The Influence Of The Method Of Dispelling Wind And Dampness On The Pathological Changes Of Ulcerative Colitis Mucosa

Ulcerative colitis(UC),an nonspecific enteritis,characterizes as recurrent diarrhea,mucous bloody stool,and abdominal pain and presents an active-remission-recurrent course.Because of there is no authoritive diagnostic standard currently,the diagnosis is based on the combination of clinic manifestations,endoscopy and histopathology.In addition,other infectious and non-infectious colitis should be excluded.Due to the poor understanding of the pathogenesis,the treatment is lack of specificity.Aminosalicylic acid,corticosteroids,immunosuppressants and biological agents are the main medications at present.However,the long treatment course,side-effect and high costs prevent the wild use of these drugs.Besides,no evidence shows that the symptom improvement does not reduce the disease course and the risk rate of complication and surgery.Recently,an increasing number of researches demonstrate that mucosal healing,especially histological improvement,can reduce the rates of complications,surgery and hospitalization,and improve the quality of life.This study focuses on mucosal pathology change of UC patients.According to the Traditional Chinese Medicine(TCM)theory,UC belongs to"diarrhea","dysentery","intestinal bleach"and "recurrent dysentery".Under the guidance of syndrome differentiation and treatment,TCM carries out various efficacious therapies,such as decoction,retention enema,acupuncture and so on.After analyzing the pathogenesis of UC,it was believed that dampness played a crucial role in the process of UC who presented as dampness-heat in large intestine syndrome.Besides,according to the theory of wind could remove dampness,expelling wind-clear-damp method was used in this study to observe its effect on histological change of intestinal mucosa.Objective:A prospective clinical randomized controlled trail(RCT)was conducted to observe the effect of expelling wind-dampness therapy on intestinal mucosa pathological changes in patients with UC.Method:During Mar.2014 to Feb.2016,sixty patients with active ulcerative colitis of damp-heat type were randomly allocated into the Wind-Clear-Damp granules group(n=30,a dose of TCM,bid po)and Mesalazine group(n=30,1.5g/d tid po),with a 4-week treatment.After the treatment course,endoscopic and histologic tests were taken to evaluate the efficacy.Clinical manifestations,synptoms of TCM,endoscopic performance and intestinal mucosa Geboes Index of histopathology were taken records before and after the treatment.SPSS 22.0 software was used to analyzed the data.Measurement data were presented as mean with standard deviation(X±s).T test was performed when the data consist with normal distribution.Otherwise,non-parametric test was carried out.In addition,count data were analyzed by Chi-square test.Result:Trial group(F=13),aged from 22 to 73,and the control group(F=12),aged from 25 to 74,were comparable on the base line which contained gender,age,disease courses,etc(P<0.05).(1)Diarrhea.With a general effective rate of 92.3%,trial group was superior to control groups(64.0%)(P=0.004<0.05).(2)mucous bloody stool.With a general effective rate of 89.7%,trial group was superior to control groups(55.6%)(P=0.011<0.05).(3)Abdominal pain.With a general effective rates of 61.9%and 61.1%,no significance was found between trail and control group(P=0.814>0.05).(4)Main symptoms.With a general effective rate of 86.7%,trial group was superior to control groups(66.7%)(P=0.046<0.05).(5)TCM manifestations.With a general effective rate of 90.0%,trial group was superior to control groups(74.1%)(P=0.178>0.05).(6)Endoscopic manifestations.After treatment,endoscopic manifestations were significantly improved in both two groups(P<0.01).dditional,trail group had a better improvement than control group(P<0.05).(7)Intestinal mucosa Geboes Index.After treatment,Geboes Index were significantly reduced in both two groups(P<0.01).Additional,trail group had a superior improvement to control group(P<0.05).(8)Geboes Index classification scores.After treatment,Geboes Index classification scores were significantly reduced in both two groups(P<0.01).Additional,trail group had a superior improvement to control groupexcept structural modification,eosinopilic granulocyte,erosion and ulcer(P<0.05).Conclusion:Both the wind-clear-damp granules group and Mesalazine group were efficacious for UC patients with active ulcerative colitis of damp-heat type.The wind-clear-damp granules group has an advantage of efficacy and disadvantage of adverse event,meanwhile can promote the restoration of intestinal mucosa and reduce inflammatory cells in the intestinal mucosa.The Wind-Clear-Damp granules group has an advantage of efficacy and disadvantage of adverse event.