OBJECTIVETo investigate the efficacy and mechanisms of Bawei Xilei Powder (BXP) in treating ulcerative colitis (UC).

METHODSTotally 103 patients with left hemicolon mild to moderate UC in the active phase at the outpatient clinics of West China Hospital from June 2009 to October 2010 were randomly assigned to the treatment group (55 cases) and the control group (48 cases). Patients in the treatment group were treated with BXP (adding 1 g in 60 mL worm boiled water) and those in the control group received by 50 mg/60 mL hydrocortisone edema solution (once every evening before sleep). The therapeutic course for all was 4 weeks. The disease activity degree (Mayo scoring), endoscopic, and histologic manifestations were compared between post-and pre-treatment in the two groups. The expression of toll-like receptor-4 (TLR4), nuclear factor-kappaB (NF-kappaB), and Occludin were detected.

RESULTSThe clinical remission rate and the response rate in the treatment group were 78.2% and 89.1% respectively, higher than those of the control group (58.3% and 72.9%, P < 0.05).The endoscopically mucosal healing rate was 50.9% in the treatment group and 31.3% in the control group (P < 0.05). The histological remission rate and the effective rate in the treatment group were 32.7% and 65.5% respectively, but higher than those of the control group (27.1% and 58.3%, P > 0.05). The rate of adverse events was 3.8% in the treatment (occurred in 2 cases) and 4.3% in the control group (occurred in 2 cases, P > 0.05). Compared with pre-treatment, the expression of TLR4 and NF-kappaB p65 significantly decreased (P < 0.05), while the expression of Occludin significantly increased (P < 0.05).

CONCLUSIONSBXP was effective and safe in patients with active mild to moderate UC. Its effects might be involved in regulating the expression of inflammatory factors and enhancing mucosa barrier functions. ulcerative colitis; Bawei Xilei Powder; enema therapy