Cute little bird Kui Jie Qing in the Treatment of IBS and Chronic Non-Specific Ulcerative Colitis

Appearing originally in The Journal of Traditional Chinese Medicine

by Wang Bihui
Sino-Japanese Friendship Hospital, Beijing 100029

Ren Shunping
Affiliated Hospital, Shanxi College of Traditional Chinese Medicine

Feng Wujin, Zhao Zhizhong
Shanxi Provincial Institute of Chinese Medicine

Qin Changlin
Affiliated Hospital of the Handan Steel General Factory, Hebei Province


Chronic non-specific ulcerative colitis (CNUC) is an idiopathic inflammatory disease of the intestine. Rather satisfactory results have been achieved in recent years in treating CNUC with a Chinese medicine known as KUI JIE QING (KJQ). The results are thus reported as follows.

Clinical Data

95 cases were treated with the Chinese medicine KJQ (called the therapeutic group), having been accurately diagnosed according to Clinical Diagnostic Criteria Regarding Ulcerative Colitis formulated at an academic meeting on diseases of the digestive system held in 1978. Of these, Sixty-five of the patients were male and 30 female. The oldest was 70 years of age and the youngest 18, with an average of 34 years. The longest course of disease was 39 years, the shortest one month, for an average of 5.6 years. Another 11 patients selected according to the diagnostic criteria mentioned above received Western medicine and were under controlled observation (called the control group). Eight of these patients were male and 3 female. Age range was from 20 to 60 years, for an average of 35.5 years. The longest course of disease was 15 years and the shortest 8 months, for an average of 5.8 years.

Therapeutic Methods

The patients in the therapeutic group received KJQ enema for therapy. KJQ had been prepared into a powder by mixing alum, Halloysite, Calmine, Indigo Naturalis and plum-blossom tongue- pointing pills. The dosage of KJQ powder was 8 grams, into which 60 to 80 ml of warm boiled water was added to make a smooth paste, the temperature of which was maintained at 36 to 40¡C. KJQ was used as a routine enema q.d. The patient having had the enema maintained a knee-chest position for half an hour. The use of other drugs was stopped during the treatment. Each patient in the control group received 1.5 g of Salicylazosulfapyridine and 10 mg of hydroprednisone orally t.i.d. To this was added q.d. a retention enema containing 100 mg of succinic acid hydrocortisone with water added to 60-100 ml. The course of therapy for both groups was 20 days. In severe cases 2 to 3 courses were administered with an interval of 5 to 7 days between courses. The last therapy was followed by a colonoscopy.

Therapeutic Results

  1. The criteria for curative effect fall into three categories; i.e., basically cured, improved, and failed.

    "Basically cured" means the disappearance of clinical symptoms with normal findings in colonoscopy and fecal routine exam. "Improved" means a relief from clinical symptoms, improvement in fecal routine exam, and less pathological changes in intestinal mucosa. "Failure" means no definite improvement in clinical symptoms, fecal exam or colonoscopy.

  2. Cure rate: There were 68 basically cured cases in the therapeutic group, 22 cases improved, and five failures. The Short-term basically cured rate was 71.6%, and total effective rate 94.7%. The average therapeutic course lasted 36 days. There was only one basically cured case in the control group, 6 cases improved and 4 failures. The Short-term basically cured rate was only 9.1%, and the total effective rate was 63.6%. The average therapeutic course lasted 68 days. The short-term basically cured rate for the therapeutic group appears very optimistic, being higher than in the controls (P<0.001). As analysed by the relationship between the types of pathological differentiation and the curative effect in the therapeutic group, most of the cases in the therapeutic group with best curative effect fall into the type of deficiency of vital energy in spleen with damp-heat. Other types with good curative effect have been observed as well. 59 of the short-term recent basically cured cases in the therapeutic group have been followed up. Of these, 18 cases were given a period of follow-up within one year, 30 cases a period between one and 3 years, and another 11 cases between 3 and 5 years. Results showed relapses in 4 cases, making a relapse rate of 6.8%
.

During the first KJQ enema dull pain of transient duration was felt in the abdomen in some cases. It was not usually necessary to halt the treatment in these cases, while an enema temperature not lower than 36¡C (approximately body temperature) was better tolerated.

Discussion

Ulcerative colitis belongs to the scope of Diarrhea and Dysentery as viewed in traditional Chinese medicine, the site of disease being the spleen, stomach and large intestine. The disease is mainly characterized by moisture (or "dampness," as it is sometimes called). It usually results either from weakness of stomach and spleen, or from dietary indiscretion, at times from melancholy and anger. These lead to injury to the stomach and spleen, causing the liver wood to overcome its earth, and the moisture and heat thus gradually generated to dwell within the gut. There the circulation stagnates, bringing about necrosis of muscle and resulting in bleeding and pus formation. Since the course of disease is generally long, such pathological conditions as inner deficiency with outer solidity and alternation of cold and fever occur frequently.

KJQ is composed of various Chinese herbs for topical use. Of these, alum (Ming Fan), being acid and astringent, is cold in nature and puckers the intestinal mucosa, thus stopping bleeding and diarrhea. Halloysite (Chi Shi Zhi) also brings about hemostasis and checks diarrhea. It is effective in promoting muscle regeneration, and made into powder and applied topically, may heal old ulceration. Calamine, (Lu Gan Shi) being astringent, is effective in dispersing toxins and puckering ulceration to enhance absorption of ulcerative secretions and thus promote healing of the ulcer. Plum-blossom tongue-pointing pills dissipate heat and disperse toxins as well as reducing swelling and pain. Experiments have shown that the pills can strengthen immunological function of the body. Topical application of Indigo Naturelis dissipates heat and disperses toxins aside from absorbing moisture, puckering ulcer and effecting hemostasis. The ingredients of KJQ supplement each other in dissipating heat and dispersing toxins, collecting moisture to stop diarrhea, invigorating blood circulation and removing necrotic tissue to promote the growth of new. The final goal is clearing moisture and heat from the colon so that hemostasis may be effected with healing of ulcerations. The exact mechanism of this process, however, awaits further investigation.

In recent years, investigation of the route of drug administration for the treatment of ulcerative colitis has shown retention enema to be clinically a routine means. This method was used in the present experiment. Local application of KJQ brings it in direct contact with the lesion, thus avoiding action by the digestive juices and enzymes on KJQ and prolonging the duration of drug action. Clinical treatment indicates that KJQ has a high total rate of effectiveness, good remote curative effect, low relapse rate, simple application, and little side effect.

In those pathological models of ulcerative colitis reproduced in rats by auto-immunological means, observation on the therapeutic group using KJQ indicated obvious shrinkage in the area of infiltration by ulcerative lesion and thickening of peripheral granulomatous tissue. These changes show definite difference from those of the control group with physiological saline (P<0.01). KJQ is thus thought to promote ulcer healing and relieve chronic inflammation of intestinal mucosa. The underlying mechanism may be related to the modulation and strengthening of the immunological function of the body.


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