Evaluation Of Curative Effect Of Prescription Of Traditional Chinese Medicine Sequential Therapy In The Treatment Of Ulcerative Colitis And The Mechanism Of D-limonene

Objective The aim of this study is to observe the clinical effect of QingGanJiangPi and PingTiaoGanPi method sequential treating ulcerative colitis.To observe the potential antioxidant and anti-inflammatory properties of D-limonene in colonic tissue of rats,and to explore the possible action mechanism through animal experiment.Methods Clinical part:70 cases of traditional Chinese medicine syndrome for damp pathogen obstruction the spleen,Fire Derived from Stagnation of Liver-QI Type of the mild to moderate ulcerative colitis patients were randomly divided.into two groups,of which the traditional Chinese medicine treatment group(35 cases)and Measalazine control Group(35 cases),the traditional Chinese medicine treatment group of patients in the active stage with traditional Chinese medicine Qinggan Jianpi Decoction oral treatment,the symptoms were relieved to continue to maintain treatment for 1 week,and then switch to Pingtiao Ganpi Prescription;The control group of patients in the active stage with Measalazine tablets 4g/d,the disease was relieved to continue to maintain treatment for 1 week,and then changed to a small dose of Measalazine tablets 2g/d consolidation treatment,the total course of 24 weeks,To observe the clinical efficacy of patients,the clinical complete remission rate,the main symptoms of the points to improve the situation,the rate of disappearance of symptoms,TCM syndrome,colonic mucosal improvement,C-reactive protein content,remission rate,drug safety and so on.Experimental part:The SD rats were randomized divided into 4 groups as follows:normal control group,model control group,high-dose treatment group and low-dose treatment group.Make rat models of ulcerative colitis with TNBS and detect the expression of TNF-??IL-10?IL-6?NF-?B?SOD?GSH and PGE2 in the rat's serum by the method of ELISA,the expression of MMP-2?MAP-9?TGF-? in the rat's colon tissue by the method of RT-PCR,the expression of iNOS?COX-2?p-ERK1/2 in the rat's colon tissue by the method of Western blot.Results Clinical research:the clinical efficacy of TCM group was better than the Mesalazine group(P<0.05).In the three main symptoms of the UC,hematochezia,diarrhea and abdominal pain disappearancerate of TCM group(77.14%,62.86%,74.29%)were better than the Mesalazine group(40.00%,28.57%,40.00%)(P<0.05).Colonoscopy efficacy of TCM group was better than the Mesalaxine group(P<0.05).According to the changes of C-reactive protein levels,we had confirmed the effieacy of TCM group was better than theMesalazine group(P<0.05).Experimental results:In UC rats,disease activity and colonic mucosa damage were significantly reduced by the anti-inflammatory effects of D-limonene,via suppression of matrix metalloproteinase(MMP)-2 and-9 gene expression(P<0.05).In addition,treatment with D-limonene significantly increased antioxidant,inducible nitric oxide synthase(iNOS)and cyclooxygenase-2(COX-2)protein expression levels in UC rats.A decrease in prostaglandin E2(PGE2)production,transforming growth factor-?(TGF-?)gene expression and an increase phosphorylated-extracellular signal regulated kinase(ERK)1/2 expression levelswere observed in UC rats treated with D-limonene(P<0.05).Conclusion The curative effect of QingGanJiangPi and PingTiaoGanPi method Sequential treating ulcerative colitis patients is better than that of 5-ASA,especially in improving TCM syndrome and intestinal mucous membrane.According to the experimental study,we conjecture that D-limonene reduced MMP-2 and-9 mRNA expression levels via regulation of the iNOS,COX-2,PGE2,TGF-? and ERX1/2 signaling pathways in a UC rat model,indicating its potential antioxidant and anti?inflammatory properties.