How should ulcerative colitis be treated?

  The treatment of ulcers should be a combination of therapies: including rest; dietary regulation into less dregs diet; avoidance of dairy and allergic foods; heavy should be performed parenteral nutrition (TPN); correction of water-electrolyte disorders; protein supplementation; improvement of general condition; relief of psychiatric factors and symptomatic treatment.  1, the drug treatment of ulcerative nodules 1, salazosulfapyridine (SASP) class SASP treatment of ulcerative nodules for many years oral 4-6g/day 64%-77% of patients with good efficacy of the drug bitter taste after the relief of symptoms to 2g/day maintenance for at least 1 year 89% of patients can remain symptom-free SASP dosage when the efficacy of the increase in side effects SASP to the colon by the intestinal bacterial azo reductase cleavage to 5-aminosalicylic acid (5-aminosalicylic acid) The former is the effective part of the treatment, while the latter is the factor causing side effects. If only 5-ASA is taken, it is not effective because it is absorbed by the upper gastrointestinal tract and does not reach the colon in sufficient quantity. In recent years, many scholars have noticed that the side effects can be reduced by topical administration, such as the application of SASP or 5-ASA anal suppositories or enemas, which increase the concentration of the drug and maintain it for a longer period of time, thus improving the efficacy. 4-Aminosalicylic acid (4-ASA), also known as PAS, is an antituberculosis drug that is dissolved in 2 g in 100 ml of water and administered by enema once a day for 8 weeks, with an efficiency of 83%. The mechanism of 4-ASA in the treatment of ulcerated nodes is unknown. 3. Adrenocorticotropic hormone can reduce capillary permeability, stabilize cells and lysosomal membranes, regulate immune function, reduce the entry of macrophages and neutrophils into the inflammatory zone, block the formation of leukotrienes, prostaglandins, thromboxanes, etc., reduce the inflammatory response and cause rapid improvement in the clinical symptoms of ulcerated nodes. 40-60 mg/day of oral pine is usually given for active ulcerated nodes. In severe cases where oral treatment is not effective, intravenous hydrocortisone succinate 200-300mg/day or 100mg of hydrocortisone succinate in 100ml of liquid can be administered rectally, which is better than reserved enema. In recent years, some new corticosteroids such as Budesonide, Tixocorto pivalate, etc. have no systemic side effects and are more effective than other corticosteroids in the treatment of ulcers by enema. Fluticason Propionate is a fluorinated corticosteroid with low systemic bioavailability, which is not easily absorbed and mostly reaches the colon. It is administered orally at 5mg per dose 4 times a day for 4 weeks. When glucocorticoid treatment is not good or cannot tolerate its side effects, azathioprine, cyclophosphamide, 6-MP, etc. can be used; in recent years, methotrexate, cyclosporin-A (Cyclosporin-A) 10mg/kg, sometimes with good results, but these drugs have certain side effects and should be used with caution, and also reported the application of penicillamine, levamisole, interferon, 7S-γ globulin, etc., with certain efficacy. Fish oil is an inhibitor of leukotriene synthesis and can be used orally to treat mild to moderate active ulcers, resulting in clinical improvement. Disodium cromoglycate can stabilize mast cell membranes, prevent degranulation, inhibit the release of histamine, 5-hydroxytryptamine, slow-reacting substances and other mediators, and reduce damage to the intestinal wall from antigen-antibody reactions. 200mg/dose 3 times daily before meals; or 600mg as a reserved enema. ①Clonidine has the effect of inhibiting the release of renin and some neuromediators, and is effective for ulcers when taken orally 0,15-0,225mg/dose 3 times daily. In addition, free radical scavengers such as superoxide dismutase, 5-lipoxygenase inhibitor Zileuton (A-64077), ketotifen, etc. can reduce the symptoms of ulceration. In Chinese medicine, ulcerative stones should belong to the category of “diarrhea”, “intestine”, “resting dysentery”, etc. The treatment is based on the combination of Chinese medicine and Western medicine. The treatment should be guided by the “holistic concept” which is a combination of Chinese medicine and Western medicine. Therefore, the treatment should be both offensive and complementary, with the main treatment being to eliminate evil and at the same time to cultivate the soil and help the righteousness, to strengthen the spleen and stomach, and to relieve dampness and heat. The treatment of ulcers has been reported by adding and subtracting Radix et Rhizoma Ginseng and Atractylodes Macrocephalae with Lian Li Tang, or adding and subtracting Radix et Rhizoma Huo Pu Xia Ling Tang, or adding and subtracting Radix et Rhizoma Painful Diarrhea with Radix et Rhizoma Macrocephalae. The above two prescriptions are decocted with 50-100ml of water and left to cool. The enema is reserved once a night before bedtime, and a half month is a course of treatment. Surgery should be performed if internal treatment is ineffective or if there is cancer. Comparison of the efficacy and price of various drugs for the treatment of ulcers on the market: drugs for the treatment of ulcers are divided into: 5-aminosalicylates, corticosteroids (hormones), immunosuppressants.  Corticosteroids and immunosuppressants are not the first-line drugs of choice because of their long-term side effects. 5-aminosalicylates are always the first-line drugs for inflammatory bowel disease because of their high efficacy and few side effects.  The “Recommendations for the Diagnosis and Treatment of Inflammatory Bowel Disease” formulated by the Chinese Society of Gastroenterology in October 2000 standardized the diagnosis and treatment of IBD in clinical practice and put forward the principle of “graded, staged and segmented” treatment: for patients with mild or moderate active or remission IBD, amino salicylic acid is preferred. For patients with mild, moderately active or remission IBD, aminosalicylates are preferred.