AIM: To study the different therapy for different types ofulcerative colitis (UC) in China.METHODS: Among 102 UC patients,42 chronic relapsetype UC patients were randomly divided into olsalazinesodium treatment group (n=21) and SASP group (n=21).Clinical effects and safety were observed in the 2 groups.Forty-two first episode type UC patients were randomlydivided into Heartleaf houttuynia herb treatment group(n=21) and SASP group (n=21).Clinical effects wereobserved in the 2 groups while ultrastructure of colonicmucosa,ICAM-1 and the pressure of distant colon werestudied in Heartleaf houttuynia herb group.Eighteenpatients (8 males,10 females) with refractory UC andunresponsive to high-dose prednisolone and sulfasalazinetherapy more than one month were treated withKangshuanling (7 200 U/d).Prednisolone was graduallystopped and sulfasalazine was maintained.Stool frequency,rectal bleeding,colonoscopy,general well-being,histologywere observed and CD62p,CD63,CD54,Pgp-170 (flowcytometry),TXA2 (RIA),blood platelet aggregation rateand thrombosis length in vitro were assessed.RESULTS: In the 42 chronic relapse type UC patients,theoverall clinical effects of olsalazine sodium group (completeremission in 16,improvement in 4,inefficiency in 1) werebetter than those of SASP group (complete remission in 10,improvement in 4,inefficiency in 7,P<0.05).Symptomaticremission of olsalazine sodium group (complete remissionin 15,partial remission in 5,inefficiency in 1) was betterthan that of SASP group (complete remission in 10,partialremission in 5,inefficiency in 6,P<0.05).The colonoscopicremission of olsalazine sodium group(complete remissionin 11,partial remission in 9,inefficiency in 1) was betterthan that of SASP group (complete remission in 7,partialremission in 8,inefficiency in 6,P<0.05).The histologicremission of olsalazine sodium group (complete remissionin 13,partial remission in 7,inefficiency in in 1) was betterthan that of SASP group (complete remission in 6,partialremission in 10,inefficiency in 5,P<0.05).The side effectsof gastrointestinal tract in olsalazine sodium group wereless than those of SASP group except for frequency ofwatery diarrhea.No other side effects were observed in olsalazine sodium group while ALT increase,WBC decreaseand skin eruption were observed in SASP group.Twopatients relapsed in olsalazine sodium group while 8 casesrelapsed in SASP group during the flow-up period (fromsix months to one year).In the 42 first episode type UCpatients,the clinical effect of Heartleaf houttuynia herbgroup (complete remission in 20,95.2%; improvement in1,4.8%) was better than that of SASP group (completeremission in 15,72.4%,improvement in 5,23.8%; inefficiencyin 1,3.8%,P<0.01).The time of stool frequency recoveringto normal (5.6±3.3 d),and blood stool disappearance(6.7±3.8 d) and abdominal pain disappearance (6.1±3.5 d)in Heartleaf houttuynia herb group was all shorter than thatin SASP group (9.5±4.9 d,11.7±6.1 d,10.6±5.3 d,P<0.01).Heartleaf houttuynia herb could inhibit the epithelial cellapoptosis of colonic mucous membrane and the expressionof ICAM-1 (45.8±5.7% vs 30.7±4.1%,P<0.05).Comparedwith normal persons,the mean promotive speed of contractionwave stepped up (4.6±1.6 cm/min vs 3.2±1.8 cm/min,P<0.05) and the mean amplitude of the wave decreased(14.2±9.3 kPa vs 18.4±8.0 kPa,P<0.05) in active UC patients.After treatment with Heartleaf houttuynia herb,these 