Skip to main content
SpringerLink
Log in

Clinical presentation and treatment strategies for ulcerative colitis: A retrospective study of 247 inpatients

  • Original Article
  • Published:
Chinese Journal of Integrative Medicine Aims and scope Submit manuscript

Abstract

Objective

Complementary and alternative medicine, particularly herbal therapy, is widely used by patients with ulcerative colitis (UC), but controlled data are limited. To describe the clinical presentation and treatment strategies for UC in inpatients from Shanghai, China and to improve the therapeutic outcomes for patients with UC.

Methods

Medical records from 247 patients with UC who were admitted to Longhua Hospital Affifiliated to Shanghai University of Traditional Chinese Medicine between January 2008 and June 2013 were analyzed for gender, age, course of the disease, clinical type, extent and severity of the disease, treatment strategies, and therapeutic outcomes.

Results

Gender ratios and disease onset of inpatients with UC in the Shanghai area were consistent with other reports in the literature. In contrast to previous studies, most patients exhibited disease of the left colon, over half of the patients had problems of the rectum or sigmoid colon, and most patients had either mild or moderate UC. Comparison of Sutherland Disease Actirity Index scores for patients treated with Chinese medicine (CM) and those treated with integrated CM and Western medicine revealed signifificant reductions in scores for both groups after treatment (P<0.01), with no signifificant difference in therapeutic effects between groups (P=0.938).

Conclusions

Herbal medicine has been widely used in patients with mild to moderate disease and as adjunct therapy in patients with moderate to severe disease. Therefore, the strategy was proposed for the treatment of UC with CM therapy based on 2 steps according to the stage of the disease, even in the clinical setting.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Dai YC, Tang ZP, Ma GT, Gong YP, Liu W, Zhang YL. A review of Qingchang Shuan for treatment of ulcerative colitis. J Tradit Chin Med 2010;30:237–240.

    Article  PubMed  Google Scholar 

  2. Jiang XL, Cui HF. An analysis of 10,218 ulcerative colitis cases in China. World J Gastroenterol 2002;8:158–161.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Inflammatory Bowel Disease Cooperation Group of China. A retrospective study of 3100 inpatients with ulcerative colitis in China. Chin J Dig (Chin) 2006;26:368–372.

    Google Scholar 

  4. Wang Y, Ouyang Q; APDW 2004 Chinese IBD Working Group. Ulcerative colitis in China: retrospective analysis of 3100 hospitalized patients. J Gastroenterol Hepatol 2007;22:1450–1455.

    Article  PubMed  Google Scholar 

  5. Meier J, Sturm A. Current treatment of ulcerative colitis. World J Gastroenterol 2011;17:3204–3212.

    PubMed  PubMed Central  Google Scholar 

  6. Yadav PK, Liu Z. Current strategies for the treatment of ulcerative colitis. Recent Pat Inflamm Allergy Drug Discov 2009;3:65–72.

    Article  CAS  PubMed  Google Scholar 

  7. American College of Gastroenterology, Practice Parameters Committee. Ulcerative colitis practice guidelines in adults. Am J Gastroenterol 2010;105:501–523.

    Article  Google Scholar 

  8. Bitton A, Buie D, Enns R, Feagan BG, Jones JL, Marshall JK, et al; Canadian Association of Gastroenterology Severe Ulcerative Colitis Consensus Group. Treatment of hospitalized adult patients with severe ulcerative colitis: Toronto consensus statements. Am J Gastroenterol 2012;107:179–194.

    Article  CAS  PubMed  Google Scholar 

  9. Ke F, Yadav PK, Ju LZ. Herbal medicine in the treatment of ulcerative colitis. Saudi J Gastroenterol 2012;18:3–10.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Sandborn WJ, Targan SR, Byers VS, Rutty DA, Mu H, Zhang X, et al. Andrographis paniculata extract (HMPL-004) for active ulcerative colitis. Am J Gastroenterol 2013;108:90–98.

