A System Ana Lysis For The Yiqi Jiedu Recipe On The Recurrence Rate Of UC And The Study Of Its Mechanism In Maintaining Autophagocytosis

Ulcerative colitis(UC)is one of the most refractory diseases all over the world because of its recidivity.UC is characterized by clinical symptoms as abdominal pain,diarrhea with mucous pus-bloody stool.The most conventional treatment for UC are aminosalicylates,such as Sulfasalazine and Mesalamine.Meanwhile,the treatments nowadays cannot provide patients complete healing.In Traditional Chinese medicine(TCM),UC is known as "Jiu-Li" and"Xiuxi-Li",which means long term and intermittent attack diarrhea with mucous pus-bloody stool.Yiqi jiedu treatments for UC can reduce toxicity and increase efficiency,they have advantage as few side effect.Using TCM for UC has a broad development prospects.ObjectiveThis study provides evidence for the recurrence rate of Yiai Jiedu recipe in treating UC by means of traditional review,systematic review and meta analysis,and researches the possible mechanism of Yiqi Jiedu recipe in maintaining autophagocytosis of intestinal epithelial cells(IECs).The purpose is beneficial for TCM to UC.MethodsSystematic review and meta analysis:By retrieving clinical randomized controlled trials about yiqi jiedu recipe for UC,according to the inclusion criteria and exclusion criteria,select literatures which use Yiqi Jiedu method or combining western medicine as the experimental group and use western medicine without Chiese treatment for the control group,and the recurrence rate must be reported in the literature.Extract the details for systematic review and meta analysis.Use Review Manager5.0 software to analyze its comprehensive effect rate and recurrence rate,and test publication bias.Use descriptive analysis for bias risk and safety evaluation.The purpose is to obtain objective evaluation for Yiqi Jiedu treatments to UC about the recurrent rate.Experiment part:At first,establish adherent-invasive E.coli(AIEC)invaded intestinal epithelial cells(IECs)in vitro by GIM1.539 infecting IECs(HCT116).Secondly,transfect miR130a mimics and inhibitors into the IECs,at the same time treated by Yiqi Jiedu serum made after gavage in rat.Compare ATG16L1 protein and gene expression,LC3 autophagy protein content and miR130a gene expression level in different means of treatments and transfection scheme.Combine with miRNAs/ATG control network,in order to search the possible mechanism of Yiqi Jiedu recipe in maintaining cell autophagocytosis of IECs.ResultsSystematic review and meta analysis results:Clinical randomized controlled trials were included in article 17 adopt parallel randomized controlled design.Research objects are the clinic or hospital medical records,participants included 1185 patients.All included in the documents indicate the diagnostic criteria of traditional Chinese medicine,western medicine and curative effect evaluation standard,abide by the principle of evidence-based medicine,basic research results are reliable.Reference literature Jadad quality criteria of 17 articles were included in the quality score,although 7 research literature for high quality,but mostly because there is no use randomized to hide or blind method,score is low,so that may affect the credibility of the results in the conclusion.About the comprehensive effect of total effective rate of Meta analysis,five studies into the combined effect of RR = 1.25,95%CI(1.15,1.37],Z=5.03,P<0.00001,the difference was statistically significant and significant difference,the prompt yiqi jiedu oral treatment of UC comprehensive clinical curative effect of total effective rate effect is significantly better than pure western medicine treatment;Merge into seven studies effect of RR = 1.19,95%CI(1.10,1.28],Z=4.46,P<0.00001,the difference was statistically significant and significant difference,prompt yiqi jiedu oral plus Chinese medicine enema against western medicine treatment the formulas for the comprehensive effect of total effective rate of UC effect is significantly better than pure western medicine treatment;Merge into three studies effect of RR = 1.32,950%CI(1.14,1.52],Z=3.79,P=3.79<0.01,the difference was statistically significant and significant difference,suggest combine traditional Chinese and western medicine therapy against western medicine treatment for UC comprehensive curative effect of total effective rate significantly better than pure western medicine treatment effect.Recurrence of Meta analysis into five research combined effect of RR = 0.21,95%CI(0.14,0.33],Z=6.93,P<0.00001,the difference was statistically significant,suggesting yiqi jiedu oral clinical intervention UC recurrence rate is better than pure western medicine treatment;7 study merged into the effect of RR = 0.27,95%CI(0.19,0.38],Z=7.18,P<0.00001,the difference was statistically significant,suggesting yiqi jiedu oral plus Chinese medicine enema clinical intervention recurrence rate is better than pure western medicine treatment of UC.About the comprehensive effect of total effective rate and recurrence rate of publication bias RR funnel are the distribution figure on both sides of the middle route of the basic,but there are different degrees of skewness distribution,prompt Meta analysis results may be affected by publication bias.Reports of security event group a total of 11 cases,control group a total of 19 cases;Reports of adverse reactions,patients in all 3 cases,control group a total of 42 cases,prompt yiqi jiedu therapy of traditional Chinese medicine than western medicine has the advantages of low adverse reactions.Experimental results:Yiqi Jiedu serum medicated interventions miR130a groups ATG16L1,LC3 protein content are the same as the group with no medicine serum intervention method increased,the difference was statistically significant(P<0.05);Medicated serum intervention mode between groups ATG16L1 gene expression increased no medicine serum group,the difference was statistically significant(P<0.05);Drug-containing serum intervention mode between groups miR130a gene expression is no medicine serum group decreased,the difference was statistically significant(P<0.05).According to the different transfection group,results show that no matter what kind of means of intervention,miR130a analog group compared with blank transfection group,miR130a ATG16L1,LC3 protein content in analog group were decreased significantly,the difference was statistically significant(P<0.05);MiR130a antisense analog group compared with blank transfection group,miR130a antisense analog ATG16L1,LC3 protein levels were significantly increased,the difference was statistically significant(P<0.05);Under two kinds of means of intervention,miR130a analog,respectively,compared with intervention in the same way blank transfection group,miR130a analog group miR130a gene expression,gene expression of ATG16L1 raised up and down,the difference was statistically significant(P<0.05);Under two kinds of means of intervention,miR130a antisense analog respectively compared with blank transfection group intervention in the same way,miR130a antisense analog group miR130a gene expression decreased obviously,ATG16L1 gene expression increased obviously,the difference was statistically significant(P<0.05).ConclusionYiqi jiedu recipe is good for UC in clinical comprehensive effect and control the recurrence rate,and it has advantages as few side effect.Yiqi Jiedu recipe may inhibit the expression of autophagy related miRNAs,and than improve expression of autophagy related gene to maintain IECs autophagocytosis.Yiqi Jiedu recipe may play a role to support IECs drving AIEC out,and cooperate with heat-and-toxin-clearing for the result of reducing the recurrence rate of UC.