Clinical Stufy About The Effects Of Reyusan On The Ulcerative Colitis Of Damp-heat Type And The Serum TNF-ALPHA

Objective:A comparison of the efficacy and safety in treatment of Ulcerative colitis(damp-h eat syndrome) on Reyusan and Etiasa,investigation on the relations among intesti nal mucosal changes, histologic mucosal changes and Patients with syndrome of dampness-heat in large intestine.Besides,observe changes of TNF-alpha, CRP level s in serum of patients before and after treatment,study on interaction mechanism of Reyusan in treatment.Method:First,selection of 50 patients with active mild and moderate Ulcerative Colitis(Syndrome of dampness-heat in large intestine) who were diagnosed and treated in the first affiliated hospital outpatient and in-patient departments of Anhui University of traditional Chinese medicine form September 2012 to December 2014;next,these patients were randomly divided into treatment group(Reyusan only) and control group(Etiasa only),compared two groups of symptom effects and main symptoms scores,measure serum levels of TNF-alpha and CRP of pre-treatment and post-treatment.Result:⑴Active period of mild and moderate damp-heat syndrome Ulcerative colitis pati ents’ lesion site mainly distributed in rectal(26%) and distal colon(30%,30%),few distributed in extensive colon(14%);Electronic colonoscopic manifestations of col on mucosa index was 5.24±1.46,rough mucosa(24%),Significant congestion and edema(66%),Large intestine Ulcer,Extensive erosion, necrosis(86%),crisp and exten sive bleeding(70%),inflammatory polyps(12%);Mucosal Geboes index was 3.14±0.67,expression of inflammatory cells in intestinal mucosa increased(100%);Paneth cells increased,but goblet cells decreased(58%);Crypt abscesses(20%).⑵It was significant positive correlation among TNF-alpha, CRP levels and muco sal Geboes index before treatment(P<0.01), and TNF-alpha, CRP levels of mild p atients were significantly less than moderate patients, there was a statistically sig nificant(P<0.01).⑶Mayo index for both groups after treatment was lower than before treatment,an d it was a significant difference(P<0.05);treatment group and control group treat ment efficiency were 92%, 76%, there was a significant difference between the t reatment group and the control group(P<0.05);During the whole period of treatme nt and after treatment,both groups of patients with adverse reactions that are not apparent.⑷After treatment, the Mayo index, Rachmilewitz index,Geboes index for patients in each group were lower significantly than before treatment(P<0.01), and the treatment group declined more significantly.⑸After treatment, the serum concentrations of TNF-α,CRP in patients with acti ve period of mild and moderate damp-heat syndrome Ulcerative colitis were decr eased(P<0.01), the treatment group were declined more significant.Conclusions:⑴The mucosa changes and mucosal pathology features of 50 patients can provid e objective evidence for research on large intestinal damp-heat of Ulcerative colit is.⑵There was a positive correlation among TNF-alpha, CRP levels in serum andseverity of patients,Patients with more severe illness, higher serum levels of TN F-alpha, CRP levels.⑶Reyusan and Etiasa can inhibit the expression of TNF-α,CRP,controlling intesti nal mucosal inflammation and promoting healing of ulcers,ut Reyusan is superior to Etiasa.⑷Reyusan and Etiasa were effective and safe for the patients of active mild and moderate Ulcerative Colitis(damp-heat syndrome), but the former is more effect ive.