中药内服与灌肠治疗活动期溃疡性结肠炎的临床疗效

目的观察中药自拟方肠愈宁内服配合灌肠方保留灌肠对活动期溃疡性结肠炎(ulcerative colitis,UC)患者临床症状及病理组织学的影响,并评价其临床疗效及安全性。方法选择2014年1月—2016年6月黑龙江中医药大学附属第一医院肝脾胃病科收治的活动期UC患者,共68例,采用随机数字表法将其分为对照组和治疗组,每组各34例。2组患者均给予必要的常规内科治疗,在此基础上治疗组予中药自拟方肠愈宁内服配合灌肠方保留灌肠,内服中药每日1剂,2次/d,早晚饭后半小时温服;灌肠中药每日1剂,每晚睡前灌肠1次。对照组予美沙拉嗪肠溶片口服,1 g/次,4次/d,2组均治疗1个月。治疗后评价2组患者临床主要症状积分、结肠黏膜评分,并对比其临床疗效,观察不良反应。选择SPSS 19.0统计软件对数据进行分析。结果经治疗后,治疗组和对照组临床总有效率分别为85.29%、61.77%,治疗组显著优于对照组(P<0.05)。2组患者经治疗后腹痛、腹泻、黏液脓血便症状积分,结肠黏膜内镜评分较治疗前均有明显降低(均P<0.05),且治疗组治疗后腹痛、腹泻、黏液脓血便症状积分,结肠黏膜内镜评分较同期对照组明显降低(均P<0.05)。结论中药自拟方肠愈宁内服配合灌肠方保留灌肠治疗活动期UC疗效确切,能明显改善患者腹痛、腹泻、黏液脓血便等主要症状,修复结肠黏膜损伤,促进溃疡愈合,且无明显不良反应。

Clinical observation on treatment of active ulcerative colitis with Chinese herbal decoction for oral taking and enema

Objective To observe the patients’ clinical symptoms and histopathological changes of Chinese herbal decoction for oral taking and enema in the treatment of active ulcerative colitis(UC), and evaluate the clinical efficacy and safety. Methods The 68 cases of UC were selected from January 2014 to June 2016 in the first affiliated hospital of Heilongjiang university of TCM department of Gastroenterology. The 68 patients with active ulcerative colitis were randomly divided into control group and treatment group with 34 cases in each group. Two groups of patients were given the necessary routine medical treatment. On these, the treatment group was treated with Chinese herbal decoction for oral taking and enema. Oral Chinese medicine were given 1 dose daily, 2 times/day, half an hour after breakfast and dinner. Enema Chinese medicine were given every night 1 dose daily. The control group was given Mesalazin Enteric-coated tablets orally, 1 g/times, 4 times/day. The two groups were treated for 1 months.After treatment, we observed the improvement of three main symptoms and colonic mucosal scores of two groups. We compared the clinical effect and observed the adverse reactions. We used statistics software SPSS 19.0 for the research of statistical data. Results After treatment, the total clinical efficiency of the treatment group was 85.29%, significantly better than 61.77% in the control group, and the difference between the two groups was statistically significant (P<0.05). After treatment, the symptoms of abdominal pain, diarrhea, pus and blood stool and mucous abscess and the internal mirror score of the colonic mucosa was significantly lower than before of two groups (all P<0.05). The improvement rate of the treatment group was significantly better than the control group after treatment (all P<0.05). Conclusion It was effective in the treatment of active ulcerative colitis with Chinese herbal decoction for oral taking and enema. It can obviously improve the main symptoms like abdominal pain, diarrhea, pus and blood stool. After that, it can repair mucosal injury and promote ulcer healing, and no obvious adverse reactions.