Clinical Presentation and Treatment Strategies for Ulcerative Colitis: A Retrospective Study of 247 Inpatients

Objective

Complementary and alternative medicine, particularly herbal therapy, is widely used by patients with ulcerative colitis (UC), but controlled data are limited. To describe the clinical presentation and treatment strategies for UC in inpatients from Shanghai, China and to improve the therapeutic outcomes for patients with UC.

Methods

Medical records from 247 patients with UC who were admitted to Longhua Hospital Affifiliated to Shanghai University of Traditional Chinese Medicine between January 2008 and June 2013 were analyzed for gender, age, course of the disease, clinical type, extent and severity of the disease, treatment strategies, and therapeutic outcomes.

Results

Gender ratios and disease onset of inpatients with UC in the Shanghai area were consistent with other reports in the literature. In contrast to previous studies, most patients exhibited disease of the left colon, over half of the patients had problems of the rectum or sigmoid colon, and most patients had either mild or moderate UC. Comparison of Sutherland Disease Actirity Index scores for patients treated with Chinese medicine (CM) and those treated with integrated CM and Western medicine revealed signifificant reductions in scores for both groups after treatment (P<0.01), with no signifificant difference in therapeutic effects between groups (P=0.938).

Conclusions

Herbal medicine has been widely used in patients with mild to moderate disease and as adjunct therapy in patients with moderate to severe disease. Therefore, the strategy was proposed for the treatment of UC with CM therapy based on 2 steps according to the stage of the disease, even in the clinical setting.

     

马贵同治疗胃肠病验案3则

通过3则病案,介绍马贵同教授治疗常见胃肠病如溃疡性结肠炎、慢性萎缩性胃炎、反流性食管炎的辨证及用药经验。     

溃疡性结肠炎的中医药治疗

中医认为,溃疡性结肠炎的发生与六淫邪气、饮食不节、情志内伤及先天禀赋不足有关.中医药治疗常用的给药途径是中药口服、中药保留灌肠、中药栓剂及各种方法的联合应用,治疗上具有多途径、多方法、多靶点等特点和毒副作用小,费用低等优势.     

健脾温肾清化方治疗溃疡性结肠炎近期疗效观察

目的评价健脾温肾清化方对溃疡性结肠炎(UC)患者的近期疗效。方法采用多中心、随机、对照设计,将72例UC患者随机分为试验组37例和对照组35例。在口服美沙拉嗪治疗的基础上,试验组给予健脾温肾清化方灌肠治疗,对照组给予柳氮磺吡啶栓纳肛治疗,疗程均为4周,观察2组患者诱导缓解率和症状改善情况。结果治疗结束时试验组缓解率为56.8%,对照组为40.0%,差异无统计学意义(P0.05)。试验组腹泻单项症状总有效率为97.2%,对照组为78.8%,差异有统计学意义(P0.05);脓血便、腹痛、腹胀单项症状有效率组间比较差异无统计学意义(P0.05)。结论健脾温肾清化方治疗UC与柳氮磺吡啶栓疗效相当,但对于腹泻症状具有较好的改善作用。     

唐志鹏教授理脾法治疗溃疡性结肠炎经验

溃疡性结肠炎是一种无法根治的难治性疾病,唐志鹏教授认为此病虽病位在肠腑,但其致病之本仍在于脾,故常以健脾益肠、温脾止泻、清脾祛滞、解郁舒脾等理脾助运之法来治疗,常获良效。     

健中愈疡片对半胱胺性溃疡大鼠胃壁细胞凋亡影响的实验研究

目的观察健中愈疡片对半胱胺性溃疡胃壁细胞凋亡的影响.方法采用皮下注射半胱胺酸法制造慢性十二指肠溃疡模型,取60只SD大鼠随机分成雷尼替丁组、健中高组、健中中组、健中低组、模型组、空白组6组,以原位末端标记技术研究胃壁细胞在溃疡愈合阶段的凋亡情况.结果十二指肠溃疡发生后28天,胃壁细胞的凋亡呈现凋亡活跃的情况.其凋亡指数大大高于正常组及健中中和健中高组(P《0.01),而雷尼替丁组经治疗后其凋亡指数也仍保持在造模组的高凋亡水平.中药治疗组呈现出量效相关的调节效应,使胃壁细胞的凋亡状态接受或回复正常水平.结论中药健中愈疡片对高泌酸状态下的胃壁细胞凋亡有良好的调节作用.     

植物药的肝毒性

随着植物药的普遍应用，人们逐渐认识到其对肝脏的毒性。最近的研究表明42％的美国人服用替代药品(CAM)，67％的人一生中至少使用一种CAME。在过去10年中，植物药的使用已增加5倍，达到人口的12．5％，20％～30％的临床肝病病人使用植物药疗法。     

胃祺饮加减治疗慢性萎缩性胃炎临床疗效评价

目的:对胃祺饮加减药物治疗慢性萎缩性胃炎进行临床疗效评价。方法:通过对治疗前后患者症状及胃镜病理变化的综合分析,评价胃祺饮加减方的临床疗效。结果:胃祺饮加减方对萎缩性胃炎患者症状改善的总有效率为87.67%,对胃黏膜病理有逆转作用。结论:胃祺饮加减方作为治疗慢性萎缩性胃炎的协定方药,疗效确切,值得推广使用。     

虫草菌丝提取物抗二甲基亚硝胺诱致大鼠肝硬化肝窦毛细血管化作用机制的研究

目的 探讨虫草菌丝提取物（CME）对二甲基亚硝胺（DMN）诱致大鼠肝硬化肝窦毛细血管化作用的机制。