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Objective:To evaluate the clinical efficacy of Rougan Jianpi therapy combined with Mesalazine enema in the treatment of distal ulcerative colitis (DUC) with Ganyu-Pixu syndrome.Methods:This study is a prospective parallel randomized controlled study. From November 2021 to May 2022, 115 patients with DUC in Changshu Hospital Affiliated to Nanjing University of Chinese Medicine were selected and randomly divided into a control group of 58 patients and a study group of 57 patients. The control group was treated with Mesalazine enema, and the study group was treated with Rougan Jianpi Decoction on the basis of the control group. Both groups were treated for 8 weeks. The severity of the disease was evaluated by using the Modified Mayo Scale, and the clinical and endoscopic efficacy was evaluated based on the changes in the score before and after treatment. TCM syndromes were scored from four aspects: abdominal pain, diarrhea, mucopurulent bloody stool, Rectal tenesmus, and anal burning. The quality of life was evaluated by using the IBD Quality of Life Scale (IBDQ). The serum TNF-αand IL-10 level were detected by using ELISA method. The adverse reactions during treatment were observed and recorded.Results:The total effective rate of the study group was 91.23% (52/57), while that of the control group was 79.31% (46/58). The difference between the two groups was no statistically significant ( Z=1.47, P=0.143). The proportion of patients in the study group who achieved clinical response[40.35% (23/57) vs. 51.72% (30/58)] and clinical relief [59.65% (34/57) vs. 43.11% (25/58)] the total proportion were significantly higher than those in the control group [100.00% (57/57) vs. 94.83% (55/58); Z=1.97, P=0.049]. The proportion of patients with endoscopic response [52.63% (30/57) vs. 56.90% (33/58)] and mucosal healing [33.33% (19/57) vs. 17.24% (10/58)] the total proportion in the study group were significantly higher than those in the control group [85.96% (49/57) vs. 74.14% (43/58); Z=2.23, P=0.026]. after treatment, the IBDQ score [(194.3±15.1) vs. (172.6±18.4), t=6.90] in the study group was significantly higher than that of the control group. After treatment, the patient's TCM symptom score: mucopurulent bloody stool [(1.7±0.8) vs. (2.0±0.6), t=2.03], rectal tenesmus [(1.5±0.6) vs. (1.8±0.6), t=2.32] and anal burning [(1.3±0.6) vs. (1.6±0.7), t=2.38] in the control group were significantly lower than those in the control group ( P<0.05). The level of IL-10 [(53.3±8.0) ng/L vs. (49.0±6.7) ng/L, t=3.10] in the study group after treatment was higher than that of the control group ( P<0.01), and TNF-α [(28.3±7.9)ng/L vs. (36.8±8.1)ng/L, t=3.58] was lower than that of the control group ( P<0.01). There were no significant adverse reactions observed during the treatment in both groups. Conclusion:Method of Rougan Jianpi combined with mesalazine enema can improve the clinical symptoms of DUC patients, improve clinical efficacy, and have good safety.
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Objective To establish a rat chronic atrophic gastritis with dysplasia model and observe the effect of Shidan granules on the positive expression of NF-κB p65 in gastric tissues and the extent of IKKβprotein content in gastric tissues of chronic atrophic gastritis with dysplasia model rats. Methods Seventy SPF male Wistar rats were randomly divided into the blank group and 60 into the model group. In addition to the blank group, the modeling group was made using the MNNG-based comprehensive modeling method (150 μg/ml MNNG 5 ml/kg each stomach, containing 0.03％ ranitidine feed, free drinking 0.1％ ammonia), and then model successed at the 28th week. The remaining rats in the modeling group were randomly divided into 5 groups: the model group with intragastric administration of gavage, the western medicine group with intragastric administration of viralin, the Shidan granules group with intragastric administration of low/medium/high concentration Chinese medicine decoction. After 12 weeks of treatment, they were sacrificed and the expression of NF-κB p65 and IKKβ was measured and compared. Results Compared with the model group, the average optical density of NF-κBp65 (0.387 ± 0.011, 0.252 ± 0.022, 0.193 ± 0.003 vs. 0.442 ± 0.035) and the expression level of IKKβ (0.309 ± 0.056, 0.216 ± 0.025, 0.125 ± 0.016 vs. 0.405 ± 0.042) in the low-, middle- and high-dose Shidan granules groups significantly decreased (all Ps<0.01). Conclusions The mechanism of improving the precancerous lesions of gastric cancer by Shidan granules may be achieved by inhibiting the expression of IKK, reducing the abnormal activation of NF-κB.