| ObjectiveAccount of a great quantity clinical practice and protophase research outcome, We deeply investigate the influence on clinical synthesize curative effect, clinical prostecdtive efficacy, adverse effect by means of traditional Chinese medicine anti-ulcerative colitis recurrence prescription according to increasing pneuma, promoting blood flow and deintoxication. Through clinic and animal experiment, We approach the capillary vessel action mechanism of anti-ulcerative colitis recurrence from the spect of the blood disk activation, adhesion molecule, and the capillary vessel dynatron effect mechanism from the spect of intestinal tract energy metabolism and multidrug resistance.MethodsClinical therapeutic effectOn the basis of diagnosis criterion established on Inflammatory Bowel Disease Seminar at chengdu in 2000, 90 case of chronic recurrent type in UC active phase and chronic persistence type was selected, treated group received addition and decrease treatment of anti-ulcerative colitis recurrence prescription, control group received sulfasalazine (SASP)(4-6g/d). Both treatment course was 3 months, and attend 6 months, main observed index including clinical general effect, clinical prostecdtive efficacy and adverse reaction observation .Capillary vessel mechanism of contra-relapseThrough clinic and animal experiment, We approach the mechanism of anti-ulcerative colitis recurrence by increasing pneuma, promoting blood flow and deintoxication. Main observation indicatrix in person and rat: P-selectin in blood plasm and colon architecture(P-selectin), plasma TetramethylpyrazineB2, 6-keto-prostaglandin F1α(TXB2, 6-Keto-PGF1α), peroxydase accrementition activation acceptor(PPAR-γ)in colon architecture, P-glucoprotein in colon architecture and ICAM-1mRNA in rat colon architecture.ResultsTherapeutic effect and recur condition1.Clinical synthetic efficacyAfter treating 3 months,Clinical therapeutic effect of treated group is better than control group (P<0.05); the total remission percentage of two group(67.44%vs42.86%), total effective percentage of two group(90.70%vs76.20%), the statistic analysis is difference, treated group is obviously better than control group.2. Clinical prostecdtive efficacyAfter 6 months follow-up visit, treated group is obviously better than that of control group in the relapse rate,syndrome penthemeron scores,endoscopic index,pathomorphology observation and endoscope grade (P<0.01). 3. Ill-effectThere was no obvious ill-effect on treated group, the treated group significantly lower than control group (P<0.05).Results of contra-relapse capillary vessel mechanism Clinical results of contra-relapse capillary vessel mechanism1.Blood plasm and colon organization P-selectin level of patients in UC active phase were remarkblely higher normal value (P<0.01).The level in relapse phase of UC patients were significantly higher than that of not relapse patients (P<0.01). After treatment and six months of treatment, The level of treated group were significantly lower than that of control group(P<0.05vsP<0.01).2.Plasma TXB2,6-Keto-PGF1α concentration and ratio of TXB2/6-Keto-PGF1αof patients in UC active phase were remarkblely higher than normal value (P<0.01). Plasma TXB2,6-Keto-PGF1αconcentration and ratio of TXB2/6-Keto-PGF1αin relapse phase of UC patients were significantly higher than that of not relapse patients(P<0.01vsP<0.05).After treatment and six months of treatment,Plasma TXB2,6-Keto-PGF1αconcentration and ratio of TXB2/6-Keto-PGF1αof treated group were significantly lower than that of control group(P<0.01vsP<0.05).3.Colon organization PPAR-γlevel of patients in UC active phase were remarkblely lower normal value (P<0.01).The level in relapse phase of UC patients were significantly lower than that of not relapse patients(P<0.05). After treatment, the level of treated group were significantly higher than that of control group(P<0.05). After six months of treatment,two groups havenot significantly difference(P>0.05).4.Colon organization P-gp level of patients in UC active phase were remarkblely higher normal value(P<0.01).The level in relapse phase of UC patients were significantly lower than that of not relapse patients(P<0.01). After treatment and six months of treatment, the level of treated group were significantly lower than that of control group(P<0.01).Empirical study results of contra-relapse capillary vessel mechanism1.On the aspect of improving the general state of health and body weight, two groups of the traditional Chinese medicine and western medicine are better control group.2.As the observation of the local colon mucosa, two groups have the effects of inhibiting the injury and improving the plerosis of mucosa tissues. The effect emphasized on the different aspect.3.Animal experiment results of amynology index①In treating 10 days, Blood plasm and colon organization P-selectin level of western medicine group were remarkblely lower than that of the traditional Chinese medicine group(P<0.05). In treating 30 days,two groups havenot significantly difference(P>0.05). In discontinuation 10 days, P-selectin level of the traditional Chinese medicine group were remarkblely lower than that of western medicine group(P<0.01vsP<0.05).②In treating 10 days, two groups havenot significantly difference(P>0.05). In treating 30 days,Plasma TXB2 content of western medicine group was remarkblely lower than that of the traditional Chinese medicine group(P<0.01). In discontinuation 10 days, two groups havenot significantly difference(P>0.05).In treating 10 days, Plasma 6-Keto-PGF1αcontent of two groups havenot significantly difference(P>0.05). In treating 30 days, two groups havenot significantly difference(P>0.05).In discontinuation 10 days, two groups havenot significantly difference(P>0.05). In treating 10 days, ratio of TXB2/6-Keto-PGF1α in two groups havenot significantly difference(P>0.05). In treating 30 days, ratio of western medicine group was remarkblely lower than that of the traditional Chinese medicine group(P<0.05). In discontinuation 10 days, ratio of the traditional Chinese medicine group was remarkblely lower than that of western medicine group(P<0.05).③In treating 10 days, Colon organization PPAR-γlevel of rats of two groups havenot significantly difference(P>0.05). In treating 30 days, the level of western medicine group was remarkblely higher than that of the traditional Chinese medicine group(P < 0.05). In discontinuation 10 days, two groups havenot significantly difference(P>0.05).④In treating 10 days, Colon organization ICAM-1mRNA level of rats of western medicine group was remarkblely lower than that of the traditional Chinese medicine group(P<0.05).In treating 30 days, two groups havenot significantly difference(P>0.05).In discontinuation 10 days, the level of rats of western medicine group was remarkblely higher than that of the traditional Chinese medicine group(P<0.01).⑤In treating 10 days, Colon organization P-gp level of rats of two groups havenot significantly difference(P>0.05). In treating 30 days, two groups havenot significantly difference(P>0.05).In discontinuation 10 days, the level of rats of western medicine group was remarkblely higher than that of the traditional Chinese medicine group(P<0.01).ConclusionsWe have got satisfied Clinical synthetic efficacy in treating UC by using the methods of increasing pneuma,promoting blood flow and disintoxication. And the therapeutic effect was obviously better than SASP in the traditional Chinese medicine syndrome penthemeron integration, the endoscopic index and patho-grade. Compared with western medicine, it had no obvious ill-effect.The following is the contra- relapse mechanism of Chinese medicine:1. Restraining the activation of platelet and endothelial cell, promoting the circulation of blood so as to promote the repair of injuried mucous membrane.2. Restraining the express of adhesion molecule so as to decrease the sticky adnexal of blood corpuscle and endothelial cell.3. Rivalring the express of P-gp so as to elevate therapeutic efficacy and degrade relapse rate.
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