| 1ObjectiveStudy on the differences of patients with large intestinal damp-heat and cold-damp repression syndrome of traditional Chinese Medicine of ulcerative colitis (ulcerative colitis, UC):the clinical characteristics,features of TCM Syndromes, different stages, severity of illness, biochemistry,immunology examination, pulmonary function injury, colonoscopy endoscopic manifestation. And combined with the theory of traditional Chinese medicine to guide the clinical diagnosis and treatment.2MethordStudy selection through colonoscopy and pathology with ulcerative colitis, and according with the TCM Syndrome Differentiation for the large intestine damp-heat80cases and cold-damp repression syndrome35cases, and no history of smoking or having quitted smoking for ten years, without chronic respiratory diseases,in addition to select31checkup healthy persons as normal control group. To observe the general information of patients with UC:gender, age, course of disease,disease staging and type, extent of disease,severity and extraintestinal manifestations. Auxiliary examination:blood routine, liver and kidney function, lung function, ESR, CRP, T cell subsets. Statistical analysis was performed by SPSS20.0software, normality, homogeneity of variance and comparability of testing level at0.05, count data using chi-square test, multiple independent sample rank sum test with measurement data (Kruskal-Wallis H test).3Results80cases UC of Large intestine damp-heat syndrome were chosed which41cases were male,39cases were female, mean age were41.9±14.369;35cases UC of cold-damp repression syndrome were at the same observed which15cases were male,20cases were female, mean age was42.82±14.540. Age and sex of the two group were in the same baseline, the onset in peak of the two syndromes was at30-40years.Among the main factors inducing aggravated were the improper diet(accounted for58.26%), bad emotions(accounted for53.04%).The Damp-heat syndrome group course was mainly in1-5years (P=0.000),When it come to more than10years, the cold-damp repression group was the main group (P=0.030). The symptoms of Large intestine damp-heat patients with UC were as follows:purulent blood and mucus,red much less white in the defecate (85%),abdominal bearing-down pain or burning pain (73.75%),tenesmus (72.50%), yellow thick greasy tongue coating(68.75),dry and bitter taste (80%);The cold-damp repression syndrome in patients with UC were:the red white sticky frozen, white much less red, or pure for white frozen in the defecate (80.82%), abdominal pain,abdominal cold chills(94.29%),heaviness in head and body(94.52%),tenesmus feeling(60.00%).In the defecation integral,damp-heat syndrome group was higher than that of cold-damp block group (P=0.019), while the cold-damp repression group abdominal symptom integral and systemic symptom total score were higher than that of damp-heat syndrome group (P=0.021,0.028).Two groups of syndromes were mainly in active period.Intestinal mucosal lesions of large intestine damp-heat syndrome and dampness repression syndrome mainly in the rectum,followed by direct sigmoid colon,colon. The parenteral complications of damp-heat syndrome group and cold-damp repressor group were mainly in pulmonary function damage (66.01%), followed by recurrent oral ulcer (14.38%), acute arthritis (9.80%). The severity of the disease in the two growps were mainly in mild and moderate.In the endoscopic classification (by Roth classification), the damp-heat syndrome group were more than the cold-damp repression syndrome group in grade Ⅲ(P=0.049)and IV(P=0.039); The endoscopic index of two groups were mainly distributed in class Ⅱ, Ⅲ. The endoscopic index of damp-heat syndrome group (6.08±3.86) was significantly higher than that of the cold-damp repression syndrome group (4.51±3.20),(P=0.016＜0.05).The damp-heat syndrome group was more significantly obvious than the cold-damp repression syndrome group, in the exudate, erosion, ulcer,cellulose (P=0.000,0.003,0.000,0.018), while in the mucosa of the particles and rough hand,the cold-damp repression syndrome group was more significantly obvious (p=0.031); The differences between the two groups in the crisp, mucous membrane vascular network blurred or disappeared, mucus were not significant (P=0.958,0.177,0.372).CRP,ESR were inflammation activity index, in the large intestine damp-heat and cold-damp repression groups were increased with the aggravation of disease degree and the average were higher in the active phase than in remission stage. The mean of CRP, ESR in cold-damp repression group were higher than the damp-heat syndrome group (P=0.019,0.817).In the large intestine damp-heat and cold-damp repression groups,CD3+(%) CD3+CD8+(%) showed increased trend with the aggravation of disease degree and the activity of the disease. But the mean of CD3+(%)、CD3+CD8+(%) in cold-damp repression group was in a higher level than that of the damp-heat syndrome group.In the large intestine damp-heat and the cold-damp repression group, the mean of CD3+CD4+(%) was higher with the increasing trend of the disease, but when the disease was very serious, its value was significantly reduced and the severe patients were lower than those patients in mild.The mean value of CD4+/CD8+(%) in the overall cold-damp repression group showed increased trend with the aggravation of disease degree and the activity of the disease. While in the damp-heat syndrome group CD4/CD8(%) manifested increased first and then decreased.The function of the ventilatory in the damp-heat syndrome group, cold-damp repression group and healthy people were basically the same,but they remained differences in the residual total ratio increase, airflow limitation and diffusing capacity decrease(P=0.000,0.031,0.036). Patients of the cold-damp repression group were more prone to be in residual total ratio increase, small airway flow limitation, decreased diffusing capacity.4ConclutionThe study found many differences existed between the damp-heat syndrome and the cold-damp repression syndrome.Based on the syndrome differentiation of TCM,we need to combine the physical and chemical examination of Western medicine.Through the further integration of the syndrome differentiation and disease differentiation,we can better understand the disease of the typing, staging, and serious degree so as to provide a better basis for the combination treatment in traditional Chinese and Western medicine treatment.1.The main course of disease distribution in the large intestinal damp-heat was in1-5years, but along with the time prolonged, especially, after10years, the cold-damp repression syndrome appeared more.2. The typical symptoms of large intestine wet-heat syndrome were much more differert than that of the cold-damp repression syndrome. In the endoscopic classification (by Roth classification), the two group were main in II, III, but the damp-heat syndrome group were much more in grade Ⅲ, Ⅳ than that of the cold-damp repressor group.3. CRP, ESR are disease inflammatory activity index, in the large intestine damp-heat and dampness blocking groups, with an exacerbation of the disease they were increased, and they were higher in the activity than in remission stage. CRP and ESR in the cold-damp group were higher than that of the damp-heat syndrome group,while in the colonoscopy and endoscopic index the large intestineal damp-heat were more serious.All showed that the local inflammatory reaction in the intestine damp-heat was more obvious, and the body Inflammatory reaction in the cold-damp repression was more obvious. All above may reflected the relationship between local and whole.4. The abnormality of T cell subsets in the Large intestine wet-heat and dampness blocking groups showed the disorder of immune function.The whole immune function of the cold-damp block group, with the development of the disease severity and activity,was relatively decreasing; But the immune function of damp-heat syndrome group,at the begin was much more active then with the exacerbation of the disease,the immune function becomes relatively lower. It may be the immune imbalance to make foreign antigens are not well cleared,which may further explains the mechanism of UC in chronic recurrent.At the same time,it also showed the immune function of heterogeneity and diversity,and the exact cause remains to be studied further.5. Compared with the damp-heat syndrome, the cold-damp block group was much more obvious in the residual total ratio increase, the airflow limitation and dispersion decrease.This may be because the cold-damp has relatively long period,and with the time extension of the disease, pulmonary function in patients with UC are more prone to abnormal. |
PDF Full Text Request