| Through clinical research,this thesis explored the use of microprobe endoscopic ultrasonography to observe the the colonic wall mucosal thickness and mucosal repair in patients with ulcerative colitis,to evaluate the effect of Qingchang Wenzhong Decoction on the inhibition of intestinal inflammation and the repair of colonic mucosa in UC patients.Factor analysis and cluster analysis were used to explore the traditional Chinese medicine syndrome differentiation and distribution of ulcerative colitis.1.Endoscopic ultrasonography was used to evaluate the effect of Qingchang Wenzhong Decoction on mucosal repair in ulcerative colitis.Objective:Microprobe endoscopic ultrasonography was used to evaluate the effect of Qingchang Wenzhong Decoction on the inhibition of intestinal inflammation and the repair of colonic mucosa.At the same time,we compared the therapeutic effects of Qingchang Wenzhong Decoction with Mesalazine among the patients.Methods:The cases were collected in the gastroenterology clinic and ward in Dongfang Hospital Beijing University of Chinese Medicine.We randomly divided the 22 patients meeting inclusion criteria into two groups,12 cases in the the Qingchang Wenzhong Decoction(TCM)group and 10 cases in the mesalazine enteric-coated tablets(medicine)group.The TCM group was given the Qingchang Wenzhong Decoction and mesalazine enteric-coated tablets analog,while the other group was given mesalazine enteric-coated tablets and the Qingchang Wenzhong Decoctionanalog.Two groups were both treated continuously for 8 weeks.Before and after treatment,by using microprobe endoscopic ultrasonography the thickness of the second and third layer of intestinal wall was measured for statistical comparison and analysis,where the rectum or sigmoid colon inflammation was most obvious.The individual symptoms,TCM syndrome scores,therapeutic effect of mucosal lesions,clinical efficacy and quality of life among the patients were evaluated respectively after 8 weeks.The research datas were analyzed by SPSS 20.0 statistical software.Results:(1)Evaluation of mucosa under endoscopic ultrasonography:Mucosal integrals in both groups were lower than before treatment,and the differences both have statistical significance(P<0.05).The two kinds of treatments could improve the mucosal integral under EUS.The maximum thickness,middle thickness,minimum thickness and average thickness of the second layer of mucosa in the TCM group and the western medicine group were thinner than those before treatment,and the differences both have statistical significance(P<0.05).Both the two kinds of treatments could improve the thickness of the second layer of the mucosa.The maximum,middle,minimum and average thickness of the third layer of mucosa in the TCM group and the western medicine group were thinner than those before treatment,and the differences both have statistical significance(P<0.05).Both the two kinds of treatments could improve the thickness of the third layer of the mucosa.(2)Improving the Single Symptoms of TCM:The differences between before and after treatment have statistical significance(P<0.05)in abdominal pain,diarrhea,purulent blood stool and tenesmus in both the two groups.And both the two kinds of treatments could improve the symptoms/signs of abdominal pain,diarrhea,tenesmus,and purulent blood stool among the patients.(3)In improving the curative effect of TCM syndromes:The total effective rate of TCM syndromes was 75%in TCM group and 60%in western medicine group.The differences between before and after treatment have statistical significance(P<0.05)in both the two groups.And both the two kinds of treatments could improve TCM syndromes score.(4)In terms of the efficacy of mucosal lesions:After treatment,there were 4 cases of mucosal healing,2 cases in the TCM group and 2 cases in the western medicine group.7 cases of mucosal lesion relief,4 cases in the TCM group and 3 cases in the western medicine group.3 cases of mucosal lesion improvement,2 cases in the TCM group and 1 case in the western medicine group.8 cases of ineffective,4 cases in the TCM group and 4 cases in the western medicine group.After treatments,Baron integral of both the two groups were all lower than that before,and the differences have statistical significance(P<0.05).Both the two kinds of treatments could improve the mucosal integral.(5)Clinical efficacy evaluation:After treatments,12 patients with modified Mayo score were clinically effective,including 8 patients in the TCM group and 4 patients in the western medicine group.There were 10 mild cases,including 4 cases in TCM group and 6 cases in western medicine group.The differences have statistical significance(P<0.05).Both the two kinds of treatments could improve the clinical efficacy.(6)In terms of quality of life assessment:Comparing with that before treatment,the intestinal symptoms,systemic symptoms,emotional function,social function and overall score all have statistical significance(P<0.05)in both two groups.Both the two kinds of treatments could improve the intestinal symptoms,systemic symptoms,emotional function,social function and the overall score of the scale.(7)Safety evaluation:After treatment,there was no obvious abnormality in the results of safety test,and no adverse events related to the experimental drug.Conclusions:Microprobe endoscopic ultrasonography can clearly show the inflammatory lesions and thickness of intestinal wall in ulcerative colitis.And it is helpful for the treatment and prognosis of UC.The Qingchang Wenzhong Decoction can significantly improve the clinical symptoms,repair mucosal lesions,reduce disease activity,and improve the quality of life of the patients.And the efficacy has no significant difference from Mesalazine.The Qingchang Wenzhong Decoction has no obvious adverse reactions in clinical application,and it is safe to use.2.Study on TCM Syndrome of Ulcerative Colitis Based on Factor Analysis and Cluster AnalysisObjective:Factor analysis and cluster analysis were used in this study to explore the classification and distribution of UC TCM syndromes.Methods:The cases were collected in the gastroenterology clinic and ward in Dongfang Hospital Beijing University of Chinese Medicine.Following the requirements of quality control in epidemiological investigation,the "Clinical Questionnaire of TCM Syndromes of Ulcerative Colitis" was formulated.The data of TCM four diagnoses of the patients were collected strictly according to the clinical design scheme.The information of TCM four diagnoses of 120 patients was studied by factor analysis and cluster analysis,so as to obtain the classification and distribution of the main TCM syndromes of Ulcerative Colitis.Results:Through factor analysis and cluster analysis,the syndrome information of the patients was analyzed,and three main syndromes were obtained:liver depression and spleen deficiency combined with Spleen Yang deficiency(32 cases,27%),cold and heat miscellaneous combined with liver depression and spleen deficiency(34 cases,28%),and large intestine dampness-heat combined with spleen deficiency and dampness accumulation(54 cases,45%).Conclusions:Factor analysis and cluster analysis can objectively analyze the classification and distribution of TCM syndromes of ulcerative colitis,and the characteristics of TCM syndromes of UC can be found. |
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