To evaluate the clinical efficacy of mesalazine combined with Chinese herbal compound enema in the treatment of ulcerative colitis, we searched CNKI, Wangfang, VIP, CBM, The Cochrane Libarary, Pubmed, Web of Science and EMBase databases. Randomized controlled trials (RCTS) about mesalazine combined with TCM compound enema for ulcerative colitis were randomized controlled trials (RCTS), all randomized controlled trials were conducted from database establishment to August 2022, in which control group received mesalazine treatment, and treatment group received TCM reenema on the basis of control group. The "risk bias assessment" tool provided by the Cochrane Reviewer's Handbook was used for literature quality assessment, and RevMan5.3 software was used for statistical analysis. Eleven literatures were finally included, all of which were randomized controlled trials with a total of 1029 patients. The results of meta-analysis showed that the clinical effective rate of the treatment group [RR=4.26, 95%CI (2.79,6.50), P<0.00001] was higher than that of the control group. It can effectively reduce Baron score [MD=-0.98, 95%CI (-1.25, -0.71), P<0.00001], DAI score [MD=-1.61, 95%CI (-1.81, -1.42), P<0.00001], CRP value [MD=-6.61, 95%CI (-7.29. 56,-5.93), P<0.00001], the treatment group was more effective than the control group in relieving clinical symptoms, including abdominal pain [MD=-1.03, 95%CI (-1.99, -0.07), P = 0.03), diarrhea (MD = 0.86, 95% CI (1.46, 0.25), P = 0.006), and purulent blood [MD = 0.86, 95% CI (1.62, 0.09), P = 0.03). Funnel plot of clinical response rate showed obvious asymmetry between left and right, suggesting possible publication bias. Mesalazine combined with Chinese herbal compound enema has significant clinical efficacy in the treatment of ulcerative colitis, but the literature included is too few and the quality evaluation is not high, so it needs to be further confirmed by multiple books and high-quality RCT tests in the future.

Hua Li, Jiehong Wang. Meta Analysis of Mesalazine Combined with Chinese Herbal Compound Enema in the Treatment of Ulcerative Colitis. Academic Journal of Medicine & Health Sciences (2023) Vol. 4, Issue 6: 60-70. https://doi.org/10.25236/AJMHS.2023.040610.

[1] Sun Juan; Jiang Xiaojuan, et al. Mechanism of Shenling Baizhu Powder in alleviation of ulcerative colitis in mice based on high-throughput transcriptome sequencing[J/OL]. China Journal of Chinese Materia Medica: 1-10[2022-08-13]. 

[2] Ryan U, Saurabh M, Patrick B A, et al. Ulcerative colitis. Lancet, 2017, 389(10080): 1756-1770. 

[3] Ocansey D K W, Zhang L, Wang Y, et al. Exosome-mediated effects and applications in inflammatory bowel disease[J]. Biol Rev Camb Philos Soc, 2020, 95(5): 1287. 

[4] Wang Yadong, et al. Mechanism of butyl alcohol extract of Baitouweng Decoction on ulcerative colitis in mice colonized by Candida albicans based on NLRP3 inflammasome. Chinese Traditional and Herbal Drugs, 2022. 53(13): 3997-4006. 

[5] Miao Zhiwei et al., Efficacy and Safety of Danshen Injection in Adjuvant Treatment of Ulcerative Colitis: A Systematic Review [J]. Chinese Archives of TraditionalChinese Medicine, 2020. 38(01): 51-57. 

[6] Zhang Shengsheng, Shen Hong, Zheng Kai, Ye Bai. Expert Consensus on TCM Diagnosis and Treatment of Ulcerative Colitis (2017)[J]. China Journal of Traditional Chinese Medicine and Pharmacy, 2017, 32(08):3585-3589. 

[7] Liang Jie, Zhou Lin, Sha Sumei, Lei Shaoni, LUO Guanhong, WU Kaichun. Interpretation of the Consensus on Diagnosis and Management of Inflammatory Bowel Disease(Guangzhou,2012) from the Perspective of Diagnosis of Ulcerative Colitis [J]. Chinese Journal of Gastroenterology, 2012,17(12):712-720. 

[8] A. Dzeshka M S, Shahid F, Shantsila A, et al. Hypertension and atrial fibrillation: an intimate association of epidemiology, pathophysiology, and outcomes[J]. Am J Hypertens, 2017, 30 (8) : 733-755. 

[9] Li Xuejun et al. Clinical Observation of Piwei Peiyuan Enema in Treating Ulcerative Colitis of Deficiency of Spleen Qi[J]. Clinical Journal of Traditional Chinese Medicine, 2017. 29(1). 

[10] Ying Dong et al. Clinical Observation of Piwei Peiyuan Enema in Treating Ulcerative Colitis of Deficiency of Spleen Qi [J]. Guiding Journal of Traditional Chinese Medicine and Pharmacy, 2011. 17(07): 32-33. 

[11] Huo et al., Clinical Effect of Ziai Decoction Retention Enema Combined with Mesalazin Enteric-Coated Tablets Oral Treatment of Distal Colon Ulcerative Enteritis[J]. Chinese Archives of Traditional Chinese Medicine, 2018. 36(03): 748-750. 

[12] Zheng Xiaotao, Ulcerative Colitis Treated by Kuijie Decoction Enema Combined with Mesalazine for 48 Cases [J]. Chinese Medicine Modern Distance Education of China, 2014. 12(17):56-57. 

[13] Yang Lei et al., Effects of Qingbai Enema on Inflammatory Factors and Adhesion Factors in Patients with Active Ulcerative Colitis[J]. Journal of Emergency in Traditional Chinese Medicine, 2017. 26(7). 