2 indexesimproved significantly (17.3±8.3 kPa,3.7±1.7 cm/min,P<0.05).In normal persons,the postprandial pressure ofsigmoid (2.9±0.9 kPa) was higher than that of descendingcolon (2.0±0.7 kPa) and splenic flexure (1.7±0.6 kPa),whilethe colonic pressure (1.5±0.5 kPa,1.4±0.6 kPa,1.3±0.6 kPa)decreased significantly (P<0.05) in active UC patients.Aftertreatment with Heartleaf houttuynia herb,the colonicpressure (2.6±0.8 kPa,1.8±0.6 kPa,1.6±0.5 kPa) recoveredto normal.The pain threshold of distant colon (67.3±18.9 mL)in active UC patients decreased significantly compared withthat of normal persons (216.2±40.8 mL,P<0.05) andrecovered to normal after treatment with Heartleafhouttuynia herb(187.4±27.2 mL,P<0.05).In the 18 refractoryUC patients with platelet activation,after more than 4 wkof combined Kangshuanling and sulfasalazine therapy,16patients achieved clinical remission,with a highly significantstatistical difference (P<0.01) between pre-and post-treatment mean scores for all disease parameters: stoolfrequency (8.2/d vs 1.6/d),rectal bleeding (score 2.7 vs0.3),colonoscopy (score 2.6 vs 1.1),histology (score 12.0vs 5.0),general well being (score 4.0 vs 0.6) and CD62p(8.0±3.1% vs 4.1±1.8%),CD63 (6.3±2.1% vs 3.2±1.6%),TXA2 (548±85 ng/L vs 390±67 ng/L),platelet aggregationrate (43.2±10.7% vs34.8±8.1%),thrombosis length in vitro(2.3±0.6 cm vs 1.8±0.3 cm),CD54 in blood (26.9±6.9% vs14.4±5.1%),CD54 in tissues (51.1±6.2% vs 23.1±4.1%),Pgp-170 in blood (18.9±3.9% vs 10.4±2.7%),Pgp-170 intissues (16.5±3.2% vs 10.2±2.3%,P<0.01 or 0.05).CONCLUSION: Based on the characteristics of UC casesin China,different therapy should be given to different typesof UC with expected satisfactory results. AIM: To study the different therapy for different types of ulcerative colitis (UC) in China. METHODS: Among 102 UC patients, 42 chronic relapsetype UC patients were divided into olsalazinesodium treatment group (n = 21) and SASP group . Clinical effects and safety were observed in the 2 groups. Forty-two first episode type UC patients were differentiated into Heartleaf houttuynia herb treatment group (n = 21) and SASP group (n = 21). Clinical effects wereobserved in the 2 groups while ultrastructure of colonic mucosa, ICAM-1 and the pressure of distant colon were stutied in Heartleaf houttuynia herb group. Eighteen patients (8 males, 10 females) with refractory UC andunresponsive to high-dose prednisolone and sulfasalazinetherapy more than one month were treated with Kangshuanling (7 200 U Prednisolone was gradually stalled and sulfasalazine was maintained. Tolol frequency, rectal bleeding, colonoscopy, general well-being, histology were observed and CD62p, CD63, CD54, Pgp- 170 (flowcytometry), TXA 2 (RIA), blood platelet aggregation rate and thrombosis length in vitro were assessed .RESULTS: In the 42 chronic relapse type UC patients, theoverall clinical effects of olsalazine sodium group (complete remission in 16, improvement in 4, inefficiency in 1) werebetter than those of the SASP group (complete remission in 10, improvement in 4, inefficiency in 7, P <0.05). Symptomatic remission of olsalazine sodium group (complete remission in 15, partial remission in 5, inefficiency in 1) was betterthan that of SASP group in 10, partial remission in 5, inefficiency in 6, P <0.05). The colonoscopic remission of olsalazine sodium group (complete remissionin 11, partial remission in 9, inefficiency in 