1.Analysis of serum metabolomic characteristics of patients in the active stage of ulcerative colitis with syndrome of dampness-heat in large intestine
Changchang GE ; Yi LU ; Hong SHEN ; Lei ZHU
Journal of Beijing University of Traditional Chinese Medicine 2024;47(5):686-698
Objective To obtain the metabolomics characteristics of patients in the active stage of ulcerative colitis(UC)with syndrome of dampness-heat in large intestine through non-target metabolomics technology,and to provide a basis for promoting the theoretical system of traditional Chinese medicine(TCM)syndrome differentiation of disease syndrome combination and micro-macro combinations.Methods Non-target metabolomics technology was used to detect the serum samples from 159 patients in the active stage of UC(81 cases with syndrome of dampness-heat in large intestine and 78 cases with syndrome of non-dampness-heat in large intestine)and 30 healthy volunteers.The orthogonal partial sample least squares discriminant analysis model was constructed to screen metabolites with significant changes among groups.The variable importance in projection≥1,P<0.05,and fold change(FC)>1.20 or FC<0.83 were used as the criteria for the screening of differential metabolites.The Kyoto Encyclopedia of Genes and Genomes(KEGG)was used to annotate differential metabolites,and MetaboAnalyst software was used for pathway analysis.Results Between patients in active stage of UC with syndrome of dampness-heat in large intestine and syndrome of non-dampness-heat in large intestine,a total of 99 differential metabolites were screened in the positive ion mode,of which 48 were upregulated and 51 were downregulated.In the negative ion mode,a total of 38 differential metabolites were screened,of which 19 were upregulated and 19 were downregulated.The KEGG enrichment analysis showed that there were 21 metabolic pathways,and the pathway analysis showed that there were mainly four metabolic pathways involved in tryptophan metabolism,sphingolipid metabolism,glycerophospholipid metabolism,and pyrimidine metabolism.Conclusion Patients in the active stage of UC with syndrome of dampness-heat in large intestine have abnormal metabolic pathways,which can provide a basis for TCM syndrome differentiation and treatment for UC with syndrome of dampness-heat in large intestine.
2. Advances of Research on Patient-reported Outcome Scales for Inflammatory Bowel Disease
Yi LU ; Changchang GE ; Hong SHEN ; Lei ZHU
Chinese Journal of Gastroenterology 2022;27(2):119-123
With the transform of bio-psycho-social medical model, the research on patients’subjective feelings, that is, patient-reported outcome (PRO), has received increasing attention, which plays an important role in the monitoring of patients’disease progression and the guidance for clinical diagnosis and treatment. This article reviewed the current PRO scales commonly used in inflammatory bowel disease (IBD), aiming to help medical staff choosing an assessment tool suitable for IBD patients, to promote the application and development of IBD-PRO scale, to optimize the disease management of IBD patients, and to provide reference for its application in clinical treatment of IBD.
3.Analysis of Core Prescription and Clinical Efficacy of Professor Shen Hong's Treatment of Crohn's Disease with Dampness-Stasis Interjunction Syndrome Based on Data Mining
Yi LU ; Changchang GE ; Hong SHEN ; Lei ZHU
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(7):740-746
OBJECTIVE To analyze the medication rules of Professor Shen Hong's TCM treatment of Crohn's disease(CD)and form the core prescription using data mining technology,and to retrospectively analyze the clinical efficacy of the core prescription com-bined with ustekinumab in the treatment of CD with dampness-stasis interjunction syndrome.METHODS CD patient outpatient re-cords treated by Professor Shen Hong were collected,and the property,taste and meridian tropism,drug frequency,association rules and complex network analysis of drugs were summarized,in order to sort out the core prescription.62 cases of active ileocolic CD with TCM syndrome of dampness-stasis interjunction were retrospectively included,with 32 patients in the control group and 30 patients in the observation group.The control group was only given ustekinumab,and the observation group was given the core prescription oral treatment on the basis of the treatment in the control group.The observation course was 8 weeks.The improvement of clinical symptoms and changes of inflammatory indicators[erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),fecal calprotectin(FC)]before and after treatment were analyzed.RESULTS The core prescription was obtained by combining drug frequency,association rules and cluster analysis,which included scutellaria baicalensis,radix sophorae flavescentis,smilax glabr,angelicae sinensis,angeli-ca dahurica,atractylodes,tangerine peel,paeoniae alba,saposhnikovia,coicis semen,yam,nidus vespae,cynanchum paniculatum,radix aucklandiae,massa medicata fermentata,glycyrrhiza uralensis,and was named Qingchang Tongluo Formula by Professor Shen Hong.Retrospective clinical research showed that after treatment,the TCM syndrome scores of the 2 groups of patients were significant-ly reduced(P<0.05,P<0.01),the total TCM syndrome score of the observation group was better than that of the control group(P<0.01),and the TCM clinical significant recovery rate of the observation group was better than the control group(P<0.05);the ESR,CRP,and FC levels of patients in both groups were significantly reduced(P<0.01),and the improvement in the observation group was better than that in the control group(P<0.05).No obvious drug-related adverse reactions were found in the 2 groups of patients during treatment.CONCLUSION Professor Shen Hong distinguishes the treatment of CD by clearing heat and removing blood stasis,strengthening spleen and healing lesions.The core prescription Qingchang Tongluo prescription,combined with ustekinumab can im-prove clinical symptoms and inflammation levels.It can be used clinically as an effective treatment for ileocolonic Crohn's disease with dampness-stasis interjunction syndrome.