Effect of Jianpi Huazhi Decoction as an Adjunct to Western Medicine in the Treatment of Ulcerative Colitis and Its Impact on Intestinal Flora,and Serum Levels of IL-23,IL-12,and TLR4

YANG Tingting; LI Chaochao; CAI Chuquan; SHI Xiaoling; XU Xianfeng; LI Yilan

doi:10.3969/j.issn.1002-3429.2025.12.017

Abstract：Objective To explore the clinical effect of Jianpi Huazhi decoction as an adjunct to Western medicine in the treatment of ulcerative colitis(UC)and its impact on intestinal flora,serum interleukin-23(IL-23),interleukin-12(IL-12),and Toll-like receptor 4(TLR4)levels.Methods A total of 171 UC patients admitted from May 2022 to May 2024 were selected and divided into the combination group,the Western medicine group,and the traditional Chinese medicine(TCM)group according to the random number table method,with 57 patients in each group.The Western medicine group was treated with Mesalazine enter-ic-coated tablets,the TCM group was treated with Jianpi Huazhi decoction,and the combination group was treated with Jianpi Huazhi decoction combined with Mesalazine enteric-coated tablets.All were treated for 2 months.The clinical effect,adverse reactions,TCM syndrome scores before and after treatment,colonoscopy score(Baron score),disease activity index(Mayo score),mucosal tissue score(Geboes index),intestinal mucosal barrier function,intestinal flora,and serum factor levels of the three groups were compared.Results The total effective rate of the combination group was[92.98%(53/57)],which was higher than that of the TCM group[77.19%(44/57)]and the Western medicine group[78.95%(45/57)],and the difference was statistically significant(P<0.05).After treatment,the scores of loose stools,mucus and bloody stools,fatigue,abdominal pain,anorexia,Baron score,Mayo score and Geboes index in the combination group were all lower than those in the TCM group and the Western medicine group(P<0.05).After treatment,the levels of serum endotoxin lipopolysaccharide,diamine oxidase and D-lactic acid as well as IL-23 and IL-12 in the combination group were all lower than those in the TCM group and the Western medicine group(P<0.05).After treatment,the numbers of Enterobacterium and Enterococcus in the combination group were lower than those in the TCM group and the Western medicine group,while the numbers of Bifidobacterium and Lactobacillus were higher than those in the TCM group and the Western medicine group(P<0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion Jianpi Huazhi decoction as an adjuvant to Western medicine in the treatment of UC patients can improve the clinical effect and has certain safety.