Adhesion Of Bifidobacteria And Related Inflammatory Factors In Ulcerative Colitis With Pingkui Enema

Objective:This study is designed to investigate the effect and mechanism of Pingkui enema in treatment of ulcerative colitis,by observing the efficacy of Pingkui enema in the treatment of patients with ulcerative colitis and to investigate the effect of Pingkui enema on the adhesion of intestinal bifidobacteria and related serum inflammatory factors in rats with ulcerative colitis.Methods:Clinical part:20 patients with ulcerative colitis admitted to the Department of Gas-troenterology,Suzhou Hospital of Traditional Chinese Medicine from April 2017 to November 2018 were selected as subjects.20 patients were treated with enema and mesalazine with 3 weeks of treatment.The TCM symptom score,erythrocyte sedimentation rate(ESR)and C-reactive protein level(CRP),serum inflammatory factor interleukin IL-8 and IL-13 were ob-served before and after treatment.Experimental part:60 SD rats at SPF level were used to prepare ulcerative colitis model rats by treating them with trinitrobenzene sulfonic acid(TNBS).The rats were randomly divided into 6 groups which were normal group,model group,and the low,medium and high dose groups of Chinese medicine Pingkui enema,and sulfasalazine(SASP)enema group.The normal group and model group were given an equal volume of saline enema after modeling.After continuous administration for 10 days,the histopathological effects were evaluated after exfraction;serum interleukin-8(IL-8),interleukin-13(IL-13),tumor necro-sis factor(TNF-a),rat intestinal mucosal bifidobacteria adhesion and adhesin receptor were measured by enzyme-linked immunosorbent assay(ELISA);real-time fluorescence quantitative PCR(RT-PCR)detection of intestinal bifidobacterial content.Results:The results of clinical research showed that the scores of TCM symptoms decreased significantly after treatment,and the total effective rate of TCM symptoms reached 80%.Com-pared with the treatment before,ESR and CRP decreased(P<0.05),serum IL-8 decreased,IL-13 increased(P<0.01).The patient did not develop an adverse reaction during the treatment.The results of experimental research showed that the mortality rate in the model group was higher than that in the normal group(P<0.05).The mortality rate in the high-dose group of Pingkui enema was lower than that in the sulfasalazine group(P<0.05);the HS score was low in the high-dose group of Pingkui enema than that in the sulfasalazine group(P<0.05),the levels of IL-8 and TNF-a were decreased and IL-13 was increased in the medium-dose and high-dose group and sulfasalazine group(P<0.05).Compared with sulfasalazine group,TNF-? was de-creased and IL-13 was increased in high dose group of Pingkui enema(P<0.05);There was a statistically significant difference between rats after treatment in each group and the model group in adhesin and adhesin receptors(P<0.05).The treatment effect of the high-dose group of Ping-kui enema was the most significant,and the difference was significant compared with the sul-fasalazine group(P<0.05);the intestinal mucosa of the model group rats bifidobacteria content decreased significantly compared with the normal group(P<0.01).The contents of bifidobacteria in the low-dose group,high-dose group,and sulfasalazine group had a tendency to increase compared with the model group,but the difference was not statistically significant(P>0.05).The bifidobacteria content in the middle-dose group was significant.There was a statistically signifi-cant difference between the model group and the model group(P<0.05).Conclusion:1.Pingkui enema can effectively improve the clinical symptoms of patients with mild to moderate ulcerative colitis,reduce the levels of CRP,ESR,relieve inflammation,and no obvious side effects.2.Pingkui enema may promote the bifidobacteria colonization in intestinal epithelial cells,increase bifidobacteria adhesin and adhesin receptor,up-regulate the expression of anti-inflammatory factor IL-13,down-regulate pro-inflammatory factor IL-8,TNF-? expres-sion,thereby reducing intestinal mucosal permeability and reducing intestinal mucosal barrier damage,regulating immune balance,and repairing intestinal mucosa.