for statistical analysis,comparing the effective rate,TCM symptom score,Mayo score,Mayo endoscopic subscores,the quality of life score,changes in immunohistochemical expression of TRAF6 and p65,changes in immunofluorescence expression of TLR4.Results Comparison of the comprehensive efficacy of the disease:the therapeutic effect of the treatment group is better than that of the control group.The total effective rate of the treatment group is 93.33%,higher than that of the control group 73.33%.By the chi-square,the difference is significant(P<0.05).Comparison of the efficacy of TCM syndromes:TCM symptoms(diarrhea,mucopurulent bloody stool,abdominal pain,tenesmus)scores and total scores before treatment are not statistically different between the two groups of patients by t test(P>0.05).The total scores are all decreased,and are statistically significant by t test(P<0.05),but the treatment group has more significant effectiveness in improving diarrhea,and the difference is statistically significant(ΔP<0.05);in improving mucopurulent bloody stool,abdominal pain,and total points,the curative effect are even better,the differences are statistically significant(*P<0.01).Mayo score comparison:There is no statistical difference in Mayo score between two groups of patients by t-test before treatment(P>0.05),Mayo score of both groups decrease after treatment,and both are statistically significant by t-test(P<0.05).But the treatment group is more significant in improving the Mayo score,and the difference is statistically significant(P<0.01). Comparison of endoscopic scores:Mayo endoscopic subscores of intestinal mucosa before treatment in the two groups are not statistically different by t test(P>0.05).The scores in both groups decrease after treatment compared with before.The difference is statistically significant(P<0.05),but the intestinal mucosal improvement in the treatment group is more significant,and the difference is statistically significant(P<0.01).Evaluation of endoscopic mucosal healing rate in the two groups:the mucosal healing rate in the treatment group is 86.67%,and that is 53.33%in the control group.The treatment group is higher than the control group,and the difference is statistically significant by chi-square test(P<0.01).Comparison of the quality of life:the four dimensions and the total score of IBDQ before treatment are not statistically different by t test(P>0.05).There is a decrease after treatment,and the differences are statistically significant(P<0.05),but the improvement of the treatment group in each dimension and total points are more significant,and the differences are statistically significant(P<0.01).Comparison of colonic mucosal immunohistochemistry between the two groups of patients:there are no significant differences in the expression of TRAF6 and p65 in the two groups of patients before treatment(P>0.05).After treatment,each of the expressions of TRAF6 and p65 in the two groups are all decreased comparing with those before treatment,and the differences are statistically significant(P<0.05).However,the improvement of TRAF6 and p65 in the treatment group are more significant,and the differences are significant.Those have statistical significance(P<0.01).Comparison of weakening constitutive ratio of TRAF6 and p65 expression in colon mucosa immunohistochemistry between two groups:The weakening constitutive ratio of TRAF6 in the treatment group was 90%,and that of TARF6 in the control group is 66.67%.The difference is statistically significant(P<0.05).The weakening constitutive ratio of p65 is 93.33%in the treatment group and 63.33%in the control group,The difference is statistically significant(P<0.01),Comparison of colonic mucosal immunofluorescence of TLR4 between the two groups of patients:the expressions of TLR4 are more obvious before treatment in the two groups.After treatment,the expressions in the treatment group are generally lower than that in the control group.Conclusions Qingchang Decoction combined with mesalazine can effectively improve the clinical symptoms,intestinal mucosal healing and quality of life of active UC patients with heat and blood stasis,and the effectiveness is significant.The anti-inflammatory effect of Qingchang Decoction may be achieved by inhibiting the TLR4/TRAF6/NF-κB signaling pathway.