A systematic review of the efficacy of traditional Chinese medicine retention enema in the treatment of ulcerative colitis

The objective of this study is to summarize the efficacy and safety of traditional Chinese medicine(TCM)enema in the treatment of ulcerative colitis(UC).The randomized controlled trials on TCM enema intervention in the treatment of UC were searched in seven databases:PubMed,Embase,Web of Science,CBM,CNKI,Wanfang Database,and VIP Database from January 1,2013 to June 6,2022,and the data were analyzed using RevMan 5.3 software.A total of 18 studies involving 1514 UC patients were included.Meta analysis results showed that compared with conventional Western medicine,Chinese medicine enema had a significant effect on UC,and the clinical effective rate of the experimental group using Chinese medicine enema was 4.45 times that of the control group using conventional Western medicine(odds ratio=4.45,95%confidence interval[3.27,6.06]).Therefore,Chinese medicine enema is effective in the treatment of UC,and can significantly reduce related symptoms.

Clinical Study on the Retention Enema with Modified Dahuang Mudan Decoction in Treating Lower-Jiao Obstruction Syndrome Caused by Severe Pneumonia Complicated with Heart Failure

[Objectives]To treat patients with Lower-Jiao Obstruction Syndrome caused by severe pneumonia complicated with heart failure using the retention enema with Modified Dahuang Mudan Decoction,and to observe the effect and safety of this treatment on inflammatory indicators,cardiac function,gastrointestinal function and multiple organ failure in patients with Lower-Jiao(lower energizer)Obstruction Syndrome caused by severe pneumonia complicated with heart failure.[Methods]54 patients with Lower-Jiao Obstruction Syndrome caused by severe pneumonia complicated with heart failure diagnosed in Nanchong Chinese Medicine Hospital from January 2020 to December 2021 were randomly divided into experimental group(n=27)and control group(n=27).The control group was given conventional treatment combined with 0.9%sodium chloride injection(100 mL)+glycerine enema(40 mL).The treatment group was treated with Modified Dahuang Mudan Decoction on the basis of conventional treatment for 7 d.The efficacy indicators and adverse events such as white blood count(WBC),C-reactive protein(CRP),procalcitonin(PCT),N-terminal pro-brain natriuretic peptide(NT-proBNP),Lausanne Intestinal Failure Estimation(LIFE)and multiple organ dysfunction score(MODS)were observed.[Results](i)There was no significant difference in WBC,PCT,CRP and NT-proBNP between the two groups before treatment.All indicators after treatment were significantly lower than those before treatment in both groups(P<0.05).The levels of WBC,PCT and CRP in the treatment group were lower than those in the control group after treatment(P<0.05),and there was no significant difference in NT-proBNP between the two groups after treatment(P>0.05),but the difference in NT-proBNP before and after treatment in the treatment group was higher than that in the control group.(ii)The LIFE of the two groups decreased significantly after treatment,and the improvement of LIFE of the treatment group was better than that of the control group(P<0.05).(iii)The MODS of the two groups decreased significantly after treatment(P<0.05),and the degree of decrease after treatment in the treatment group was higher than that in the control group(P<0.05).(iv)There was no significant difference in all-cause mortality between the two groups(P>0.05).(v)No serious adverse events were found in both groups during the treatment period.[Conclusions]The conventional treatment,combined with the retention enema with Modified Dahuang Mudan Decoction could further reduce the inflammatory indicators,improve cardiac function,improve intestinal function and organ function,and the safety was good.

A Meta-Analysis of Treating Radiation Proctitis by Retention Enema with Integrated Traditional Chinese and Western Medicine

Objective:To systematically and objectively evaluate clinical efficacy of retention enema with integrated traditional Chinese and western medicine on radiation proctitis(RP).Methods:CNKI,WANFANG,VIP,CMB and foreign language databases like Embase,Central and Medline were searched.Search dates were from establishment of the databases until May 2020.Randomized controlled trials(RCTs)of retention enema with integrated traditional Chinese and western medicine for RP were retrieved.Two system reviewers selected literature materials,extracted literature data,and evaluated the quality of the literatures.RevMan 5.3 software was used for data analysis.Results:A total of 12 studies were included,including 941 patients.Meta-analysis results showed:Clinical efficacy in the retention enema group with integrated traditional Chinese and western medicine was better than that in the simple western medicine enema or blank enema group(OR=5.96,95%CI[5.50,14.29],P<0.00001).Improvement of abdominal pain in the retention enema group with integrated traditional Chinese and western medicine was better than that in the control group(MD=-0.57,95%CI[-0.72,-0.42],P<0.00001).Treatment for hematochezia in the retention enema group with integrated traditional Chinese and western medicine was better than that in the control group(MD=-0.55,95%CI[-0.69,-0.42],P<0.00001).Improvement of diarrhea in the retention enema group with integrated traditional Chinese and western medicine was better than that in the control group(MD=-0.69,95%CI[-0.91,-0.48],P<0.00001).KPS scores in the retention enema group with integrated traditional Chinese and western medicine were better than those in the control group(MD=11.91,95%CI[3.81,20.01],P<0.00001).Conclusion:Clinical efficacy of retention enema with integrated traditional Chinese and western medicine on RP is better than simple western medicine enema or blank enema.Due to the low quality of the included clinical literatures,it is necessary to carry out more deliberate,detailed,high-quality,randomized,double-blind,and multi-center RCTs in order to give more powerful demonstration on its clinical efficacy on RP.

