Therapeutic efficacy of the Qing Dai in patients with intractable ulcerative colitis
Therapeutic efficacy of the Qing Dai in patients with intractable ulcerative colitis
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DOI：
10.3748/wjg.v19.i17.2718
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发表时间：
2013-05-07
影响因子：
4.3
通讯作者：
Hyodo, Ichinosuke
中科院分区：
文献类型：
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作者：
Suzuki, Hideo;Kaneko, Tsuyoshi;Hyodo, Ichinosuke
溃疡性结肠炎(UC)是一种慢性炎症性肠道疾病，使用氨基水杨酸盐、皮质类固醇和硫唑嘌呤等常规药物治疗可能会变得难以治愈。中药青黛传统上用于治疗UC患者，但缺乏关于青黛治疗UC的疗效的公开数据。我们报告了几例服用青黛的顽固性UC患者的回顾性观察研究。此外，我们还探讨了青黛的作用机制。9例活动期UC患者接受常规药物治疗，但希望接受青黛作为替代药物，纳入我们的分析。根据临床活动指数(CAI)确定UC严重程度。此外，9例患者中有5例根据Matts分级系统进行了内窥镜检查。每例患者口服青黛2g/d，并按规定继续服用其他治疗UC的药物。应用电子自旋共振技术对青黛的作用机理进行了探讨。经青黛治疗4mo后，CAI值由治疗前的8.3±-2.4降至2.4±-3.4(平均+/-SD；P&t；0.001)。同样，胃镜下Matts分级从3.4+/-0.5降至2.2+/-0.8(P=0.02)。在参加研究时服用强的松龙的7名患者中，有6名能够停用这种皮质类固醇。电子自旋共振分析表明，青黛具有较强的清除羟基自由基活性。在常规药物无效的患者中，青黛显示出显著的临床和内窥镜疗效。清除羟基自由基似乎是青黛的一个潜在作用机制，但青黛对UC患者抗炎作用的清除能力的意义值得进一步研究。(C)2013年白石登。版权所有。
Ulcerative colitis (UC) is a chronic inflammatory bowel disease that may become intractable when treated with conventional medications such as aminosalicylates, corticosteroids, and azathioprine. The herbal medicine Qing Dai has traditionally been used in Chinese medicine to treat UC patients, but there is a lack of published data on the efficacy of Qing Dai in UC treatment. We report several cases of patients with intractable UC who take Qing Dai in a retrospective observational study. Furthermore, we explore the mechanisms of action of Qing Dai. Nine patients with active UC who received conventional medications but wished to receive Qing Dai as an alternative medication were included in our analysis. The UC severity level was determined based on the clinical activity index (CAI). Additionally, 5 of the 9 patients were endoscopically evaluated according to the Matts grading system. Each patient received 2 g/d of Qing Dai orally and continued taking other medications for UC as prescribed. Electron spin resonance was applied to explore the mechanisms of action of Qing Dai. After 4 mo of treatment with Qing Dai, the CAI score decreased from 8.3 +/- 2.4 to 2.4 +/- 3 .4 (mean +/- SD; P < 0.001). Similarly, the endoscopic Matts grade decreased from 3.4 +/- 0.5 to 2.2 +/- 0.8 (P = 0.02). Six of 7 patients who were on prednisolone upon enrollment in the study were able to discontinue this corticosteroid. Electron spin resonance revealed that Qing Dai possesses strong hydroxyl radical scavenging activity. Qing Dai showed significant clinical and endoscopic efficacy in patients who failed to respond to conventional medications. Scavenging of hydroxyl radicals appears to be a potential mechanism through which Qing Dai acts, but the significance of the scavenging ability of Qing Dai with respect to the anti-inflammatory effect in UC patients warrants further investigation. (C) 2013 Baishideng. All rights reserved.