Research On Treatment Of Ulcerative Colitis And Regulation Of Cytokine Ulcer With Combination Of TCM And Western Medicine

Objective To observe the efficacy and safety of treating ulcerative colitis with combination of traditional Chinese and Western medicine. And to observe the effect of this method on the expression of IL-4,Il-10,IL-17,IL-23 and TNF-α in colonic tissue of patients,and to explore the action mechanism of this method.Methods Clinical part:The research based on 120 cases of patients who are conformed to be ulceratie colitis in active phase.They are randomly divided into treatment group and control group,60 cases in each group. In the treatment group,60 patients in active phase are given with Thanh Hoa Huoxue grabbing ulcer Fang oral and enema treatment and Western medicine standardized treatment according to the severity of the disease,while in the remittent phase,the patients are given with ISED Huoxue square oral and Western standardized treatment.In the control group,60 patients whether in active or remittent phase,are both given with Westen Medicine standardized treatment.The course of treatment is 24 weeks, then analyze the clinical efficacy after the end of treatment.Following up to 32 weeks to observe recurrence. Experimental part:Use the method of immunohistochemistry to detect the expression IL-4,IL-10,IL-17,IL-23and TNF-α in the colon tissues which are picked from healthy people,UC patients in active phase and UC patients in remittent phase.Results Clinical part:Treatment group is more effective and efficient than the control group of improving the symptoms of anal burning,pus and blood stools(P<0.05), and at the same onset time equally; In the aspects of improving diarrhea,abdominal pain, bloating and tenesmus, treatment group is more effective and efficient than the control group(P<0.05),and the treatment group is earlier than the control group at the onset time.Treatment group can obviously improve the food less poor appetite, lassitude symptoms(P<0.05), while the control group shows no improvement(P>0.05). After 24 weeks of treatment,in terms of clinical efficacy,the treatment group total efficiency is 93.33%,while the other group is 80.00%, the treatment group is better than the control group(P<0.05).The treatment group remission rate is 88.33%, control group remission rate is 71.67%, treatment group is more effective and efficient than the control group(P<0.05).The mucosal healing rate of treatment group is 30%,while the control group is 20%,the two groups are statistically significant(P<0.05).Followed up to 32 weeks,the relapse rate in treatment group is 6.67%, the control group is 20.00%, treatment group is lower than that of the control group(P<0.05).After treatment, the colonoscopy and pathology of treatment group is better than that of the control group(P<0.05);Compared two groups of clinical comprehensive therapeutic effect,the treatment group is better than the control group(P<0.01). The total efficiency of treatment group is 96.67%, while that of treatment group is 83.33%. After treatment, compared two groups of the quality of life, the curative effect of the treatment group surpasses that of the control group. During the course of treatment, the control group has 2 cases of liver damage,3 cases of white blood cells decrease slightly, the treatment group is normal, two groups have no difference in safety indexes before and after treatment(P>0.05). Experimental part: The intensity of expression of IL-4 and IL-10 in the colonic mucosa of UC in remittent phase is significantly higher than that in active phase and normal group(P<0.01).The intensity of expression of IL-4,IL-10,IL-17 in the colonic mucosa of UC in active phase is significantly higher than that in normal group(P<0.01).The positive rate of IL-4 and IL-10 in the colonic mucosa of UC in active phase and remittent phase has no statistical significance(P>0.05). The positive rate of IL-4,IL-10 and IL-17 in the colonic mucosa of UC in active phase and remittent phase is significantly higher than that in normal group(P<0.01).The intensity of expression of IL-17 in the colonic mucosa of UC in remittent phase is significantly lower than that in active phase(P<0.01). The intensity of expression of IL-17 and TNF-α in the colonic mucosa of UC in remittent phase and normal group has no statistical significance(P>0.05).The positive rate of IL-17,IL-23 and TNF-α in the colonic mucosa of UC in active phase and remittent phase has no statistical significance.The intensity of expression of IL-23 and TNF-α in the colonic mucosa of UC in remittent phase is significantly higher than that in normal group(P<0.01).The intensity of expression of IL-23 and TNF-α in the colonic mucosa of UC in active phase is higher than that in normal group(P<0.05).The positive rate of IL-23 in the colonic mucosa of UC in active phase and remittent phase is higher than in normal group(P<0.05). The positive rate of TNF-α in the colonic mucosa of UC in active phase is significantly higher than that in normal group(P<0.01). The positive rate of TNF-α in the colonic mucosa of UC remittent phase is higher than that in normal group(P<0.05).Conclusion The treatment scheme which combines TCM and Western medicine can significantly improve the clinical symptoms, reduce the recurrence rate,improve the life quality of patients and has good safety.Also its curative effect is better than pure western medicine standardized treatment. It deserves to be further promoted and applied. According to the experimental research,we conjectures that the meehanism of this treatment scheme may be restraining inflammation and regulating immune through the expression of IL-4, IL-10 and IL-17. But this scheme is not obvious in modulation of IL-23 and TNF-α.