Liver And Spleen Particle Treatment Of Ulcerative Colitis (stagnation And Spleen Deficiency), Experimental And Clinical Studies

1. ObjectiveUlcerative colitis (UC) is a nonspecific inflammatory disease of rectum and colon, chronic recurrent type is most commonplace. Pathogenesis of the disease is not very clear. Environment, microorganism, heredity and immune factors may have relationship with it, among all of above, immune factors have been seriously concerned. Modern therapy strategy has been changed into inductive and maintenance care based on evidencebased medicine, but the side effects of western medicine restrict its clinical using, there are no positive appraisal for some brand-new treatment and medicine. Traditional Chinese Medicine shows its superiority in improving quality of life, lowering recurrence rate, but there are still many problems need to be resolved, lacking in the evidencebased medicine.My tutor Professor Zhang Yansheng considers UC active phase of chronic recurrent type has specific characteristic syndrome type of TCM, that is: deficiency of spleen yang, retention of damp-heat and blood are common. Thus, I selected UC active phase of chronic recurrent type as the research objective, observing its treatment effects and inquiring its pathology mechanism.2. MethodsThe UC of liver stagnation and spleen deficiency rats model was induced by TNBS and ties, and divided 6 groups: normal group; model group; SASP treatment group; 3 variant SGJP treatment group included large dose group, medium and little dose group. The study was strictly designed under the guidance of"Guide line for New Drugs Clinical Trials"Guidelines for Treatment of Chronic Unspecific Ulcerative Colitis with Chinese Materia Medica. In combination with actual clinical situation, adopting random positive control method, on the basis of diagnosis criterion established on Inflammatory Bowel Disease Seminar at Chengdu in 2000, 46 cases of chronic recurrent type in UC active phase was selected from out-patient clinic (OPD) and wards of Dongfang Hospital. Therapeutic effect includes clinical general effect, change of TCM syndrome, change of emotional handicap ,change of main clinical symptom (diarrhea, hematochezia, abdominal pain).3. ResultsDAI of SGJP is lower than that of SASP. There is statistic significant difference, implying that SGJP can reduce clinical symptom and that its effect is better than SASP. CMDI of SGJP is lower than that of SASP. There is statistic significant difference.IL-10 of each group is reduced and IL-1βof each group is increased. The effect of SGJP is better than that of SASP. Therefore, SGJP can efficiently control UC of liver stagnation and spleen deficiency rats.VIP of UC of liver stagnation and spleen deficiency rats is increased. SGJP can obviously improve the VIP of UC of liver stagnation and spleen deficiency rats. Clinical general therapeutic effect of treated group is better than control group ( P<0.05); total effective percentage of two group (95.65% vs 69.57% ), there is no statistic significant difference.Therapeutic effect of TCM syndrome treated group is superior to control group ( P<0.01), full recovery or significant effect percentage of TCM syndrome was obviously better than control group.The change of main clinical symptom (diarrhea, hematochezia) had significant difference between the tow group, and the therapeutic effect of SGJP group is better.The change of abdominal pain of both group had no significant difference, but considering the numeric figure, the control group was potentially higher than treated group. Before treatment, PLT of each group has no obvious difference (P>0.05). After treatment, PLT of each group has lowered, there is still no statistical diference in PLT between SASP group and SGJP group ( P>0.05 ).Before treatment, HAMA and HAMD of each group have no obvious difference (P>0.05). After treatment, HAMA and HAMD have lowered. The descending value of HAMD has statistical diference between SASP group and SGJP group (P<0.05).4. ConclusionThe SGJP made from Chinese herbs which have the effects of dispersing stagnated liver qi for strengthening spleen and activating blood, can increase the IL-10 and reduce the IL-1β, VIP level of local colon tissue. Compared with western medicine, the therapeutic effect is better, espcially in the Depressive disorder and TCM syndrome, and it had no obvious ill-effect.