    Article  PubMed  Google Scholar 

  11. Gong YP, Liu W, Ma GT, Hu HY, Xie JQ, Tang ZP, et al. Random control test of Qingchang Shuan for treatment of ulcerative colitis. J Shanghai Univ Tradit Chin Med (Chin) 2007;21:33–36.

    Google Scholar 

  12. Branch of Inflammatory Bowel Disease, Digestive Disease of Chinese Medical Association. Understanding the consensus on diagnosis and management of inflammatory bowel disease (Guangzhou, 2012). Chin J Intern Med (Chin) 2012;51:818–831.

    Google Scholar 

  13. Stange EF, Travis SP, Vermeire S, Reinisch W, Geboes K, Barakauskiene A, et al; European Crohn’s and Colitis Organisation (ECCO). European evidence-based consensus on the diagnosis and management of ulcerative colitis: Definitions and diagnosis. J Crohns Colitis 2008;2:1–23.

    Article  CAS  PubMed  Google Scholar 

  14. Satsangi J, Silverberg MS, Vermeire S, Colombel JF. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut 2006;55:749–753.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Truelove SC, Witts LJ. Cortisone in ulcerative colitis: final report on a therapeutic trial. Br Med J 1955;29:1041–1048.

    Article  Google Scholar 

  16. Branch of Gastroiaatestinal Diseases, China Association of Chinese Medicine. Consensus on Chinese medical diagnosis and treatment of ulcerative colitis (2009). Chin J Intern Med (Chin) 2010;30:527–532.

    Google Scholar 

  17. Cooperative Group of Inflammatory Bowel Diseases of Digestive Disease of Chinese Medical Association. Chinese consensus on standard management of inflammatory bowel diseases (2007, Jinan). Chin J Dig (Chin) 2007;27:545–550.

    Google Scholar 

  18. D’Haens G, Sandborn WJ, Feagan BG, Geboes K, Hanauer SB, Irvine EJ, et al. A review of activity indices and efficacy end points for clinical trials of medical therapy in adults with ulcerative colitis. Gastroenterology 2007;132:763–786.

    Article  PubMed  Google Scholar 

  19. Martínez-Salmeron JF, Rodrigo M, de Teresa J, Nogueras F, García-Montero M, deSola C, et al. Epidemiology of inflammatory bowel disease in the Province of Granada, Spain: a retrospective study from 1979 to 1988. Gut 1993;34:1207–1209.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Mayberry JF. Some aspects of the epidemiology of ulcerative colitis. Gut 1985;26:968–974.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Zhao J, Ng SC, Lei Y, Yi F, Li J, Yu J, et al. First prospective, population-based inflammatory bowel disease incidence study in mainland of China: the emergence of “Western” disease. Inflamm Bowel Dis 2013;19:1839–1845.

    PubMed  Google Scholar 

  22. Scribano ML. Adverse events of IBD therapies. Inflamm Bowel Dis 2008;14:210–211.

    Article  Google Scholar 

  23. Jelsness-Jørgensen LP, Bernklev T, Henriksen M, Torp R, Moum B. Chronic fatigue is associated with increased disease-related worries and concerns in inflammatory bowel disease. World J Gastroenterol 2012;18:445–452.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Liu FB, Li XY. Research of the quality of life of patients with ulcerative colitis: current status and future prospects. World Chin J Gastroenterol (Chin) 2011;19:498–504.

    Google Scholar 

  25. Shaw SY, Blanchard JF, Bernstein CN. Association between the use of antibiotics and new diagnoses of Crohn’s disease and ulcerative colitis. Am J Gastroenterol 2011;106:2133–2142.

    Article  PubMed  Google Scholar 

  26. Lee KH, Choi CH. The effect of probiotics in ulcerative colitis. Kor J Gastroenterol 2012;60:67–70.

    Article  Google Scholar 

  27. Nagao J, Sumiyama Y. Severity and parenteral enteral nutrition for ulcerative colitis. Nihon Rinsho 2001;59:512–517.

    PubMed  Google Scholar 

  28. Travis S. How do you avoid and treat steroid side effects? Inflamm Bowel Dis 2008;14:214–215.

    Article  Google Scholar 

  29. Kaplan G, Panaccione R. Use of combination therapy in IBD. Inflamm Bowel Dis 2008;14:219–221.

    Article  Google Scholar 

  30. Digestive Disease, China Association of Traditional Chinese Medicine. Chinese consensus on standard management of ulcerative colitis. Chin J Intern Med (Chin) 2010;30:527–531.

