Observation on therapeutic effect of hyperbaric oxygen combined with Tongxie Yaofang formula in 52 cases of ulcerative colitis
10.3760/cma.j.cn311847-20200602-00242
- VernacularTitle:高压氧联合痛泻要方治疗溃疡性结肠炎52例疗效观察
- Author:
Wenli YOU
1
;
Gang ZHAO
;
Jian GU
;
Jing XU
;
Jin’e WAN
Author Information
1. 266000 山东省青岛，青岛大学附属医院肛肠科
- Publication Type:Journal Article
- Keywords:
Hyperbaric oxygen;
Ulcerative colitis;
Tongxie Yaofang formula
- From:
Chinese journal of nautical medicine and hyperbaric medicine
2021;28(1):56-60
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe and explore the clinical effect and mechanism of Tongxie Yaofang formula combined with hyperbaric oxygen (HBO) in the treatment of ulcerative colitis (UC) with liver stagnation and spleen deficiency syndrome.Methods:A total of 98 patients diagnosed as ulcerative colitis at the Department of Anorectal Medicine of the Affiliated Hospital of Qingdao University from March 2019 to September 2019 were selected as the research subjects and divided into observation group ( n=52) and control group ( n=46) according to treatment methods. The observation group was treated with Tongxie Yaofang formula combined with HBO, while the control group was treated with mesalazine sustained-release granules. The clinical efficacy and Mayo scores were evaluated after 28 days of treatment. The serum levels of tumor necrosis factor α (TNF-α) and interleukin-17 (IL-17) were detected by enzyme-linked immunosorbent assay (ELISA). The contents of prostaglandin endoperoxide synthase 2 (PTGS2) and B-cell lymphoma 2 (Bcl-2) proteins were detected by Western blotting. Fresh colon tissues before and after treatment were taken with biopsy forceps, and the contents of Yes-associated protein 1 (Yap1) and Phospho-Yes-associated protein 1 (PYap1) (Ser127) in colon tissue before and after treatment were detected by Western blotting. The healing of colonic mucosal edema and ulcer was observed by endoscope. The counts of neutrophilic granulocytes in the diffuse inflammatory infiltration of lamina propria of colonic mucosa, colonic mucosal surface ulcer, and crypt epithelium were observed microscopically before and after treatment. Results:After 28 days of treatment, the clinical effective rate in the observation group (80.8%) was significantly higher than that in the control group (60.9%) ( P<0.05). Compared with those before treatment, the Mayo scores after treatment were significantly lower in both groups ( P<0.05). The Mayo score in the observation group was lower than that in the control group ( P<0.05). After treatment, the colonic mucosal edema and ulcer were improved, and the conditions of the observation group were better than those of the control group. Pathological observations showed that the patients in the two groups, before treatment, had diffuse inflammatory infiltration of the lamina propria of the colonic mucosa, irregular glands, destruction of the crypt epithelium, abscess, and surface ulcer. After treatment, the counts of neutrophilic granulocytes in the lamina propria and the crypt epithelium were significantly reduced, and the diffuse inflammatory infiltration turned into focal infiltration. The serum levels of TNF-α and IL-17 in both groups were significantly lower than those before treatment ( P<0.05). However, there was no significant difference in serum levels of TNF-α and IL-17 between the two groups after treatment ( P>0.05). The expressions of PTGS2 and Yap1 in colon tissues of the two groups were significantly down-regulated compared with those before treatment, and the expressions of anti-apoptotic proteins Bcl-2 and PYap1 were up-regulated( P<0.05). There was no statistically significant difference in PTGS2, Yap1, Bcl-2, and P-Yap1 levels between the two groups after treatment ( P>0.05). Conclusion:Tongxie Yaofang formula combined with HBO in the treatment of UC with liver stagnation and spleen deficiency syndrome can achieve a better clinical remission rate than that of mesalazine sustained-release granule alone, and it more strengths in reducing the modified Mayo score, reducing the level of inflammatory factors, and effectively promoting mucosal ulcer healing.