1) was betterthan that of SASP group (complete remission in 7, partial remission in 8, inefficiency in 6, P <0.05). The histologic remission of olsalazine sodium group (complete remission in 13, partial remission in 7, inefficiency in 1) was betterthan that of SASP group (complete remission in 6, partial remissionion in 10, inefficiency in 5, P <0.05). The side effects of gastrointestinal tract in olsalazine sodium group were not those of SASP group except for frequency of watery diarrhea. No other side effects were observed in olsalazine sodium group while ALT increase, WBC decreaseand skin eruption were observed in SASP group.Twopatients relapsed in olsalazine sodium group while 8 casesrelapsed in SASP group during the flow-up period (fromsix months to one year) .In the 42 first episode type UCpatients, the clinical effect of Heartleaf houttuynia herbgroup ( complete remission in 20, 95.2%; improvement in 1, 4.8%) was better than that of SASP group (completeremission in 15,72.4%, improvement in 5,23.8%; inefficiencyin 1,3.8%, P <0.01). The time of stool frequency recovering to normal (5.6 ± 3.3 d), and blood stool disappearance (6.7 ± 3.8 d) and abdominal pain disappearance (6.1 ± 3.5 d) in Heartleaf houttuynia herb group was all shorter than that in SASP group (9.5 ± 4.9 d, 11.7 ± 6.1 d, 10.6 ± 5.3 d, P <0.01) .Heartlea f houttuynia herb could inhibit the epithelial cellapoptosis of colonic mucous membrane and the expression of ICAM-1 (45.8 ± 5.7% vs 30.7 ± 4.1%, P <0.05) .Comparedwith normal persons, the mean promotive speed of contractionwave stepped up (4.6 ± 1.6 P <0.05) and the mean amplitude of the wave decreased (14.2 ± 9.3 kPa vs 18.4 ± 8.0 kPa, P <0.05) in active UC patients. After treatment with Heartleaf houttuynia herb, These 2 indexes were significantly reduced (17.3 ± 8.3 kPa, 3.7 ± 1.7 cm / min, P <0.05) .In normal persons, the postprandial pressure of sigmoid (2.9 ± 0.9 kPa) was higher than that of descendingcolon (2.0 ± 0.7 kPa) and splenic (P <0.05) in active UC patients. Aftertreatment with Heartleaf houttuynia herb, the colonic pressure (2.6 ± 0.3 kPa, 1.4 ± 0.6 kPa, 1.3 ± 0.6 kPa) 0.8 kPa, 1.8 ± 0.6 kPa, 1.6 ± 0.5 kPa) recovered to normal.The pain threshold of distant colon (67.3 ± 18.9 mL) in active UC patients decreased sign ificantly compared withthat of normal persons (216.2 ± 40.8 mL, P <0.05) and recovered to normal after treatment with Heartleafhouttuynia herb (187.4 ± 27.2 mL, P <0.05) .In the 18 refractoryUC patients with platelet activation, after more than 4 wkof combined Kangshuanling and sulfasalazine therapy, 16patients achieved clinical remission, with a highly significant statistical difference (P <0.01) between pre-and post-treatment mean scores for all disease parameters: stoolfrequency (8.2 / d vs 1.6 / 3), colonoscopy (score 2.6 vs. 1.1), histology (score 12.0 vs. 5.0), general well being (score 4.0 vs 0.6) and CD62p (8.0 ± 3.1% vs 4.1 ± 1.8% (2.3 ± 0.6 cm vs 1.8 ± 0.3), TXA2 (548 ± 85 ng / L vs 390 ± 67 ng / L), platelet aggregation rate (43.2 ± 10.7% vs 34.8 ± 8.1% CD54 in blood (51.9 ± 6.2% vs 23.1 ± 4.1%), Pgp-170 in blood (18.9 ± 3.9% vs 10.4 ± 2.7%) and CD54 in blood (26.9 ± 6.9% vs 14.4 ± 5.1% , Pgp-170 intissues (16.5 ± 3.2% vs 10.2 ± 2.3%, P <0.01 or 0.05), CONCLUSI ON: Based on the characteristics of UC casesin China, different therapy should be given to different types of UC with expected satisfactory results.