The Clinical Efficacy Of The Qingchanghuashi Decoction To Treat Ulcerative Colitis And Exprimental Study On Its Influence On NF-κB And Intestinal Mucosal Protective Factors Of MUC2、TFF3

Objective:To evaluate the efficacy and to observe the safety of QingChangHuaShi decoction of traditional Chinese medicine for therapy in adults with active UC. To observe the effect on the expression of NF-κB p65of the ulcerative colitis rats and from the point of Intestinal mucosal barrier to studye the effect of QingChangHuaShi decoction for the Intestinal mucosal protective factors:MUC2、TFF3.Providing meaningful date for the treatment of UC by Chinese medicine.Mehhods:Clinical trial part:70 patients with mild-to-moderate grade active UC were randomly divided into two groups:TCM group(35cases) and Mesalazine control group(35cases).All these patients were diagnosed by TCM belonging to colorectal Hygropyrexia Syndrome. The patients of TCM group took orally QingChangHuaShi decoction and combining with GuanChang decoction to enema. The Mesalazine group took orally Mesalazine 4000mg/d.The total treatment couse was 3 months.The clinical efficacy、syndrome efficacy, the main symptom disappeared-rates and safety evaluation were assessed.Rats experiment study:took 8 rats as blank group,the rest of rats were made as TNBS/ethanol UC model,then were divided into five groups randomly:model group,TCM low-dose group, TCM medium-dose group,TCM high-dose group,SASP group.After treatment of 2 weeks,all rats were killed and took the specimens of colonic. Detecting the changes of mucosa morphology and tissue,and MUC2、TFF3 levels were detected by ELISA in colon tissue,using western blot method to detect the expression level of NF-KBp65.Results:Clinical trial part:AT the end of the trentment,the efficacy of syndrome of TCM group were better than the Mesalazine group(P<0.05). In symptoms of UC, the blood stool disappearance rat (77.1%) of TCM group was better than Mesalazine group (54.3%) (P<0.05). But there were no differences in clinical response(85.7%vs68.6%), clinical remission (51.4%vs31.4%),endoscopic response(88.6%vs74.3%) and mucosal remissio (71.4%vs54.3%) between the two groups (P>0.05).There was no adverse events in two groups.The experiment trial part showed that:QingChangHuaShi decoction could lower both the gross morphology score and the pathology score of colon(P<0.01) and could downregulate the expression of NF-κBp65 (P< 0.05) in colon tissue of model rats and had no significant differences with SASP group (P> 0.05). The levels of MUC2、TFF3 in model control group was higher than in normal control group. As well as, levels of MUC2、TFF3 in QingChangHuaShi decoction medium-dose treatment group and high-dose treatment group were lower than that in model control group.Conclusion:The clinicalstddy had proved that,QingChangHuaShi decoction was effective in the treatment of UC of colorectal hygropyrexia syndrome,and played a better effectiveness than Mesalazine in improving syndrome and Some clinical symptoms of UC. Experiment trial further confirmed that QingChangHuaShi Presciption could reduce the level of intestinal mucosal inflammation, playing the role of protecting and repairing the intestinal mucosal barrier.