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The Experimental Study of Jiawei Lianli Decoction Treating Ulcerative Colitis and the Clinical Study of Jiawei Lianli Decoction Combined with Changdiqing

Author: LiJianHua
Tutor: HuangSuiPing
School: Guangzhou University of Traditional Chinese Medicine
Course: Chinese medical science
Keywords: Jiawei lianli decoction Changdiqing Ulcerativecolitis mouse clinical study
CLC: R259
Type: PhD thesis
Year: 2013
Downloads: 50
Quote: 0
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Abstract


Objective:This study included two parts:experimental study and clinical study. In experimental study, murine model of ulcerative colitis was induced by DSS to investigate the effect of Jiawei lianli decoction to treat UC, to the level of oxygen freeradicals and cytokine:IFN-γ、IL-4, and to explore the mechanism. In clinical study, joint group and enema group’s treatment efficacy of UC were observed, main symptom score、total symptom score、treatment efficiency and the level of CRP were compared, for looking for a cure method that had good curative effect、less adverse reaction、cheap price and was easy to use.Methods:Experiment method:60BALB/c healthy male mice of SPF were divided into four groups:normal group, model group, traditional Chinese medicine group and the western medicine group at random, each group had15mice. Normal group took normal food and water, the other three groups were manufactured model of UC by freely drinking5%DSS. Medicine were given after25days. Gastric lavage of normal group and model group were given physiological saline everyday, gastric lavage of traditional Chinese medicine group was given Jiawei Decoction everyday, gastric lavage of the western medicine group was given SASP everyday. The course was2weeks. After the course, mice’general situation、body weight、colonic mucosal injury、histological grading under the light microscope、MDA content and SOD vitality of colonic tissue homogenate、level of IFN-γ and IL-4of colon tissue were observed. Clinical method:61chronic relapsing or chronic persistent type patients met the inclusion criteria who were mild to moderate activity period and cold and heat syndrome. They were divided into joint group31and enema group30at random. Joint group were treated with Jiawei lianli decoction and Changdiqing, enema group were treated with Changdiqing. Patients’ four main symptoms score (diarrhea、mucous bloody stool、tenesmus、abdominal pain)、total symptom score、 treatment efficiency and the level of CRP were observed of two groups before and after treatment. The course was30days.Results:experiment results:1. Mice’ general situation was improved:After the second day, model group had pulpy feces, then mucus stool、bloody stool. They were languid lazy, did not like activity, had slow reaction、messy hair、 back arch、less food and water and body weight reduction, At the end of the experiment, they still excrete pulpy feces. After treating1week, mice in traditional Chinese medicine group and the western medicine group gradually reduced pus and blood stool, increased activity, increased food and water, increased weight, had silky hair and flexible response. At the end of the experiment, sections of mice excrete granular stool.2. Mice’ weight changement:Mice’ weight increasing In traditional Chinese medicine group and the western medicine group significantly higher than in model group (P<0.05) Mice’ weight increasing In traditional Chinese medicine group and in the western medicine group had not statistical significance (P>0.05).3. Mice’ colonic mucosal injury and histological grading under the light microscope: In model group, mice’ colon wall adhered to the surrounding tissue and obviously thickened, colonic mucosa had obviously congestion and edema、erosion and small ulcer; Different build erosive and ulcer、thiner mucosa、destroyed submucosal glands、goblet cells decreasing、inflammatory cell infiltration were seen under the light microscope. In traditional Chinese medicine group and the western medicine group, mice’ colon wall adhesion and thickening were improved, colonic mucosa’s congestion and edema、erosion and ulcer were reduced; colonic mucosa’s congestion and edema reduction、inflammatory cell infiltration reduction、goblet cells recovery and ulcer being repaired were seen under the light microscope.histological grading in model group were the highest, histological grading in traditional Chinese medicine group and the western medicine group significantly less than model group, the difference was statistically significant.4. The content of MDA of colonic tissue:Compared with model group, the content of MDA of traditional Chinese medicine group and the western medicine group were all reduced, the difference was statistically significant (P<0.01); The content of MDA of traditional Chinese medicine group significantly lower than the western medicine group, the difference was statistically significant(P<0.05).5. SOD vitality of colonic tissue:Compared with model group, SOD vitality of traditional Chinese medicine group and the western medicine group were all increased, the difference was statistically significant (P<0.01); SOD vitality of traditional Chinese medicine group and the western medicine group had not significantly difference (P>0.05).6. The level of IFN-γ of colonic tissue:Compared with model group, the level of IFN-γ of traditional Chinese medicine group and the western medicine group were all reduced, the difference was statistically significant (P<0.05); The level of IFN-γ of traditional Chinese medicine group significantly lower than the western medicine group, the difference was statistically significant(P<0.01).7. The level of IL-4of colonic tissue: Compared with model group, the level of IL-4of traditional Chinese medicine group and the western medicine group were all increased, the difference was statistically significant (P<0.01); The level of IL-4of traditional Chinese medicine group significantly higher than the western medicine group, the difference was statistically significant (P<0.05).8. The ratio of IFN-γ/IL-4of colonic tissue:Compared with model group, the ratio of IFN-γ/IL-4of traditional Chinese medicine group and the western medicine group were all reduced, the difference was statistically significant (P<0.01); The ratio of IFN-γ/IL-4of traditional Chinese medicine group significantly lower than the western medicine group, the difference was statistically significant (P<0.05). Clinical results:1. Two groups’symptom score before and after treatment:After30days’treatment, two groups’four main symptoms score (diarrhea、mucous bloody stool、tenesmus、abdominal pain) and total symptom score significantly lower (P<0.01); four main symptoms score and total symptom score in joint group significantly lower than enema group after the treatment (P<0.01).2. Two groups’efficiency:Joint group had31patients, total efficiency was96.8%; enema group had30patients, total efficiency was76.7%. Curative effect of joint group was better than enema group, the difference had statistical significance (P<0.01)。3. Two groups’CRP level: After treatment, two groups’CRP level had significant difference compaired with before treatment (P<0.05).After treatment, joint group’s CRP level significantly lower than enema group, the difference had statistical significance (P<0.01)Conclusions:1.Jiawei lianli decoction may significantly improve UC mice’symptoms、 increase weight, reduce colonic mucosal congestion and edema, promote ulcer healing and reduce infiltration of inflammatory cells, reduce the content of MDA, improve vitality of SOD, reduce the level of IFN-γ, increase the level of IL-4, promote the balance of IFN-γ/IL-4ratio.2. Chronic relapsing or chronic persistent type UC patients’symptoms were improved, CRP were reduced who were mild to moderate activity period and cold and heat syndrome after two groups’treatment. According to the results of experimental study, it was related to one mechanism that Jiawei lianli decoction could reduce lipid peroxidation intensity and the content of MDA、improve vitality of SOD, it was related to another mechanism that Jiawei lianli decoction could reduce the level of IFN-γ、increase the level of IL-4and promote the balance of Thl/Th2.3. Joint group was superior to enema group, It was the most satisfactory clinical therapeutic effect of UC that Jiawei lianli decoction combined with Changdiqing.

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