| Objective : To explore the mechanism of the improvement of mucosal healing quality and evaluate its clinical efficacy,by observing the expression of Claudin-2 and Claudin-5 in colonic mucosal epithelial cells before and after treatment in patients with spleen-deficiency and damp-heat type ulcerative colitis before and after treatment,enteroscopy score,mucosa Changes in histological scores and symptom scores.Methods: According to the randomized controlled study,50 patients were enrolled in our clinic and ward for diagnostic criteria from January 2016 to August 2017.The patients were divided into treatment group and control group by random number table group.The treatment group was given Jianpi Qingre Huoxue Decoction(jiubiying 15 g,baizhu 12 g,baishao 12 g,shuizhi 6g,sanqi 8g,machixian 12 g,zhigancao 6g),while the control group was given mesalazine sustained-release granule(Etiasa).Both groups took one course of treatment for 4 weeks and took three courses continuously.Baron colonoscopy score,mucosal histology Geboes score,Claudin-2 and Claudin-5expression levels and mucosal ultrastructure changes were compared between the two groups before and after treatment.Result:(1)Overall curative effect: Among the 25 patients in the treatment group,4 were completely relieved,8 were markedly effective,8 wereeffective,5 were ineffective,and the overall effective rate was 80%.Among the 25 patients in the control group,3 were completely relieved 6 cases were markedly effective,10 cases were effective,6 cases were ineffective,and the overall effective rate was 76%.The overall clinical efficacy of the two groups was comparable(P>0.05).(2)The comprehensive scores of clinical symptoms were evaluated at 4 weeks,8 weeks and 12 weeks follow-up during the course of treatment,which indicated that the treatment of both groups was lower than that before treatment(P <0.05),there was significant difference between the two groups(P <0.05)The treatment group was superior to the control group in improving clinical symptoms.(3)The 12-week follow-up,colonoscopy score,histological score of intestinal mucosa and TCM symptom score were all lower than those before treatment(P <0.05).There was no significant difference between the two groups(P> 0.05).Compared with the average optical density of Claudin-2 before and after treatment,the expression level of Claudin-2 was significantly down-regulated(P <0.05),and the average optical density of Claudin-5 before and after treatment was significantly up-regulated There was statistical significance(P <0.05).(4)The ultrastructure of the colon mucosa under the electron microscope showed epithelial cell microvilli were sparse irregularly arranged,the organelle structure was incomplete and the number was small before the treatment;the epithelial cells were dense and well-arranged,the organelle structure was basically complete,and the number was restored after treatment.Conclusion:(1)The efficacy of Jianpi Qingre Huoxue Decoction in treating spleen deficiency damp-heat type mild-moderate UC and mesalazine extended-release granules is similar.It is better than mesalazine extended-release granules in improving the clinical symptoms of patients.(2)The therapeutic effect of Jianpi Qingre Huoxue Decoction on UC may be through regulating the expression of tight junction proteins in the colon mucosal epithelium,down-regulating Claudin-2,up-regulating the expression of Claudin-5,inducing inflammation of intestinal mucosa,and promoting the healing of intestinal mucosal mechanical barrier. |
PDF Full Text Request