| ObjectiveThis study aims:Taking patients that suffered from ulcerative colitis as investigative objects, selecting the intestinal immune-inflammatory response and underlying poison theory of TCM as the pointcut, conducted clinical research with the prescriptions-disease as carrier, observed the influence that TCM clearing away underlying poison treatment under the guidance of underlying poison theory to the patients’plasma levels of MMP-1and TIMP-1, and observed the advantage that intervention therapy of TCM was better than pure western medicine treatment. Discussed the relationship between the underlying poison theory and ulcerative colitis at the level of molecular biology; Provided the objective evaluation to the relationship between the underlying poison theory and ulcerative colitis;Further, expounded the efficacy mechanism of TCM, and promoted the theory of TCM rigorous.MethodsThis subject was a nonrandomized controlled trial. We collected cases with the strict inclusion criteria and exclusion criteria, to select patients in mild and medium active stage or remission stage by west medicine diagnosis, and "protracted dysentery" or "recurrent dysentery" under the TCM diagnosis as the participants. In view of medical ethics and patients, compliance. This subject had not implemented the principle of randomization. But according to the the patients, will, into the corresponding observation groups. All the included cases were divided into4groups (TCM intervention group1, pure western medicine treatment group1, TCM intervention group2, pure western medicine treatment group2),10cases in each group. TCM intervention group1and pure western medicine treatment group1were the active UC patients. Both of them are damp-heat in large intestine stagnation or mixed cold and heat stagnation, contrasting each other. The TCM intervention group2and pure western medicine treatment group2were the remission patients. Both of them are weakened spleen and stomach stagnation or Spleen deficiency clip wet stagnation, contrasting each other.10cases in each group, the sum of the requirements cases was40. Diagnosis of active and remission using the modified Mayo scoring system (see Appendix3),^2into remission;3-5divided into mild activity;6to10as moderate activity. All the included cases were treatment with specification western medicine, the cases of TCM treatment had yet to add herbs under the guidance of underlying poison theory. The therapeutic schedule of western medicine treatment group was made by the experts who had rich experience in the UC. The cases of TCM treatment groups had be accepted from those Luo Yunjian Professor attended personally or Luo’s academic successors’s ones. Patients were selected for the first time to accept TCM clearing away underlying poison treatment under the guidance of underlying poison theory. They were treated for8weeks. We observed and recorded the clinical manifestations,the endoscopic and pathological results,the plasma levels of CRP, PGE2> MMP-1and TIMP-1before. and after treatment (The colonoscopy-> pathological results would not be collected after treatment). Collected data and established the SPSS17.0database. Used SPSS17.0software package for data statistics. The count data were compared with by chi-square test (or exact probability test);In the homogeneity of variance and the premise of normal distribution, the measurement data between two groups were compared with t test. The measurement data in multiple groups were compared with one-way analysis of variance and the comparison among groups were performed with SNK or LSD test. Correlation analysis using spearman or pearson correlation calculation. Selected P<0.05(double side)as significant level.Results1. Related statistical analysis before the treatment(1) Baseline analysis①By the statistical tests, the every groups before treatment of gender、 age、illness course, the scope of lesionsN the disease severity were no statistical difference(P>0.05), at comparable scales.㏕he levels of MMP-1、TIMP-1and PGE2of UC patients in active stage had no statistical difference between the TCM intervention group1and pure western medicine treatment group1(P>0.05). ③The levels of MMP-1、TIMP-1and PGE2of UC patients in remittent stage had no statistical difference between the TCM intervention group2and pure western medicine treatment group2(P>0.05).2. Relation between the plasma levels of MMP-1、TIMP-1、PGE2and the UC condition(1) Plasma expression levels of MMP-1、TIMP-1、PGE2in the different UC condition①The plasma levels of MMP-1in mediu UC patients were significantly higher than those mild and in remittent UC patiens (P<0.05). But the level between mild UC and in remittent UC patiens had no statistical significant difference (P>0.05).②The plasma levels of TIMP-1and PGE2in medium and mild active stage UC patients were significantly higher than those in remission(P>0.05), and the levels of medium UC patients were significantly higher than those mild patiens (P>0.05).(2) The correlation analysis (spearman correlation calculation) between the plasma levels of MMP-1、TIMP-land PGE2with disease severity (remission stage、 mediu active stage、mild active stage) showed that all of them, there were significant positive correlation. The more serious illness, the higher level.2.Related statistical analysis after the treatment shows that:(1) The levels of MMP-1and TIMP-1were discreased after the treatment between the every groups. By the method of paired-sample t test, there was significant difference in TCM intervention group1、pure western medicine treatment group1、 TCM intervention group2before and after treatment (P<0.05). But in the pure western medicine treatment group2, the depressed levels of MMP-1and TIMP-1of pretherapy and post-treatment had no significant difference (P>0.05).(2) Compared the depressed levels of MMP-1and TIMP-1of every groups in pretherapy and post-treatment:There had no statistical significance on actived groups (P>0.05).The depressed levels of MMP-1and TIMP-1of TCM intervention group2were higher than pure western medicine treatment group2(P>0.05)(3) The levels of PGE2were discreased after the treatment between the every groups. By the method of paired-sample t test, there was significant difference on PGE2of before and after treatment in TCM intervention group1、pure western medicine treatment group1(respectively, P>0.001、 <0.001,, P<0.05).But on the stage of remittent, the depressed level of PGE2in TCM intervention group2、pure western medicine treatment group2had no significant difference in pretherapy and post-treatment(respectively, P=0.456、P=0.257, P>0.05).(4) Compared the depressed level of PGE2among groups in pretherapy and post-treatment:There had no statistical significance on both active and remittent groups(respectively, P=0.969、P=0.725, P>0.05).Conclusion1. The expression of MMP-1、TIMP-land PGE2in plasma is closely correlate with UC pathogenesis and the state of an illness.2. Under the guide of underlying poison theory of TCM, the advantage to reduce related cytokines in the plasma is significant, mainly performed in remission, the specific performance is the MMP-1and TIMP-1levels discreased.3. The "poison " of the "underlying poison theory "and MMP-1and TIMP-1in molecular levels is a kind of objective analogue relations, meanwhile the "underlying" of the "underlying poison theory" is performed in the remission of UC.4. The relationship between underlying poison theory and UC has realized objectivity, and promoted the theory of TCM rigorous. |
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