    Google Scholar 

  31. Ng SC, Lam YT, Tsoi KK, Chan FK, Sung JJ, Wu JC. Systematic review: the efficacy of herbal therapy in inflammatory bowel disease. Aliment Pharmacol Ther 2013;38:854–863.

    Article  CAS  PubMed  Google Scholar 

  32. Tong ZQ, Yang B, Chen BY, Zhao ML. A multi-center, randomized, single-blind, controlled clinical study on the efficacy of composite sophora colon-soluble capsules in treating ulcerative colitis. Chin J Integr Med 2010;16:486–492.

    Article  CAS  PubMed  Google Scholar 

  33. Hao WW, Wen HZ, Li J, Tang ZP. Influence of Indirubin on Foxp3 express of CD4CD25 regular T cells in ulcerative colitis mice. J Shanghai Tradit Chin Med (Chin) 2011;45:82–84.

    Google Scholar 

  34. Zhu SM, Hao WW, Tang ZP, He XY, Wen HZ. Effect of indirubin on cytokines in colonic mucosa of DSS induced colitis in mice. Chin J Integr Tradit West Med Dig (Chin) 2011;19:370–372.

    CAS  Google Scholar 

  35. Hu HY, Ma GT, Zhu LY, Tang ZP, Gong YP, Lu X, et al. Effects of Sanqi, Qingdai and Machixian on expression of NF-kB in colon lesion of ulcerative colitis rats. J Shanghai Univ Tradit Chin Med (Chin) 2007;21:44–48.

    Google Scholar 

  36. Hu HY, Ma GT, Zhu LY, Tang ZP, Gong YP, Lu X, et al. Effects of Radix Notoginseng, Indigo Natur alis, Herba Portuacae on Fas/FasL expression in lesions of ulcerative colitis. J Shanghai Univ Tradit Chin Med (Chin) 2006;20:64–66.

    Google Scholar 

  37. Li XZ, Tang ZP, Hao WW, Xie JQ, Ma GT, Gong YP, et al. Effect of Jianpi Qingchang Formula combined with Qingchang suppository on quality of life of ulcerative colitis patients with traditional Chinese medicine type of Spleendeficiency and retention of damp-heat. Chin J Integr Trad West Med Dig (Chin) 2013;21:512–516.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Gastroenterology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Institute of Digestive Disease Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China

    Yan-cheng Dai  (戴彦成), Ya-li Zhang  (张亚利), Li-juan Wang  (王立娟), Qian Guo  (郭 倩), Kun Yang  (杨 坤), Ren-hao Ye  (叶任昊) & Zhi-peng Tang  (唐志鹏)

Authors
  1. Yan-cheng Dai  (戴彦成)
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ya-li Zhang  (张亚利)
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Li-juan Wang  (王立娟)
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Qian Guo  (郭 倩)
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kun Yang  (杨 坤)
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ren-hao Ye  (叶任昊)
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Zhi-peng Tang  (唐志鹏)
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zhi-peng Tang  (唐志鹏).

Additional information

Supported by the National Natural Science Foundation of China (No. 81403355), the Young Foundation of Shanghai Health and Family Planning Commission (No. 20034y170), and the New Star Project of Shanghai Health and Family Planning Commission (No. ZY3-RCPY-2-2001)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dai, Yc., Zhang, Yl., Wang, Lj. et al. Clinical presentation and treatment strategies for ulcerative colitis: A retrospective study of 247 inpatients. Chin. J. Integr. Med. 22, 811–816 (2016). https://doi.org/10.1007/s11655-015-2118-1

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11655-015-2118-1

Keywords

Search

Navigation