Effect And Mechanism Of Modified Shaoyao Decoction On Colonic Damp-Fever Ulcerative Colitis Based On Circular Motion Theory

Objective:The aim of this study is to observe the clinical effect of Modified Shaoyao Decoction treating ulcerative colitis under treatment based on syndrome differentiation of circular motion theory.To observe the pathological changes,permeability changes and anti-inflammatory effects of Modified Shaoyao Decoction on colonic mucosa in ulcerative colitis mice,and to explore the possible action mechanism through animal experiment.Methods:Clinical part:60 cases with mild and moderate ulcerative colitis who were identified by traditional medicine as large intestine damp-heat type were randomly divided into two groups:Modified Shaoyao Decoction observation group and mesalazine enteric-coated tablets(4g/d),30 cases in each group.After 8 weeks of treatment,the clinical treatment effect,clinical complete remission rate,changes in major symptom scores,disappearance rate of symptoms,TCM syndrome effect scores and improvement of symptoms,changes in colonic mucosa,remission rate,C-reactive protein(CRP)and ESR levels,quality of life scores,and medication safety were compared and analyzed.Experimental part:Animal models of ulcerative colitis in mice were selected by DSS method and randomly divided into high-dose observation group,low-dose observation group,model group and control group(9 per group).Each observation group continued to be administered for 1 week.Observe and record the changes of body weight,general morphology of colonic mucosa and tissues of colonic mucosa in each group of mice.The serum TNF-?,IL-1,IL-4 and IL-6 contents of mice were determined by enzyme-linked immunosorbent assay.The expressions of TLR4,NF-?B,and COX-2 in colon tissue of mice were determined by immunohistochemistry,and the expressions of tight junction proteins ZO-1 and Occludin in colon tissue of mice were determined by western blotting.Results:Clinical research:The clinical efficacy of the Modified Shaoyao Decoction observation group was superior to the mesalazine control group(P<0.05).The improvement of the symptom scores of the patients in the observation group was better than that in the control group(P<0.05);In terms of the disappearance rate of symptoms such as diarrhea,pus and blood,abdominal pain,post-emergency,dry mouth and dry mouth,the observation group(70.00%,86.67%,90.00%,86.21%,94.12%)were higher than control group(43.33%,56.67%,50.00%,40.00%,33.33%)(all P<0.05);The improvement of colonic mucosa in the observation group was more significant than that in the control group(P<0.05);The levels of serum CRP and ESR in patients in the observation group decreased significantly compared with the control(P<0.05);In terms of quality of life,patients in the observation group were significantly higher than those in the control group(P<0.05).Experimental results:The disease activity index score,colonic mucosal injury score,histological score,and serum TNF-?,IL-1,IL-4,and IL-6 expression levels in UC mice were significantly reduced after treatment with Modified Shaoyao Decoction(all P<0.05);The expression levels of TLR4,NF-?B and COX-2 in mice in the Modified Shaoyao Decoction observation group were all lower than those in the model group,and the improvement was more significant in the high-dose group and in the lower-dose group(all P<0.05).In addition,the expressions of ZO-1 and Occludin in the mice in the observation group of Modified Shaoyao Decoction were increased compared with the model group(both P<0.05),but there was no statistical difference between the high-dose group and the low-dose group(both P>0.05).Conclusion:The therapeutic effect of Modified Shaoyao Decoction on patients with large intestine damp-heat type ulcerative colitis is superior to mesalazine enteric-coated tablets,especially in patients with TCM syndromes,colonic mucosal lesions,and quality of life.The results of experimental studies suggest that the expression of inflammatory factors and COX-2 in UC mouse models can be inhibited by regulating the TLR4/NF-?B signaling pathway,the levels of Occludin and ZO-1 proteins in colonic mucosa can be restored,and the repairing of colonic mucosal barrier can be promoted.which may be the two mechanisms of action of Modified Shaoyao Decoction in the treatment of UC.