Insights & Discussion
Qing-Chang-Hua-Shi (QCHS) granules, a Chinese herbal formula, have shown significant efficacy in improving clinical remission and mucosal healing in moderately active ulcerative colitis patients.
The double-blind, randomized and placebo-controlled study was performed across multiple centers, involving patients with moderately active ulcerative colitis who had been unresponsive to mesalazine therapy for a month. The participants were randomly divided into groups, where one group received a daily dose of 125g QCHS granules along with continual 5-Aminosalicylate(5-ASA) therapy, and the other group received a placebo with the same color, taste and texture as QCHS granules, also with 5-ASA therapy.
The interpretation of the reported results revealed that both clinical remission and response were observed more substantially in the group treated with QCHS granules compared to the placebo group. Moreover, a higher rate of remission in mucus/bloody stools was seen in patients treated with QCHS granules versus the placebo. Overall, the adverse event rates did not significantly deviate between the QCHS granule and the placebo groups, indicating a similar level of safety for both treatments.
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Acupuncture and moxibustion therapies have shown effectiveness in treating ulcerative colitis according to the summarised-findings of various systematic reviews and meta-analyses.
2024 Heliyon Effects of acupuncture and moxibustion on ulcerative colitis: An overview of systematic reviews Wang D, Wang Q, Wang Y, Li T, Tian M
Systematic Review Acupuncture Moxibustion Ulcerative Colitis
Methodology: This evaluative study used an extensive and systematic methods to search data from seven different databases. The selected data were further refined by using different screening and evaluation frameworks like AMSTAR-2, PRISMA, ROBIS, and GRADE systems. These were used to determine the methodological quality, reporting quality, risk of bias, and the quality of evidence in the selected studies.
Discussion of results: After critical evaluation, the study found ten relevant reviews and analyses that showed potential for acupuncture and moxibustion therapies being effective in ulcerative colitis treatment. However, many the identified studies were reported to have several problems in their overall design and quality of outcomes. The researchers therefore stress caution when interpreting these results due to the lack of high-quality evidence in the existing studies.
Diverse acupuncture therapies, especially moxibustion, emerged as superior methods for alleviating ulcerative colitis symptoms in clinical practice.
2024 SSRN Electronic Journal Efficacy and Safety of Different Acupuncture Therapies for Patients with Ulcerative Colitis：A Systematic Review And Network Meta-Analysis Zhang X, Yang S, Jin Y, Cheng X, Lu H, Wu H, et al.
Meta-Analysis Acupuncture Moxibustion Ulcerative Colitis
Methodology: The researchers carried out a systematic review and network meta-analysis of clinical efficacy of various acupuncture therapies for ulcerative colitis patients. They accomplished this by sourcing for Clinical Randomized Controlled trial articles from databases such as PubMed, Embase, Cochrane Library, and other data knowledge service platforms, all of which were independently reviewed by two researchers. Several quality assessments were made through Review Manager software, and the meta-analysis was conducted with Stata 16 software. Interventions examined in the analysis included acupuncture, moxibustion, acupoint catgut embedding, and combinations of these therapies with Western medicine.
Discussion of results: 52 articles encompassing 3924 patients participated in randomized control trials. The investigation revealed a range of interventions, including different acupuncture therapies and combinations of these therapies with Western medicine. Namely, moxibustion, either on its own or combined with Western medicine, consistently surfaced as top-ranked for overall effectiveness and specific outcomes. Moreover, moxibustion displayed impressive performance in reducing adverse reactions and recurrence rates. Thus, various acupuncture therapies were confirmed as safe and effective for the treatment of ulcerative colitis, with moxibustion emerging as the most effective.
A combined Mediterranean, low-FODMAP diet along with partial enteral nutrition has shown promise in reducing ulcerative colitis activity and improving patients' quality of life.
2024 Scientific Reports Effectiveness of a novel diet in attenuation of clinical activity of disease in patients with ulcerative colitis: a randomized, clinical trial Narimani B, Sadeghi A, Daryani NE, Shahrokh S, Nilghaz M, Ghods M, et al.
Randomised Controlled Trial Low FODMAP Ulcerative Colitis
In the study, fifty patients with active, mild to moderate ulcerative colitis were randomly allotted one of two diets: a combined Mediterranean, low-FODMAP diet supplemented with partial enteral nutrition, or a standard diet. These diets were implemented for a duration of 6 weeks. Before and after the intervention, various indicators of the patients' conditions were measured. These variables included a disease activity index, the patients' quality of life, and concentrations of various inflammatory and oxidative stress factors in the blood. All of these were measured using tested and trustworthy questionnaires, in conjunction with blood sampling.
The combined diet was found to result in significantly decreased disease activity index values, compared to both the control diet and the baseline data. Simultaneously, patients on the combined diet reported greater enhancements in their quality of life, compared to both the control group and the initial data. Lastly, the serum level of a protein called "high sensitive C-reactive protein," known to be a general marker of inflammation within the body, was found to be reduced in the combined diet group. However, changes in the serum total antioxidant capacity were found to be statistically insignificant across both groups.
Acupoint application has been proven to be a safe and effective method for the treatment of ulcerative colitis.
2023 Medicine Efficacy and safety of acupoint application in the treatment of ulcerative colitis: A systematic review and meta-analysis Tong Y, Yu Y, Yin S, Lin S, Chen Y, Su X
Meta-Analysis Ulcerative Colitis
The methodology incorporated a systematic review of various databases including China National Knowledge Infrastructure, Chinese Biology Medicine, VIP, Wanfang, Embase, PubMed, the Cochrane Library and Web of Science up to July 2022 to find published randomized controlled trials on the use of acupoint application in treating ulcerative colitis. Meta-analysis and trial sequential analysis were then performed on the selected studies.
The results from the 13 analyzed trials involving a total of 878 cases revealed that the use of acupoint application improved the rates of effective clinical comprehensive and syndrome in ulcerative colitis treatment compared to conventional western medicine. The method also showed advantages in increasing interleukin-4 and reducing interferon-gamma. Also noted was that there were no variances seen regarding colonoscopy, pathological examination, and reaction rates when compared with traditional methods. The quality of the evidence used for these conclusions varied, with some being of moderate quality and others deemed low or very low quality.
Traditional Chinese medicine has been found to effectively treat ulcerative colitis by repairing various components of the damaged intestinal mucosal barrier.
2023 Frontiers in Pharmacology Repairing the intestinal mucosal barrier of traditional Chinese medicine for ulcerative colitis: a review Zong Y, Meng J, Mao T, Han Q, Zhang P, Shi L
Theoretical Article Ulcerative Colitis
In the methodology, the study sought to uncover the efficacy of Traditional Chinese medicine (TCM) in treating ulcerative colitis (UC). The research began by acknowledging the key role that damage to the intestinal mucosal barrier plays in the development of UC. It then explored how TCM could combat UC by protecting and repairing various aspects of this barrier including the physical, chemical, immune, and biological barrier.
In the results discussion, it was discovered that TCM not only increases the number of intestinal epithelial cells, tight junction proteins, and mucins, but also encourages the proliferation of intestinal stem cells, restores the abundance of the intestinal microbiota, and modulates immunity in the gut. Moreover, the study identified several upstream proteins and signaling pathways that were activated in the process. This gives hope to future treatment plans for UC using TCM, with the study providing a fundamental theoretical basis and new ideas for future investigations.
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