| Objective:In clinical research,Pulsatilla Decoction was used to treat patients with damp-heat ulcerative colitis（rectal type）by means of randomized control,non-blind method and prospective study,and its clinical efficacy,economic applicability and safety were evaluated.The experimental research part is to treat ulcerative colitis rat model with Pulsatilla decoction,observe its repair of intestinal mucosa damage and its influence on the expression of plasma factors TXB2and 6-keto-PGF1α,and theoretically reveal its possible mechanism of action in improving coagulation abnormalities.Methods:Clinical part:The cases were selected from patients with ulcerative colitis in the second department of anorectal department of Anhui traditional Chinese medicine hospital from December 2018 to December 2019.they were divided into experimental group（Pulsatilla decoction group）and control group（mesalazine group）with 30 cases.Pulsatilla decoction group was treated with enema,mesalazine group was treated with anal canal therapy for 8 weeks.The clinical manifestations of the patients before and after treatment were observed,and the therapeutic effects were evaluated by endoscopic baron score,traditional Chinese medicine symptom score,clinical remission rate score and modified Mayo score.The medication safety and adverse reaction events were monitored before and after treatment.Experimental part:Sixty SD rats were randomly divided into normal group,model group,experimental group（Pulsatilla decoction group）and control group（mesalazine group）,with 15 rats in each group.After the model was established by TNBS-ethanol method,the research drug was used for intervention treatment for 2 weeks.Colon tissue specimens of rats were cut out and HE staining was used to evaluate the healing of rat mucosa.Blood was collected from abdominal aorta to extract rat plasma.After standing and centrifuging,the supernatant was collected and Elisa was used to detect the expression level of TXB2and 6-keto-PGF1αin rat plasma.Results:Clinical part:（1）After treatment,both Pulsatilla Decoction and mesalazine can improve the clinical symptoms of patients（P>0.05）.Pulsatilla Decoction group is better than mesalazine group in improving purulent blood stool and abdominal distension（P<0.05）.（2）Pulsatilla Decoction and mesalazine have the same effect in clinical comprehensive curative effect and traditional Chinese medicine symptom curative effect（P>0.05）;（3）Pulsatilla Decoction is more effective than mesalazine in controlling remission of UC patients from active phase to remission phase（P<0.05）.（4）In terms of endoscopic Baron score,it is suggested that Pulsatilla Decoction is as effective as mesalazine in improving endoscopic Baron score（P>0.05）.（5）blood coagulation indexes:after the treatment,the levels of PLT,MVP,PT,Fib and D-D in the two groups were better than before（P<0.05）,but there was no significant difference between the two groups after treatment（P>0.05）,suggesting that the two treatment methods have the same effect in improving blood coagulation abnormalities of UC patients in active phase.Experimental part:（1）General situation:After modeling,rats in the normal group eat less drinking water,their weight gradually decreases,there are loose stools and watery stools remaining in the anus,and macroscopic stools gradually appear in the later stage.After treatment with Pulsatilla decoction,the activity of rats is improved,the dietary water level is increased,and the stools gradually form from watery stools,but the stools are softer,the macroscopic stools gradually disa ppear,and their weight gradually rises.After treatment with mesalazine group,the Pulsatilla decoction group is similar;（2）DAI score:Compared with the normal group,the rats in the model group,Pulsatilla decoction group and mesalazine group all showed watery stools,naked blood stools and weight loss,and the difference in DAI score was statistically significant（P<0.05）,representing the success of experimental modeling.After treatment,the DAI scores of the Pulsatilla decoct ion group and mesalazine group increased gradually compared with the rats in the model group,and the differences in DAI scores were statistically significant（P<0.05）,indicating that Pulsatilla decoction and mesalazine can both improve the DAI scores of rats.Comparing the differences in DAI scores of Pulsatillad ecoction group and mesalazine group,the differences between the two groups were not significant after calculation（P>0.05）,indicating that they have the same effect in improving DAI scores.（3）colon histomorphology score:after the experiment,compared with the model group,the colon histomorphology score of rats in the mesalazine group and the pulsatilla decoction group was significantly decreased,with a statistically significant difference（P<0.05）,indicating that compared with the model group,the colonhistomorphology score of rats in the pulsat illa decoction group and the mesalazine group was improved,while the colon histomorphology score of rats in the pulsatilla decoction group and the mesalazine group was not significantly different（P>0.05）,indicating that the improvemen t degree of the two groups was equivalent.（4）comparison of TXB2and 6-keto-PGF1αin plasma:compared with normal group,TXB2in model group was sign ificantly increased（P<0.05）,while 6-keto-PGF1αwas significantly decreased（P<0.05）;Compared with the model group,TXB2levels in the pulsatilla decoction group and mesalazine group were significantly lower（P<0.05）,while 6-keto-PG F1αlevels were significantly higher（P<0.05）.Compared with mesalazine group,the expression of TXB2and 6-keto-PGF1αin pulsatilla decoction group had no significant difference（P>0.05）.Conclusion:Pulsatilla Decoction is effective in treating patients with clinical UC in active phase.Its safety and economy are worthy of affirmation.It can effectively reduce endoscopic Baron score,improve Moya score,improve clinical remission rate,relieve hypercoagulable state of blood,and promote intestinal mucosa healing.It is worthy of further research and promotion in clinical practice. |
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