Case Report
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World J Gastroenterol. May 7, 2013; 19(17): 2718-2722
Published online May 7, 2013. doi: 10.3748/wjg.v19.i17.2718
Therapeutic efficacy of the Qing Dai in patients with intractable ulcerative colitis
Hideo Suzuki, Tsuyoshi Kaneko, Yuji Mizokami, Toshiaki Narasaka, Shinji Endo, Hirofumi Matsui, Akinori Yanaka, Aki Hirayama, Ichinosuke Hyodo
Hideo Suzuki, Tsuyoshi Kaneko, Yuji Mizokami, Toshiaki Narasaka, Shinji Endo, Hirofumi Matsui, Akinori Yanaka, Ichinosuke Hyodo, Department of Gastroenterology, Institute of Clinical Medicine, University of Tsukuba Graduate School, Ibaraki 305-8575, Japan
Aki Hirayama, Center of Integrative Medicine, Tsukuba University of Technology, Ibaraki 305-8521, Japan
Author contributions: Suzuki H designed the research and analyzed the data; Kaneko T performed the basic research; all other authors revised the draft and approved the final version for publication.
Correspondence to: Hideo Suzuki, MD, PhD, Department of Gastroenterology, Institute of Clinical Medicine, University of Tsukuba Graduate School, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan. hideoszk@md.tsukuba.ac.jp
Telephone: +81-29-8533218 Fax: +81-29-8533218
Received: December 29, 2012
Revised: January 28, 2013
Accepted: February 28, 2013
Published online: May 7, 2013
Abstract

Ulcerative colitis (UC) is a chronic inflammatory bowel disease that may become intractable when treated with conventional medications such as aminosalicylates, corticosteroids, and azathioprine. The herbal medicine Qing Dai has traditionally been used in Chinese medicine to treat UC patients, but there is a lack of published data on the efficacy of Qing Dai in UC treatment. We report several cases of patients with intractable UC who take Qing Dai in a retrospective observational study. Furthermore, we explore the mechanisms of action of Qing Dai. Nine patients with active UC who received conventional medications but wished to receive Qing Dai as an alternative medication were included in our analysis. The UC severity level was determined based on the clinical activity index (CAI). Additionally, 5 of the 9 patients were endoscopically evaluated according to the Matts grading system. Each patient received 2 g/d of Qing Dai orally and continued taking other medications for UC as prescribed. Electron spin resonance was applied to explore the mechanisms of action of Qing Dai. After 4 mo of treatment with Qing Dai, the CAI score decreased from 8.3 ± 2.4 to 2.4 ± 3.4 (mean ± SD; P < 0.001). Similarly, the endoscopic Matts grade decreased from 3.4 ± 0.5 to 2.2 ± 0.8 (P = 0.02). Six of 7 patients who were on prednisolone upon enrollment in the study were able to discontinue this corticosteroid. Electron spin resonance revealed that Qing Dai possesses strong hydroxyl radical scavenging activity. Qing Dai showed significant clinical and endoscopic efficacy in patients who failed to respond to conventional medications. Scavenging of hydroxyl radicals appears to be a potential mechanism through which Qing Dai acts, but the significance of the scavenging ability of Qing Dai with respect to the anti-inflammatory effect in UC patients warrants further investigation.

Keywords: Qing Dai, Herbal medicine, Ulcerative colitis, Hydroxyl radical, Electron spin resonance

Core tip: Nine intractable ulcerative colitis patients using the herbal medicine Qing Dai were observed in a retrospective observational study. After 4 mo of treatment, clinical activity and endoscopic findings improved dramatically in most patients. Electron spin resonance revealed that Qing Dai has a strong radical scavenging effect.