Slow Collapse Better Inhibition Of Atypical Hyperplasia And Reverse Ulcerative Colitis Clinical And Experimental Research

Ulcerative colitis is non-specific inflammation which occurs at the mucosa or submucosa. Its clinical manifestations are abdominal pain, diarrhea, blood and pus stool as the main features. The course of UC is long. It is difficult to cure, so it is considered as one of the diseases which is difficult to treat. With the progress of the inflammation, the risk of UC cancerous cumulative rate is increasing. Someone counted the risk of cancer cumulative which was2%,8%,18%in10years,20years and30years. The disease incidence is5%per person and4%per year. The mortality rate of the ulcerative colitis is15%in the overall patients. Therefore there is important clinical value in preventing, inhibiting, reversing the UC carcinogenesis. Now we use mesalazine to prevent cancer, but the side effects of drugs are great.Ulcerative colitis is called diarrhea, dysentery in Chinese medicine. The pathogenesis of UC is long and over and over again. There are many methods in treating UC and UC to cancer, such as acupuncture, the plug of chinese medicine.There is much advantage in treating UC with Chinese medicine, small side-effect,cheapness and effectiveness. There is broad prospects for the development of Chinese medicine in treating UCCRC.Enema has its unique advantages to patients.It can work directly to disease location, and50-70%of the drug can eliminate the first-pass effect. It can fully take advantage of drug efficacy. The rectal has good function of absorption, so mang drugs can be absorbed again. Enema can play important role in absorption. This topic was through research about literature firstly, then clinical observation, experimental studies finally. We studied the mechanism and clinical efficacy of the Chinese medicine by clinical and experimental research.It provided new idea in preventing and reversing UCCRC in Chinese medicine.ObjectiveExperimental rearch:Experimental studies:We made use of randomized controlled study to determine the the mice model of the dysplasia and the time of forming dysplasia. Then on this basis of the experimental One, we observed the Chinese medicine Mankuining granule preventing the dysplasia of the UC in mice though AOM/DSS. We also studied the expression of the p53and COX-2in6groups of the colonic mucosa.Clinical rearch; Observed the Mankuining enema to the dysplasia of UC patients in the clinical research and safety, It can provide the clinical basis in Traditional Chinese Medicine inhibiting and reversing ulcerative colitis carcinogenesis. MethodExperimental research:Experiment One:The method of the mice model:All mice were divided into four groups: the normal group, the AOM group, the DSS group and the AOM+DSS group. Each group has15mice. The A/D group and AOM group were given the AOM solution with dose of AOM1mg/ml by intraperitoneal injection.Each mouse was given0.2ml. After one week, AOM/DSS group and DSS group were given3%DSS in2weeks. AOM group and the normal group were given to the distilled water and so for a loop.Then maintaining3cycles. Then observe the general situation, the morphology score, the histologic injury and Pathomorphological changes.Experiment Two:6-week-old Balb/c mice were randomly divided into six groups, including the normal group, the blank model group, the Chinese medicine of low-dose group, the middle group,the high dose group and the mesalazine group. The mice model was given AOM/DSS solution,at the same time the mice were given the drugs.The normal group and the blank model group were given the saline in6weeks. Then observe the general situation, the DAI scores, the gross morphology scores. the histologic injury scores and pathomorphological changes. Then observe the expression of the p53and COX-2in6groups of the colonic mucosa in Immunohis tochemistry.Clinical research:We used a randomized controlled clinical trial methods. The40patients were divided into two groups, the treatment group and the control group. Each group has20patients. The treatment group was given the Chinese medicine and the Mankuining enema. The Mankuining enema was given50ml once before sleep. The control group was daily given mesalamine enema. Observe the TCM syndrome score after treatment, the endoscopy comparison, the comparison of total effect and the ESR, CRP comparison before and after treatment and the expression of the NF-Kb and COX-2colonic mucosa in Immunohistochemistry.ResultsExperimental research results:Experimental One:The colonic mucosa of AOM and the normal group is normal.The DSS group was not seen dysplasia in the colonic mucosa after6weeks and a little after9weeks.The group AOM/DSS could be seen much low-grade-dysplasia in the mucosa after6weeks and high-grade-dysplasia after9weeks,some were even seen adenoma and cancer.Experiment Two:After the mice model, the mice were diarrhea, pus and blood stool, hi get together and poor appetite. But after3weeks the situation would be improved after given the medicine. Chinese herbal medicine was no significant difference between with the middle and high-dose group and the western medicine group, Western medicine group and middle dose group is better than the low-dose group. The pathological results show that the inflammation did not progress to dysplasia with the prevention of the medicine. Immunohistochemical results:The expression of p53and COX-2is the most in the model group and with little or no expression in the normal group. The expression of the drug group was significantly little compared with the model group. Mesalazine group and Chinese medicine in the middle and high-dose group expressed less than those in Chinese medicine low-dose group. There was no significant difference among mesalazine group and Chinese medicine in the middle and high-dose group.Cl inical Observation Results:After treatment, the two group in the colonic mucosa lesions were not statistically significant difference by Ridit analysis, u=-2.326, P=0.057>0.05. Symptom scores were significantly improved in the two groups after treatment, but comparing the two groups there was no significant difference (P>0.05). The total effect of the two groups was compared by χ2test, still no statistically significant difference. There was significant difference before and after treatment in ESR, CRP,but no significant difference between the two groups. Both groups had incidence of adverse reactions,and there was no significant difference between the two groupss (χ2=0.54, P>0.05).Conclusion:Experimental studies:By the dug AOM and DSS combination, the model of dysplasia could short the time to six weeks, two-cycle. The Chinese medicine had the same effective with mesalazine to prevent and suppress UC to dysplasia and inhibit p53and COX-2expression in the colon.In the cilinal research the Mankuining enema can significantly in suppressing UC to dysplasia.