The Clinical Application And Mechanism Of Changning Decoction In The Treatment Of Active Ulcerative Colitis

Purpose:Summing up the clinical application of Professor Wang Chuijie's empirical prescription--Chang Ning decoction in the treatment of active ulcerative colitis,and to summarize professor Wang Chuijie's clinical treatment experience of active ulcerative colitis,at the same time,study on the mechanism of supplemented or subtracted Changning decoction in the treatment of active ulcerative colitis.Material and method:1.Collecting 40 patients diagnosed with active ulcerative colitis treated by Professor Wang Chuijie in Guo Yi Tang clinic in the first clinical college of Liaoning University of Traditional Chinese Medicine from October 2015 to December 2017,collating and summarizing the common clinical symptoms,syndrome differentiation and traditional Chinese medicine treatment,etc.Summarizing and analyzing the etiology,pathogenesis and dialectical treatment of ulcerative colitis,combined with the theory of traditional Chinese medicine and the clinical experience of Professor Wang in the treatment of ulcerative colitis.2.48 SPF SD rats were selected with 200±20g,sex in half.Establishing the rat model of ulcerative colitis at active stage by TNBS-50%ethanol solution enema.The rats were randomly divided into four groups:blank control group,model control group,western medicine group?mesalazine group?,and Chinese medicine group?Changning Decoction group?,each group had 12 rats.Except the blank control group,The other three groups were treated with 10%chloral hydrate for abdominal anesthesia by 2ml/kg,and then injectes TNBS-50%ethanol solution enema 0.4ml in to the colon in one time.The Chinese medicine group received intragastric administration of the supplemented or subtracted Changning Decoction,the western medicine group was given gastric lavage by mesalazin,the blank control group and the model control group were given equal amount of normal saline for gastric perfusion after successful modeling.Observe the general situation of rats.Kill the rats and take material after 3 weeks gavage.Observe the pathological morphology of colonic tissue in rats,the changes of PAF in rat serum,and the changes of LXA₄ in the colonic tissue of rats.Results:1.Ulcerative colitis usually takes a long course and is prone to relapse.The clinical symptoms of purulent stools,bloody stools,diarrhea and abdominal pain was the most common.Syndrome of dampness-heat in large intestine is the most common syndrome differentiation.The clinical symptom score of the patients was significantly lower after taking the supplemented or subtracted Changning decoction than that before the treatment?P<0.05?.2.Compared with the model control group,the pathological damage of the colon tissue in the Chinese medicine group and the western medicine group was obviously improved,and the infiltration of inflammatory cells decreased.Compared with the model control group,the content of PAF in the serum of the Chinese medicine group and the western medicine group was significantly reduced?P<0.05?.Compared with the model control group,the content of LXA₄ in the colon tissue of the Chinese medicine group and the western medicine group increased significantly?P<0.05?.Conclusion:1.The pathogeny of UC is complex and diverse.The deficiency of healthy qi and the excess of pathogenic factor,as well as the spleen deficiency and the retention of pathogenic factor in the large intestine are all the pathogenesis of UC at active stage.Treatment should be based on the principle of tonifying the spleen and clearing pathogenic heat as the basic principle.The clinical application of Chang Ning decoction can have a significant effect on this disease.Herbs should be added and reduced on the basis of different syndrome types on the basis of Chang Ning decoction:patients with damp-heat in large intestine should be treated by Chang Ning decoction with herbs which can clear pathogenic heat and damp evil,the patients with spleen deficiency and damp evil should be treated by Chang Ning decoction with herbs which can tonify the spleen,the patients with liver qi stagnation and spleen deficiency should be treated by Chang Ning decoction with herbs which can relieve qi stagnancy in Liver.2.The supplemented or subtracted Changning decoction can effectively reduce inflammatory cell infiltration in the colonic mucosa of UC rats at active stage,can promote the repair and healing of colonic mucosa,so it is an effective prescription for the treatment of active UC.To decrease the expression of pro-inflammatory factor PAF in UC rats,may be one of the mechanisms of the supplemented or subtracted Changning decoction in the treatment of active UC.The supplemented or subtracted Changning decoction can improve the level of anti inflammatory factor LXA4 in the colonic mucosa of UC rats at active stage,that may be one of its mechanisms for the treatment of active UC.