Active Ulcerative Colitis Tcm Syndromes And The Relationship With The Intestinal Mucosa As Research

1 The purpose of the researchObserved the syndromes of TCM for 137 Active Ulcerative Colitis, identified the mucosa microstructure under the colonoscopy, and analyse the relationship between them. Preliminary discusse the correlation of macro TCM syndrome differentiation and micro modern medicine for Ulcerative Colitis, provide objective basis of TCM syndrome differentiation.2 Research methodThis research is accordant with the rules of intergrated of traditional Chinese and western medicine treatment of UC, and design Syndrome Ulcerative Colitis Distribution of observed clinical data table of Chongqin Meeting in 2003. The objects are collected from 137 patients,who are at the stage of Active Ulcerative Colitis, diagnosed by the colonoscopy and pathological, we gathered in information of general information, medical history, symptoms, IBDQ score, colonoscopy information and TCM Syndrome, and analysis the relationship among them. Using SPSS 17.0 for statistical analysis, counting data with the Chi-square test, measurement data samples with multiple independent rank sum test(Kruskal-Wallis H test), test the level ofα= 0.05, two-sided test,P<0.05 statistically significance.3 Results3.1 Clinical characteristic①The disease often occurs in the young and middle aged people, the ration of female is lightly more than male, most of the disease course is lasting 1-5 years or even more, the improper diet and bad temper are more likely to aggravate or induce the disease.②The patients with Chronic recurrent type and Chronic continuous type are in the majority,and the patients with the initial onset is less; Lesions range are more likey at rectum and Straight B colon, and the majority of the the illness degree moderate and mild.③The data shows the typical clinical symptoms on the top 5 are:diarrhea, pus and blood stools, abdominal pain, limb fatigue, and bowel. The entire colon had the highest symptom score for defecation integral, systemic symptom score, symptom total score. The regional colon score is the highest for abdominal and chest symptom scores. There is positive relationship between the points and extent of disease symptoms (P<0.05). IBDQ total scores and symptoms scores are negative correlated (Pearson coefficient=-0.585);④Endoscopy index is the highest in the whole colon, the lowest (P<0.05) in rectum. Those with distal colon lesions most affected with classⅡand classⅢ. And regional involvement of the colon and the entire colon are more performance for the gradeⅢ,Ⅳlevel (P> 0.05); mucosal histological grade (using the Truelove-Richards) in the main classⅡandⅢ(P> 0.05).3.2 Analysis of SyndromesThe frequency of main syndrome:Damp-heat of large intestine>Deficiency of spleen and kidney Yang>Liver-depression and spleen-deficiency>Blood stasis of the intestine meridian>Deficiency of Blood and Yin; 76 cases are complex syndrome, the most symptoms are Damp-heat of Large Intestine and Blood stasis have accompanied symptoms.Analysis the relationship between TCM and Western Medicine, the intestine damp-heat syndrome (P>0.05) is the most often seen in this disease, liver spleen deficiency, spleen deficiency syndrome, deficiency syndrome temper the proportion is still higher (P>0.05)In the damp-heat of Large Intestinal, Bowel symptoms score is the highest.In Binding depression of liver Qi and Spleen deficiency syndrome, abdominal symptoms score is the highest.In the spleen Qi deficiency syndrome, the chest symptom score is the highest. In the deficiency of spleen and kidney yang, systemic symptom score is the highest. In the liver depression and spleen deficiency, symptoms score the highest. The IBDQ score of the large intestine damp is the lowest. (P<0.05)Between the relationship with TCM Syndromes and endoscopic integral,the highest score is Damp-heat of large intestine,however blood stasis of intestinal meridian is the lowest (P<0.05);and in the Roth grading, Damp-heat of large intestine and Deficiency of Spleen Qi are more primarily in gradeⅢ, Blood stasis of intestine meridian are more ofen occur in gradeⅡ,the number of gradeⅡand gradeⅢare equal in Deficiency of spleen and kidney Yang, liver-depression and spleen-deficiency, deficiency of Yin and Blood (P> 0.05); In the Truelove-Richards classification,the Damp-heat of large intestine and the Dificiency of Spleen and Kiddney Yang are mainly in gradeⅡ,most of the deficiency of Spleen Qi are mainly in gradeⅠ,the blood stasis of intestinal meridian are mainly in gradeⅡ,while the Yin and Blood Deficiency are equally in each grade.(P<0.05)3.3 The summary of the relationship between Syndromes and the colonoscopy manifestationDifferent syndromes and mucosal under the endoscopic are significant correlated. (P< 0.05)①Damp-heat of large intestine:mucosal color manifests red or dark red, diffuse hyperemia, edema is more serious and may have scattered or dense sheet ulcers, shallow folds, colon bags disappeared,vascular blurred or disappeared serious,contact bleeding, bleeding colors and more dark red than other color; more yellow pus from the mucous membrane covering the surface of moss, or intestinal stenosis, intestinal fibrosis,associated with abnormal bowel movements or bowel symptoms.②Deficiency of Spleen Qi:the color is more pink or pale in mucous membranes, may have local congestion, edema, with mild erosion, ulcer, a small amount of thin secretions (mucus), crisp, contact bleeding, bleeding color is generally lighter than red.③Deficiency of Spleen and Kidney Yang:mucosal lighter in color, with mostly pale, severe diffuse congestion and edema, folds shallow junction,intestinal bags lost, blood vessels more clearly out of shape, mild fuzzy disorder, scattered and bleeding ulcers ulcer compared gray color,a lot of secretions within the intestine,usually expressed as quality thin mucus or pus moss white, slightly fuzzy rough texture of vascular disorder,bleeding pink in color.④Liver-depression and Spleen-deficiency:dark red in color and mucous membranes, blood vessels darker texture, was dark purple, or vascular texture thickening, mucosal rough, grainy, crisp colonic bleeding, and bleeding dark red in color, abnormal bowel movements, obvious sign of irritation, discharge and more pus moss,yellow, white coating equal number.⑤Dbeficiency of Yin and Blood syndrome:dull red color of the mucous membrane of the rough texture of the mucosa,with grainy, blurred vessels, texture disappears, congestion, edema relatively light, scattered in a small amount of erosion,ulcer, ulcer clean off-color red, the surrounding non-flush, no lumen mucus, pus and other secretions moss attached.⑥Blood stasis of Large intestine meridian:the color of dark red mucosa,mucosal rough, granular, scattered in a small amount of erosion, ulcers, colon bags disappear,intestinal deformation, lead pipe-like performance, intestine stenosis or intestinal fibrosis,mucosal atrophy, can be attached a small amount of white discharge or mucus, or see polypoid bulge.