The Clinical Evaluation Of Curcumin Combined With Mesalazine In The Treatment Of Mild To Moderate Ulcerative Colitis

BackgroundUlcerative colitis(UC.)is a chronic recurrent inflammatory bowel disease of unknown etiology.With the development of economy,the incidence of ulcerative colitis has been increasing in recent years.Currently,the low remission rate and potential side effects of traditional drugs associated with ulcerative colitis limit their use in patients,underlining the need to seek new therapeutic agents or combinations Curcumin has shown powerful anti-inflammatory properties in animal models of colitis.Th.rough literature search,it was found that there were clinical studies on curcunin combined with mesalazine in the treatment of mild and moderate ulcerative colitis in Iran and India in the Asian region,but there were differences in the evaluation of the efficacv of curcumin.In addition,there were differences in the meta-analysis results of curcumin combined with mesalazine in the treatment of mild to moderate ulcerative colitis.In view of the current controversv over the efficacy evaluation of curcumin combined with mesalazine in the treatment of mild to moderate ulcerative colitis.In this study.we first collected the relevant literatures of curcumin combined with mesalazine in the treatment of mild to moderate ulcerative colitis at home and abroad.and conducted a meta-analysis to summarize and comprehensively and systematically evaluate the effectiveness of curcumin combined with mesalazine in the treatment of mild to moderate ulcerative colitis.In addition,a clinical study was designed to observe the efficacy and safety of curcumin combined with mesalazine in the treatment of mild to moderate ulcerative colitis.Therefore,this study is divided into two partsPart ? Systematic Review and Meta Analysis of curcumin combined with mesalazine in the treatment of mild to moderate Ulcerative ColitisObjectThe randomized controlled clinical trial of curcumin combined with mesalazine in the treatment of mild and moderate ulcerative colitis was collected for systematic evaluation and meta analysis through database search,to explore the efficacy of curcumin combined with mesalazine in the treatment of mild and moderate ulcerative colitis.Materials and MethodsAll randomized controlled trials of curcumin combined with mesalazine for the treatment of ulcerative colitis were collected by searching CNKI,VIP and WANGFANGDATA,NSTL,Pubmed,Embase and Cochrane/Central databases.After the quality evaluation and heterogeneity test of the included literatures were conducted according to the inclusion and exclusion criteria,the Meta analysis of the extracted data was conducted with Revman 5.3 software and the results were discussed.ResultA total of 261 patients were enrolled in 5 RCTs.In the analysis of the actual compliance group,the combination of curcumin and mesalazine increased the clinical response rate(OR=9.30,95%CI:3.44-25.16,12=16%,P<0.0001),the rate of DAI improvement increased(OR=9.00.95%CI:3.64-22.26,I2=0%,P<0.00001),and the mucosal healing rate increased(OR=10.97,95%CI:2.89-41.58.I2=0%,P=0.0004).In the analysis of the intended treatment group,the clinical remission rate increased in the curcumin group(OR=4.78,95%CI:1.24-18.47.I2=52%,P=0.02),the DAI improvement rate increased(OR=4.61,95%CI:2.22-9.57,I2=28%,P<0,0001).and the mucosal healing rate increased(OR=4.58,95%CI:1.79-11.73,12=49%.P=0.0004).ConclusionCurcumin combined with mesalazine is more effective than mesalazine alone in the treatment of mild to moderate ulcerative colitisPart ? The clinical observation of curcumin combined with mesalazine in the treatment of mild to moderate ulcerative colitisObjectTo observe the efficacy and safety of curcumin combined with mesalazine in the treatment of mild to moderate ulcerative colitis.MethodOutpatients and inpatients diagnosed as mild to moderate ulcerative colitis were randomly included.The control group was treated with mesalazine enteric-coated tablets,and the experimental group was treated with curcumin preparation(the soft capsule of Jiangzhitongluo(The main ingredient is curcumin))on the basis of the control group.After 4 weeks of treatment,the decrease of disease activity index and endoscopic remission were evaluated.The changes of laboratory indexes such as leukocyte count,hemoglobin content,platelet count,erythrocyte sedimentation rate,serum albumin content and C-reactive protein content were observed.SPSS software was used for statistical analysis.Result1.Evaluation of curative effect in two groupsThe difference of Mayo score before and after treatment in the experimental group was 2.96±1.02,while that in the control group was 1.74±1.10 before and after treatment.The Mayo score of the experimental group was significantly lower than that of the control group,and the difference between the two groups was statistically significant(P<0.001).The clinical response rate of the experimental group(95.65%)was higher than that of the control group(78.26%),and the difference between the two groups was statistically significant(P<0.002).2.Endoscopic evaluation was performed in both groupsThe endoscopic response rate of the experimental group(95.7%)was higher than that of the control group(73.9%),with no statistical difference(P=0.101).The endoscopic healing rate of the experimental group(91.3%)was higher than that of the control group(56.5%),and the difference between the two groups was statistically significant(P=0.019).3.Comparison of laboratory parameters between the two groups after treatmentCompared with the control group,the content of hemoglobin and albumin in the experimental group increased more significantly,Vwhile the white blood cell count,platelet count,esr value and c-reactive protein content decreased more significantly.There were statistically significant differences between the two groups(P<0.05).4.Safety assessmentThere were 2(8.7%)cases of adverse reactions in the experimental group and 4(13.0%)cases in the control group.The above discomfort was relieved after the corresponding simple treatment in time,and did not interfere with the study.There was no significant difference between the two groups(P>0.05).ConclusionCurcumin combined with mesalazine in the treatment of mild and moderate ulcerative colitis can produce better clinical efficacy without increasing the occurrence of toxic side effects,and this treatment scheme is safe and effective.