The association between pulmonary function impairment and colon inflammation in ulcerative colitis patients: A scientific basis for exterior-interior correlation between lung and large intestine / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigated the involvement of pulmonary function impairment in ulcerative colitis (UC), to explore a scientific basis for the Chinese medicine (CM) theory of exterior-interior correlation between Lung (Fei) and Large intestine (Dachang).</p><p><b>METHODS</b>Totally 120 patients with a diagnosis of UC were recruited and the demographics, clinical data, and blood samples were collected. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) concentrations were measured. Every patient accepted pulmonary function test and took chest radiograph (CXR).> RESULTS: Pulmonary function abnormalities were present in 72 of 120 patients. The median (interquartile range) vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 s (FEV), carbon monoxide diffusion capacity (DL) of lung, total lung capacity (TLC) and functional residual volume (FRV) were decreased in distal UC and pancolitis compared with ulcerative prochitis (P <0.0005). Male patients had increased VC, FEV/FVC, and residual volume (RV)/TLC compared with female (P <0.0005), but decreased DLand carbon monoxide iffusion capacity (K) of lung/alveolar ventilation (P <0.0005). Age was strongly correlated with RV (Spearman rank correlation coefficient (rs)=-0.57,P <0.0001), and RV/TLC (rs=0.48,P<0.0001). Age was also correlated with FEV/FVC (rs=-0.29, P=0.001), forced expiratory flow in 75% vital capacity (FEF75%, rs=-0.20, P=0.03), DL(rs=-0.21, P=0.02), TLC (rs=-0.25, P=0.006), and FRV (rs=-0.28, P=0.002). The course of disease was correlated with FEF75% (rs=-0.18, P=0.049) and K(rs=-0.19, P=0.036). Chest radiograph abnormalities were presented in 38 of 120. Pulmonary symptoms were presented in 10 of 120. Other extraintestinal complications were presented in 21 of 120.</p><p><b>CONCLUSIONS</b>Pulmonary function impairment was more frequently than other extraintestinal complications in UC patients, which may be affected by sex, age, extent and course of disease. These results may be a scientific basis for the theory of exterior-interior correlation between Lung and Large intestine.</p>

Correlation between pulmonary function impairment and levels of alpha1-antitrypsin in serum and colon of ulcerative colitis patients: a clinical research / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the mechanism of pulmonary involvement in ulcerative colitis (UC) patients by observing the correlation between pulmonary functions and levels of alpha1-antitrypsin (A1AT) in serum and colon tissue in UC patients.</p><p><b>METHODS</b>Totally 90 patients with confirmed UC were assigned to different groups according to the extent of disease, the disease activity, the staging of severity, and course of disease. The serum level of A1AT in UC patients with different extent of disease, the disease activity, the staging of severity, and course of disease were compared. And 30 healthy volunteers were recruited as the control group. The serum renal and hepatic functions, pulmonary functions, and serum levels of A1AT were detected in the UC group and the control group. The correlation between A1AT and each pulmonary function index in UC patients was analyzed. The A1AT content in the colon tissue was detected with immunohistochemical assay in 20 UC patients as well as in 10 healthy volunteers.</p><p><b>RESULTS</b>Of the 90 UC patients, 54 patients were accompanied with pulmonary function abnormality (60.0%), and 24 with extraintestinal manifestations (26.7%). Compared with the control group, the serum level of A1AT was significantly lower in the UC group (P < 0.05). The serum level of A1AT was significantly higher in those with proctitis than in those with distal colonitis and pancolitis (P < 0.05). The serum level of A1AT was lower in patients with the course of disease 5 years and more than 5 years than in those with the course of disease less than 5 years (P < 0.05). Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1.0), total lung capacity (TLC), function residual volume (FRV), and the ratio of diffusion capacity for carbon monoxide of lung (DLCO) were much lower in those with proctitis than in those with distal colonitis and pancolitis (P < 0.05). The ratio of FVC was negatively linear correlated with the course of disease (r = -0.23, P = 0.018). There was a positive correlation between the serum level of A1AT and peak expiratory flow (PEF) (r = 0.22, P = 0.03). The level of A1AT in the colon tissue was obviously lower in the UC patients than in those of the control group (P < 0.05). Mild and moderate UC patients had increased levels of A1AT in the colon tissue, when compared with severe UC patients (P < 0.05). The level of A1AT in the colon tissue was higher in those with proctitis than in those with distal colonitis and pancolitis (P < 0.05).</p><p><b>CONCLUSIONS</b>The prevalence of pulmonary function impairment was higher than other extraintestinal manifestations in UC patients. The pulmonary function test was helpful to screen the pulmonary impairment of UC patients. The A1AT level in the serum and the colon tissue obviously decreased in UC patients, indicating the pulmonary function impairment of UC patients might manifest as decreased A1AT levels correlated chronic airway inflammation, remodeling of airway, and obstructive changes.</p>

Study on the correlation between Chinese medicine syndrome and the intestinal mucosal manifestations of 137 patients with active ulcerative colitis / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the distribution features of Chinese medicine syndrome (CMS) in 137 patients with active ulcerative colitis (AUC), and to analyze the correlation between the intestinal mucosal manifestations and CMS.</p><p><b>METHODS</b>Totally 137 AUC patients were syndrome typed. The intestinal mucosal manifestations were observed under endoscope, thus analyzing the correlation between the intestinal mucosal manifestations and CMS.</p><p><b>RESULTS</b>In the distribution of main syndromes, the case numbers were sequenced as the damp heat of Dachang syndrome > the yang deficiency of Pi-Shen syndrome > the Gan-depression and Pi-deficiency syndrome > the deficiency of Pi-qi syndrome > the blood stasis of the intestine meridian syndrome > the deficiency of blood and yin syndrome. The frequency of intestinal mucosal manifestations more than 50% covered mucosal damage, abnormal mucosa membrane color, congestion, edema, erosion, ulcer, pus tongue fur, and obscure or disappeared blood vessels. The edema, erosion, and ulcer occurred more in the damp-heat of Dachang syndrome, followed by the yang deficiency of Pi-Shen syndrome and the Gan-depression and Pi-deficiency syndrome (P < 0.05, P < 0.01). Polypi, abnormal enterokinesia, grainy occurred more in the damp-heat of Dachang syndrome and the Gan-depression and Pi-deficiency syndrome (P = 0.010). Shallower plica or disappeared sacculations of colon occurred more in the yang deficiency of Pi-Shen syndrome and the damp-heat of Dachang syndrome (P = 0.002). The mucosa bridge occurred more in the yang deficiency of Pi-Shen syndrome and Gan-depression and Pi-deficiency syndrome (P = 0.280). Fragility or contact bleeding occurred more in the damp-heat of Dachang syndrome, the deficiency of Pi-qi syndrome, and Gan-depression and Pi-deficiency syndrome (P = 0. 045). Pale blood of the intestinal hemorrhage occurred more in the deficiency of Pi-qi syndrome while dark blood occurred more in the damp-heat of Dachang syndrome (P = 0.017). Pus tongue fur occurred more in the damp-heat of Dachang syndrome, the yang deficiency of Pi-Shen syndrome, and the Gan-depression and Pi-deficiency syndrome. White pus tongue fur occurred more in the yang deficiency of Pi-Shen syndrome while yellow pus tongue fur occurred more in the damp-heat of Dachang syndrome (P < 0.001). Mucus occurred more in the yang deficiency of Pi-Shen syndrome, the Gan-depression and Pi-deficiency syndrome, and the deficiency of Pi-qi syndrome (P = 0.012). Narrow enteric cavity or intestinal canal fibrosis, lead pipe like manifestations occurred more in the blood stasis of the intestine meridian syndrome (P = 0.001). Atrophic mucosa occurred more in the blood stasis of the intestine meridian syndrome and the deficiency of blood and yin syndrome (P < 0.001).</p><p><b>CONCLUSIONS</b>The intestinal mucosal manifestations of AUC showed certain laws in CMS. The microscopic differences could verify macroscopic CMS to some extent.</p>

