Clinical And Experimental Study On The Treatment Of Ulcerative Colitis Associated Polyps With

Objective:Ulcerative colitis is a common and frequently occurring disease. During its developing process, there is often a variety of complications, and ulcerative colitis-associated polyp is one of the common ones. There is possibility that ulcerative colitis-associated polyp can develop to cancer if the course is long enough. So the treatment and intervention for ulcerative colitis-associated polyp is quite significant. It will help to suppress and delay the gradual process of UC-adenoma-carcinoma development, and reduce the incidence of colorectal cancer. There are cancer-related factors during the transformation of ulcerative colitis-associated polyp to cancer. In general, the greater the volume of the polyps, the higher the degree of dysplasia, the greater the proportion of adenomatous polyps, the heavier the mucosal injury, the higher COX-2and TNF-a content, then the incidence of ulcerative colitis-associated polyp developing to cancer is higher. Therefore, the use of various treatments to intervene on the above factors will help to reduce the rate of ulcerative colitis to colorectal cancer through the ulcerative colitis-associated polyp course.Methods:The research includes animal experiments and clinical observation to explore the effects of mesalazine combined with yukuixiaoxifang in treating ulcerative colitis-associated polyps.Experiment I:75BALB/c mice of6week old were randomly divided into five groups, control group, model group, the yukuixiaoxifang group, mesalazine group, and combination group (mesalazine and yukuixiaoxifang),15in each group. Azoxymethane (AOM) and dextran sulfate sodium (DSS) were used for making ulcerative colitis-associated polyp model in model group, the yukuixiaoxifang group, mesalazine group, and combination group, but not in control group. The yukuixiaoxifang group, mesalazine group, and combination group were given medicine from the first day that they began modeling, yukuixiaoxifang for yukuixiaoxifang group, mesalazine for mesalazine group, and combined use of yukuixiaoxifang and mesalazine for combination group. Control group and model group were given the same dose of normal saline. Each mouse was given medicine once daily, and last for nine weeks. All mice were sacrificed on the ninth weekend, rapid laparotomy, bowel taken from the anus to the ileocecal region. The colonic mucosa injury, the number of polyps, polyp size, polyp atypical hyperplasia and adenomas growth in each group were observed.Experiment II:Based on the already produced pathological section in experiment I, we use the way of immunohistochemistry to observe the impact of AOM/DSS modeling for COX-2and TNF-a levels in mice, and also observe and compare the therapeutic effects of mesalazine and yukuixiaoxifang in the aspect of COX-2and TNF-a levels. Clinical Study:40cases of ulcerative colitis-associated polyp patients were randomly divided into symptomatic treatment group, the yukuixiaoxifang group, mesalazine group and combination group,10cases in each group. Symptomatic treatment group was given general symptomatic treatment, the yukuixiaoxifang group was given yukuixiaoxifang on the basis of symptomatic treatment, mesalazine group was given oral mesalamine delayed-release particles on the basis of symptomatic treatment,1.5g/d, the combination group was given both yukuixiaoxifang and mesalazine on the basis of symptomatic treatment. Treatment time is two months. The number of polyps, polyp size, polyp atypical hyperplasia, and colonic mucosa injury score before and after treatment were observed and analyzed.Result:Both yukuixiaoxifang and mesalazine have a good therapeutic effect for ulcerative colitis-associated polyps. They can both reduce the number of polyps, the size of polyps, and reduce polyp atypical hyperplasia and mucosal damage, and can also reduce the content of COX-2and TNF-α in the body. Yukuixiaoxifang and mesalazine can generate interactive effects when using them together.The combined use of the two medicines can improve clinical effect in the treatment of ulcerative colitis-associated polyps, and can have a better effect for ulcerative colitis-associated polyp number, size, atypical hyperplasia, mucosal injury, and the content of COX-2and TNF-α than using each of yukuixiaoxifang or mesalazine alone.Conclusion:Yukuixiaoxifang and mesalazine can generate interactive effects when using them together in treating ulcerative colitis-associated polyps.The combined use of the two medicines can improve clinical effects, and reduce the rate of ulcerative colitis-associated polyps developing to cancer.