| Objective: 1.To explore the distribution of clinical factors in ulcerative colitis(UC)patients with anxiety,so as to provide theoretical basis for clinical psychological intervention and treatment.2.To observe the anxiety-like behavior changes of UC rats and analyze it from the perspective of intestinal flora.Methods: In experiment 1,we developed a collection table of diseases and emotions of UC patients.According to the scores of hospital anxiety and depression scale(HADS),the patients were divided into anxiety group and non anxiety group.Then the distribution of clinical factors of UC with anxiety were analyzed by statistical methods,including rank sum test,chi square test and Fisher exact test.In experiment 2,we selected 24 SPF male rats.We performed additional data collection with dextran sulfate sodium(DSS)to establish the rat models of UC.After the models were established successfully,treatment group(n=5)was received retention enema daily with Huayu Tongyang decoction(0.54g/ml).Model group(n=5)and control group(n=4)were received retention enema daily with the same dose of normal saline for ten consecutive days at a dose of either 2ml.At the end of the treatment,the rats in each group were tested by elevated plus maze(EPM).The feces of rats were collected at the same time,and the changes of intestinal flora were detected by macro gene sequencing.Results: Experiment 1 1.There were 38 patients with anxiety symptoms in 103 UC patients,accounting for 36.89% of the total.Among them,there were 24 mild patients,14 moderate and severe patients.2.The duration of 103 UC patients ranged from 1 to 15 years,with an average of 4.94±2.930 years;There were 48 UC patients whose lesions were located in rectum.There were 35 UC patients whose lesions were located in the left colon.There were 20 UC patients with extensive colon lesions;Distribution of TCM syndrome types: the most common UC patients with large intestine damp heat syndrome were 31 cases,accounting for 30.10% of the total cases,followed by spleen deficiency and dampness accumulation syndrome(21.36%),liver depression and spleen deficiency syndrome(19.42%),qi stagnation and blood stasis syndrome(17.48%),cold heat syndrome(7.77%),spleen kidney yang deficiency syndrome (3.88%);There are 51 cases of UC with mild disease activity,42 cases of UC with moderate disease activity and 10 cases of UC with severe disease activity.3.There were no significant difference in the course of UC,the range of disease and the activity of UC in anxiety group and non anxiety group(P>0.05).There were significant difference in the distribution of TCM syndrome types in the two groups(P<0.01).There were more cases of qi stagnation and blood stasis syndrome,liver depression and spleen deficiency syndrome in anxiety patients(P<0.05).There were more cases of large intestine dampness heat syndrome and spleen deficiency dampness excess syndrome in patients without anxiety,the difference were statistically significant(P< 0.05).Experiment 2 1.The TDI score of colon in model group(n=3)increased,while that in treatment group(n=3)decreased(P<0.01).2.The percentage of times entering the open arm decreased in the model group and increased in the treatment group,the difference were statistically significant(P<0.05);The percentage of time entering the open arm decreased in the model group and increased in the treatment group,the difference were not statistically significant(P>0.05).3.There were differences in the composition of intestinal flora among the three groups of rats.The results showed that at the genus level,Mediterranea and Paraprevotella were the dominant species in the control group.Clostridium,Tricibacter and Faecalibaculum were the dominant species in the model group.Lactobacillus and Akkermansia were the dominant species in the treatment group.4.Compared with the model group,the Inositol phosphate metabolism and Lysine biosynthesis were increased,Phenylalanine metabolism of intestinal flora in the treatment group was decreased,the difference were statistically significant(P<0.05).Conclusion: 1.Qi stagnation and blood stasis syndrome and liver depression and spleen deficiency syndrome are the most common syndromes in UC patients with anxiety 2.The UC rats induced by DSS showed anxiety tendency.The level of anxiety tends to decrease after treatment.3.The abundance of Clostridium,Tricibacter and Faecalibaculum in the intestine of UC rats increased after DSS induction.The abundance of Lactobacillus and Akkermansia in the intestine of UC rats increased after the treatment of Huayu Tongyang decoction.At the same time,the Inositol phosphate metabolism and Lysine biosynthesis were increased,Phenylalanine metabolism of intestinal flora in the treatment group was decreased.It is tiped that the change of anxiety level of UC rats may be related to intestinal flora. |
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