Clinical Observation on the Treatment of Chronic Severe Hepatitis B by Retention Enema with Huchang Jiedu Decoction(护肠解毒汤)

Objective： To observe the efficacy of retention enema with Huchang Jiedu Decoction （护肠解毒汤, HJD） in treating chronic severe hepatitis B （CSHB）. Methods： Sixty patients of CSHB were equally randomized into the treated group and the control group. Both groups were treated with conventional integrative medicine, but to patients in the treated group, retention enema with HJD was given in addition, once every day for 3 weeks. The dominant symptoms, physical signs, and related biochemical indices, as well as the incidence of complications in patients before and after treatment, were observed. Results： Good therapeutic effects were shown in the treated group, with a total effective rate better than that in the control group （83.3% versus 60.0%, P〈0.05）, superior in terms of lowering alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, total bilirubin （TBil）, globulin （GIb）, and endotoxin （ET） levels and increasing prothrombin activity （PTA）, total cholesterol （TC）, and calcium （Ca） levels, as well as eliminating ascites and preventing hepatic encephalopathy （P〈0.05）; especially in treating middle/early stage patients with Chinese medicine syndrome differentiated as water-toxin accumulation pattern. Conclusion： Retention enema with HJD is surely effective in treating CSHB, and its primary mechanism may be related to the mitigation of enterogenous endotoxemia.

Clinical Study on Treatment of Hyperuricaemia by Retention Enema of Chinese Herbal Medicine Combined with Allopurinol

Objective:To study the effect of retention enema of Chinese herbal medicine combined with allopurinol in treating hyperuricaemia(HUE).Methods:Seventy-eight patients with HUE were assigned to two groups,the 40 patients in the treated group were treated with retention enema of Chinese herbal medicine combined with oral intake of allopurinol,and the 38 patients in the control group were treated with allopurinol alone. The therapeutic course for all was 6 weeks.The clinical efficacy,changes of symptoms,blood le...

Treatment of Inflammatory Bowel Disease with Chinese Drugs Administered by Both Oral Intake and Retention Enema

Objective：To study the clinical effect of Chinese drugs administered by both oral intake and retention enema on inflammatory bowel diseases（IBD）.Methods：Adopting a randomized controlled design,78 patients were assigned to three groups：26 patients in group A treated with Chinese drugs given by both oral intake and retention enema,27 in group B with Chinese drugs given by retention enema only,and 25 in group C with given Western medicine.The changes before and after a 30-day treatment of the patients＇ symptoms （including diarrhea,abdominal pain,mucous or pus-bloody stool）,colonoscopic examination scores and histopathology of the colonic membrane were observed.Results：Group A showed the best outcomes in all the aspects of clinical comprehensive effectiveness.Improvements in the main symptoms,colonoscopic scores and histopathology of the colonic membrane were significantly different from those in groups B and C,respectively （P〈0.05）.Meanwhile comparisons between groups B and C showed insignificant differences（P〉0.05）; group B was better in ameliorating tenesmus（P〈0.05）.Conclusion：Through the use of Chinese drugs administered by both oral intake and retention enema to treat IBD,which combined external-internal therapies for both overall regulation and local managment,it was confirmed that the Chinese medicine could embody the therapeutic principle of attending to both disease-diagnosis and syndrome-differentiation.

Clinical and Experimental Study on Treatment of Infantile Autumn Diarrhea by Retention Enema with Qilian Liquid (芪连液)

Objective:To find out the effective treatment for infantile autumn diarrhea(IAD).Methods:Retention enema with Qilian Liquid(QLL) was applied to 106 patients of IAD with positive antigen of rotavirus in stool,and the result in the treated group was compared with that in the control group(82 patients) in aspects of clinical effect, negative conversion rate of rotavirus in stool and change of serum immunoglobulin. Animal experimental study was also conducted.Results:The disappearance time of principal symptoms, negative conversion rate of rotavirus in stool and serum levels of IgA and IgG in the treated group were significantly better than those in the control group (P<0.01, P< 0.05). Experimental study showed that QLL not only has the anti-viral effects to stop diarrhea, but also has effects in enhancing immune function and protecting intestinal mucous membrane. Conclusion:Retention enema with QLL is an effective therapy for the treatment of IAD.

Administration of modified Gegen Qinlian decoction for hemorrhagic chronic radiation proctitis: A case report and review of literature

BACKGROUND Hemorrhagic chronic radiation proctitis(CRP) is a common late complication of irradiation of the pelvis and seriously impairs life quality. There is no standard treatment for hemorrhagic CRP. Medical treatment, interventional treatment, and surgery are available, but they are limited in their applications due to nondefinite efficacy or side effects. Chinese herbal medicine(CHM), as a complementary or alternative therapy, may provide another option for hemorrhagic CRP treatment.CASE SUMMARY A 51-year-old woman with cervical cancer received intensity-modulated radiation therapy and brachytherapy with a total dose of 93 Gy fifteen days after hysterectomy and bilateral adnexectomy. She received six additional cycles of chemotherapy with carboplatin and paclitaxel. Nine months after radiotherapy treatment, she mainly complained of 5-6 times diarrhea daily and bloody purulent stools for over 10 d. After colonoscopy examinations, she was diagnosed with hemorrhagic CRP with a giant ulcer. After assessment, she received CHM treatment. The specific regimen was 150 mL of modified Gegen Qinlian decoction(GQD) used as a retention enema for 1 mo, followed by replacement with oral administration of 150 mL of modified GQD three times per day for 5 mo. After the whole treatment, her diarrhea reduced to 1-2 times a day. Her rectal tenesmus and mild pain in lower abdomen disappeared. Both colonoscopy and magnetic resonance imaging confirmed its significant improvement. During treatment,there were no side effects, such as liver and renal function damage.CONCLUSION Modified GQD may be another effective and safe option for hemorrhagic CRP patients with giant ulcers.