| ObjectiveUlcerative colitis is a chronic inflammatory bowel disease of mucosa and submucosa inflammation in large intestine. We studied TCM on Treating Ulcerative colitis in remission to prevent exacerbations and complication sutilizing evidence-based practice guidelines and patient empowerment strategies; and evaluates clinical, humanistic, and economic outcomes on an on-going basis with the goal of improving overall health. At the same time, UC four stages as the experimental group, healthy people as control group, to explore biomarker for the UC.MethodWe had done a large sample and multicenter clinical research of ulcerative colitis in the remission to make scientific evaluation of the recent and forward curative effect, relapse prevention and security of ulcerative colitis.60 UC patients were recruited for our case-control study.Reference to western medicine diagnostic criteria for ulcerative colitis patients in remission is specification for the diagnosis and treatment of inflammatory bowel disease in our country consensus. After establishing Database, We have done statistical analysis and master descriptive and inferential analysis of the clinical characteristics.The experiment research:the object of study were from Guangdong hospital of TCM who were diagoned of ulcerative colitis, divided into four groups:remission UC group, mild activity UC group, moderate activity UC group, and severe activity UC group,8 cases of healthy controls. The determination of serum IL-33, ST2, peripheral blood CRP, ESR, and routine blood were tested for statistical analysis.Result1 TCM syndrome in UC remission were relatively complex. In the study the communist party was divided into eight types, including Wet aggregates pixu (spleen deficient) type, cold and heat cuza, Deficiency of qi and blood type, large intestine damp-heat, yang deficiencyof the spleen and kidney, stagnation of liver qi and spleen deficiency, Yinanaemia empty type and Thermal Kang Cheng lung were (1.8%).Main treatmentfor UC in remission was invigorating spleen and supplementing qi suppleme-nted by colon cleansing, dampness, promoting blood circulation to remove blood stasis, regulating liver-qi, regulation of lung phlegm, negative lead lag and so on.2 The clinical research:2.1 In the total score Symptoms of clinical curative effect, the treatment group had higher symptom score than the control group after treating 1-4 months (P<0.05), but compared with the control group, the treatment group had no statistical difference after treating 5-6 months(P>0.05). In abdominal pain,t he treatment group had statistical difference after treating 1 month (P<0.05); the control group is better than that of the treatment group. But the treatment group overall showed a trend of lower abdominal pain score, with statistical difference after treating 4-6 months(P<0.05), while the control group had higher abdominal pain score after treating 6 months with statistical difference(P<0.05).we could conclude the treatment group worked slowly in improving symptoms, with stable and lasting curative effect.2.2 The two groups had no statistical difference in CRP, ESR, WBC(P>0.05);we could conclude both had the curative effect for clinical inflammatory activity index.To improve anemia, the treatment group was better thanthat control group, and there was statistical difference (P<0.05);we could conclude the treatment group could better improve systemic symptomssuch as anemia.2.3 There was no statistical difference in this study in treatment group compared with control group in mucosa recovery of colonoscopy review, but the pathological results reminded the treatment group could better improve inflammatory conditions compared with control group, with statistical difference(P< 0.05);we could conclude the treatment group could better promote the healing of intestinal mucosa than the control group.2.4 3 cases recurred in the treatment group, with the recurrence rate of 10%;The control group with 5 cases and 16.7%, and there was no statistically significant difference(P>0.05).1 case was admited in the treatment group, admission rate of 3.33%;The control group was hospitalized in 2 cases, admission rate of 6.67%, there was no statistically significant difference (P>0.05);we could conclude the treatment group could better maintain remision and preven trecurrence compared with control group.2.5 SF-36 scale of this research results indicate that the treatment group improve in general health (GH), the functions of emotion (RE),mental health (MH) eight dimensions with statistically difference (P<0.05), comparing the control group, only in the physiological function (PF) and general health (GH) (P<0.05). SAS and SDS had no statistical difference(P>0.05) in treatment group before and after treatment comparison,;SAS and SDSscore were higher after treatment in the control group with statistically difference(P< 0.05). Treatment group and control group before UC inpatients with depression and anxiety score were higher than norm level in China. We could infer that there was a high incidence of depression, anxiety, UC patients in treatment group than the control group better improved in modern and mental health, and thus improve the quality of survival.2.6 The control group had a total of 7 cases of adverse reactions during the follow-up period, abnormal liver meritorious service in 5 cases, abnormal renal function in 1 case, anemia occurred in 2 cases;the incidence of adverse reactions was 20% in the control group and the incidence of in treatment group.It Hinted of traditional Chinese medicine of treatment group had less side effects.2.7 Two groups had statistical difference in daily expenses (P<0.05), the average daily cost in treatment group was obviously lower than the control group.It hinted Chinese medicine treatment of chronic disease management in maintaining UC remission can reduce medical costs.3 significance of IL-33/ST2 on UCST2 values as follows:severe UC group>moderate UC group>mild UC group>UC remission group, the difference was statistically significant;Compared with the remission, severe UC group and moderate group difference were significant (P< 0.05),mild UC group had no statistical significance(P>0.05).Compared with the remission, the expression level of IL-33 in severe UC group, moderate group and mild group differences were significant (P<0.05) by analysis of variance;severe UC group was higher than the moderate group and mild group, through the analysis of variance, the difference was significant.CRP values as follows:severe UC group>moderate UC group>mild UC group> UC remission group, each group differences,by analysis of variance, was statistically significant (P<0.05);Compared with healthy controls, the severe UC group and moderate group difference was statistically significant (P< 0.05),mild UC group and remission group has no statistical significance (P>0.05).ESR value as follows:severe UC group> moderate UC group> mild UC group>UC remission group) healthy control group, each group differences by analysis of variance was statistically significant(P< 0.05);Compared with healthy controls, the severe UC group and moderate group difference were statistically significant(P<0.05), mild UC group and remission group had no statistical significance(P>0.05).The WBC values as follows:severe UC group> moderate UC group> mild UC group>UC remission group, each group differences by analysis of variance was statistically significant (P<0.05); Compared with healthy controls, the severe UC group and moderate group difference were statistically significant(P< 0.05),mild UC group and remission group had no significance(P>0.05).Platelet in UC group was significantly higher than healthy controls, and the activity UC is higher than the remission;we prompt active UC platelet activation may cause high blood coagulation state and the formation of blood clots. ConclusionTraditional Chinese medicine to maintain UC in remission had satisfactory curative effect;compared with the control group, the treatment group had the same recurrence rate and less side effects, improve symptoms with lasting stability, improve anemia and other systemic symptom, improve the quality of the intestinal mucosa healing, reduce medical costs, improve the quality of life and mental health.we could conclude Traditional Chinese medicine to maintain UC in remission had certain advantages and development potential, with the advantages of cheap, efficient, safety, and worthy of further research.This study found that IL-33/ST2 system may be different in the pathogenesis of UC and play a role in the course of the disease, which can predict the extent of inflammatory activity in UC, so it can be used as a new biological indicator for UC slow disease management in the future. |
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