| Objective:This study is divided into two parts: clinical study and experimental study.The part of clinical study for the use of Changyu Guangchang recipe(CYGCR)in the treatment of damp heat left ulcerative colitis,and to evaluate the clinical curative effect of retention enema with medication safety and economy.The experimental study was designed to observe the effect of Changyu Guangchang recipe on TNF-,TGF 1 and the protein of DOR,β-arrestin1,Bcl-2 in the intestinal wall of ulcerative colitis rats,revealing the possible mechanism of the treatment of ulcerative colitis by Changyu Guangchang recipe.Methods:Clinical part: 60 patients who were diagnosed with left ulcerative colitis in mild to moderate active stage,and TCM syndrome type is endoretention of damp heat type were divided into experimental group(Changyu Guangchang recipe group)and control group(Mesalamine group).The patients in the experimental group were treated with Changyu Guangchang recipe,the control group was treated with Mesalamine western medicine,the total course of treatment was 8 weeks.To observe the disappearance rate of clinical primary and secondary symptoms,clinical remission rate,TCM clinical syndrome effect,comprehensive efficacy,physical and chemical indicators,colonoscopy mucosal healing rate,analyzing changes before and after treatment and monitor the safety of medication and calculate the economics of the drug.Experimental part: A total of 60 adult male SD rats were randomly divided into normal group,model group,experimental group and control group(n = 4)in each group(n =15).The rat model of ulcerative colitis was induced by TNBS / ethanol.After 2 weeks of treatment,rats were sacrificed and colon specimens,the levels of TNF-α and TGF-β1 in colonic mucosa were measured by Elisa method.The expression of DOR,β-arrestin1 and Bcl-2 protein in colon samples were detected by Western Bloting.Results:Clinical part: The scores of the two groups of TCM symptoms,total score and remission rate were significantly lower than those before treatment(P<0.05),and the efficacy of the experimental group was significantly better than the control group(P<0.05),the trial group was superior to the western medicine control group in improving diarrhea,pus and blood,abdominal pain,bloating,and anal burning.There was no significant difference between the two groups in the comprehensive curative effect and the efficacy of TCM syndrome(P>0.05).In the comparison of mucosal healing,Guangchang recipe group and western medicine group can significantly improve the healing of intestinal mucosa(P<0.05).Two groups of ESR,CRP comparison: the two groups after treatment and before treatment compared to the value,there were significant differences(P<0.05).Experimental part: After 2 weeks of treatment,the tracheal traits of the rats became normal,the mental state became better,the activity increased,and other basic conditions were significantly improved and returned to normal,but there was no significant difference between the experimental group and the treatment group.Compared with the normal group,the DAI scores of the rats in the model group,the changyu Guangchang recipe group and the Mesalamine group were significantly different(P<0.05),compared with the model group,the DAI score of the changyu Guangchang recipe group and the Mesalamine group was significantly better than that of the model group(P<0.05).Compared with the normal group,the levels of TNF-α and TGF-β 1 in colonic mucosa of rats were significantly higher than those in the control group(P<0.01),compared with the model group,the levels of TNF-α in the intestinal enema group and the American salad group were significantly decreased(P<0.01,P<0.05).There were significant differences in the expression of DOR,-arrestin1 and Bcl-2 protein in thecolon tissue of rats in each group(P<0.05),compared with the normal group,the expression of DOR,β-arrestin1 and Bcl-2 protein in the colonic mucosa of the model group was significantly higher(P<0.01),compared with the model group,the expression of DOR,β-arrestin1 and Bcl-2 protein in the colonic mucosa of the rats were significantly lower than those in the changyu Guangchang recipe group and the Mesalamine group(P<0.01,P<0.05).Conclusion:1.The effect of changyu Guangchang recipe on patients with active ulcerative colitis is significant,and it is superior to that of Mesalamine in the part of clinical symptoms,improvement of TCM symptom score,reduction of disease activity and disease remission rate,at the same time drug safety and economy are still good,it is worth further study and promotion in clinical.2.changyu Guangchang recipe can improve diarrhea in rats,mucus pus and blood and other general living conditions,can promote the healing of intestinal mucosal healing.3.changyu Guangchang recipe treatment of UC significant effect,can improve the associated inflammatory factors TNF-α,TGF-β 1 imbalance,to restore to balance,thereby reducing the release of inflammatory mediators,is conducive to tissue damage repair.The mechanism of action may be through the activation of DOR-β-arrestin1-Bcl-2 signal transduction pathway in the activation of CD4 + T cells in intestinal mucosa to promote the repair of intestinal mucosal barrier,Immune homeostasis,and ultimately play the purpose of treatment of ulcerative colitis. |
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