[14] Huang J et al., A Multicenter Randomized Controlled Study of Qingbai Enema Decoction on Acute Ulcerative Colitis[J]. Journal of Emergency in Traditional Chinese Medicine, 2017. 26(11). 

[15] Liu Xuejin and Chen Ken, The clinical effect of Qingchang Yuyang decoction combined with mesalazinein treating ulcerative colitis[J]. Chinese Journal of Integrated Traditional and Western Medicine, 2017. 25(06): 413-415. 

[16] Xie Liusong and Wei Yi, Curative effect of integrated Chinese and Western medicine in the treatment of damp-heat type ulcerative colitis[J]. China Journal of Pharmaceutical Economics, 2015. 10(z2). 

[17] Fan Yufeng and Gu Yanhong, The effect of self-made Jiedu Liangxue decoction coloclysis in combination with Mesalazine for treatment of distal ulcerative colitis[J]. China Modern Doctor, 2015. 53(09): 111-115. 

[18] Ning Yufeng, Yang Cuilan and Cao Shenghai. Effect of Retention Enema of Yuchang Decoction Combined Mesalazine in Treating 60 Patients with Ulcerative Colitis[J]. Chinese Journal of Experimental Traditional Medical Formulae, 2015. 21(13):199-203. 

[19] Zhang Juan and Cao Zewei, The Effect of Qingchang Yuyang Decoction plus Mesalazine for Treatment of Ulcerative Colitis[J]. Chinese General Practice, 2012. 15(01): 90-92. 

[20] Wei W, XiaoLan S, Yang Y, et al. Effect of Weichang＇an Pill on TH17/Treg immune balance in mice with ulcerative colitis[J]. Gastroenterology, 2020, 158(6):S788—S789

[21] Zhang Yiqing; Guo Yu; Xu Aili; Liu Tao; Sun Xiaohong; Zhang Xiaohong; Wei Wei. Effects of TCM Wenshen Jianpi Decoction Enema in Controlling Recurrence of Colonic Polyps and Its Influence on Intestinal Flora[J]. Journal of Liaoning University of Traditional Chinese Medicine, 2018, 20(10): 176-178. 

[22] Wei Wei. Thinking and Practice of Multidisciplinary Joint Tackling of Major and Difficult Diseases [J]. Chinese Journal of Integrated Traditional and Western Medicine, 2021, 41(03):302-304. 

[23] Li Gege; Bai Guang; Jiao Zheng. Correlation between Traditional Chinese Medicine (TCM) Syndromes of Ulcerative Colitis and Enteroscope [J]. Chinese Archives of Traditional Chinese Medicine, 2022, 40(02):90-93+266. 

[24] Zhang Beiping, Liu Side, Li Mingsong, Huang Suiping. Research about Correlation between The Endoscope Classification, The Histological Grouping of Mucosa, and The TCM's Syndromes of Deficiency and Excess of Ulcerative Colitis[J]. Digestive Disease and Endoscopy, 2008(03):5-8. 

[25] Xu Daifu, Zheng Bo, Li Zhihong, Li Yonghua, Yang Dequan. Correlation Study of TCM Syndrome Types in Ulcerative Colitis and Colon Mirror Image[J]. Journal of Practical Traditional Chinese Medicine, 2013, 29(01):4-5. 

[26] Zhang Y B. Study on the relationship between TCM syndrome of active ulcerative colitis and mucosal image under colonoscopy[J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 2019, 28(01):89-92+106. 

[27] Liu Qiong; Cheng Zhe; Chen Guang. Review of Traditional Chinese Medicine Treatment of Ulcerative Colitis[J]. Chinese Journal of Basic Medicine in Traditional Chinese Medicine, 2021, 27(07): 1191-1194. 

[28] Zhao Hongbo, WU Xiaojing, Yang Yun, Ge Zhiming, Zhang Xing, Fan Xianxian. . Clinical Observation on Enteral Infusion of Modified Baitouweng Decoction Combined with Acupoint Catgut Embedding for 33 Cases of Ulcerative Colitis[J]. Journal of Traditional Chinese Medicine, 2012, 53(24): 2112-2114+2121. 

[29] Han Ying; Zhang Yan; Yang Dfang, Zhang Chunlei, Wang Xingmiao, Zhao Jing, Ji Shunxin. Clinical efficacy of Dongbin organ-nourishing decoction in ulcerative colitis patients regarding disease activity and serum inflammatory cytokines[J]. Journal of Clinical and Experimental Medicine, 2019, 18(09):936-939. 

[30] Zhu Leilei; Li Li; Gu Zhijian; Geng Qi; Cui Chen; Zhou Dan; Jiang Jian. Pattern analysis on prescriptions and medicines for oral administration and enema in treatment of ulcerative colitis with traditional Chinese medicine based on data mining[J]. Shanghai Journal of Traditional Chinese Medicine, 2019, 53(07):10-14. 

[31] Gan Jingang; Fan Hainan; Zhang Zhiqiang. Effects of chlorhexidine hydrochloride on intestinal flora and immune status in patients with ulcerative colitis[J]. Chinese Journal of Integrated Traditional and Western Medicine on Digestion, 2020, 28(12):949-953. 

[32] Cheng Fengjingming; Lyu Jian; Xie Yanming. Systematic review and Meta-analysis of efficacy and safety of Ganshuang Granules in treatment of liver injury[J/OL]. China Journal of Chinese Materia Medica: 1-20[2022-08-15]. 

[33] Schulz K F, Altman D G, Moher D, et al. CONSORT 2010 Statement:updated guidelines for reporting parallel group randomised trials[J]. BMC Med, 2010, 8:18.