Study on the correlation between the pulmonary injury and the ET-1 serum level in ulcerative colitis patients / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the correlation between the pulmonary injury and the ET-1 serum level in ulcerative colitis (UC) patients, and to study the mechanism for UC induced pulmonary injury.</p><p><b>METHODS</b>Recruited were 90 UC outpatients from the clinics of Gastroenterology Department, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine from Nov. 2009 to Mar. 2011. The course of disease, disease range, serum ET-1 level of UC patients were observed and compared. The correlation between the serum ET-1 level and each pulmonary function index were studied [including vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, peak expiratory flow (PEF), maximal mid expiratory flow (MMEF), maximal expiratory flow in 25%, 50%, 75% vital capacity (FEF25%, 50%, 75%), diffusion capacity for carbon monoxide of lung (DLCO), diffusion constant (KCO), total lung capacity (TLC), alveolar ventilation (VA), residual volume (RV), function residual volume (FRV), and RV/TLC]. Besides, another 30 healthy volunteers were enrolled as the control group. The pulmonary symptoms, chest X-ray, the lung function, the serum ET-1 level, and liver and kidney functions [including alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), serum creatinine (SCr) were compared between the UC group and the control group.</p><p><b>RESULTS</b>Ten UC patients were accompanied with cough and chest distress (accounting for 11.1%), 25 with abnormal chest films (accounting for 27.8%), and 54 with pulmonary function abnormality (accounting for 60.0%). In the UC group ALT increased in 2 cases (2.2%) and AST increased in 2. They were normal in the control group. The BUN and SCr were normal in the two groups. Compared with the control group, the serum ET-1 level in the UC group was significantly higher than that in the control group (P < 0.05). There was no statistical difference in the serum ET-1 level (P > 0.05). There was statistical difference in the serum ET-1 level in the UC group between those with the disease course > or = 5 years and those with the disease course <5 years, showing statistical difference (P < 0.05). There was negative correlation between the serum ET-1 level and FEF25% and between the serum ET-1 level and KCO (P < 0.05).</p><p><b>CONCLUSIONS</b>Serum ET-1 level could reflect the pulmonary injury of UC patients earlier. Serum ET-1 level might be a sensitive indicator reflecting the pulmonary injury of UC. The pulmonary injury of UC patients might be correlated with small airway obstruction, reduced lung elasticity, and injured lung diffusion.</p>

The interior-exterior correlation between fei and dachang from the lung function injury in ulcerative colitis patients / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the probability of the lung injury and the features of the lung function injury in ulcerative colitis patients, and to preliminarily study the correlation with its severity, and further to analyze the interior-exterior correlation between Fei and Dachang.</p><p><b>METHODS</b>Seventy patients with UC were assigned to the mild group and the moderate-severe group by the severity, 35 cases in each group. Another thirty healthy subjects were recruited as the control group. Relative indices of the lung function in each group were observed and compared.</p><p><b>RESULTS</b>The lung injury occurred in 67. 14% of the UC patients (47 cases). Forced expiratory volume at 1st s/forced volume capacity (FEV1/FVC), maximal expiratory flow in 75% vital capacity (FEF75), total lung capacity (TLC), diffusion capacity for carbon monoxide of lung (DLCO), and diffusion capacity for carbon monoxide of lung/alveolar ventilation (DLCO/VA) were lower compared with those of the control group, showing statistical significance (P < 0.05). The ratio of residual volume/total lung capacity (RV/TLC) was lower in the mild group than in the moderate-severe group (P < 0.01). The DLCO was higher in the mild group than in the moderate-severe group (P < 0.05).</p><p><b>CONCLUSIONS</b>Most UC patients were complicated with the lung function injury, mainly featured as middle and small airway obstruction and decreasing diffusing capacity. Besides, along with the aggravation of the disease, the decreasing diffusing capacity and increasing RV/TLC occurred. They provided objective reliance for Fei and Dachang interior-exteriorly correlated.</p>