中医药分期治疗溃疡性结肠炎27例临床研究

目的 观察中医药分期治疗溃疡性结肠炎(UC)的临床疗效.方法 53例符合纳入标准的UC患者随机分为研究组27例,对照组26例.研究组活动期予清肠化湿方口服联合灌肠方外治；缓解期予扶正清肠方口服,若病情复发加用灌肠方.对照组给予美沙拉嗪肠溶片口服治疗.两组疗程均为84d,分别于治疗前、治疗后第28天、56天和84天进行症状评分及生活质量评分.结果 治疗前后比较,研究组能够明显改善总体症状评分,且在治疗后第56天对总体症状的改善优于对照组(P＜0.05).研究组能够在不同治疗阶段改善腹泻、脓血便、腹痛、肛门灼热、里急后重、乏力评分,且治疗后第56天腹泻、脓血便评分,治疗后第84天腹泻、脓血便、乏力评分低于对照组(P＜0.05).两组患者治疗后第84天,生活质量评分中胃肠症状、全身症状、情感能力、社会能力积分较治疗前均明显升高(P＜0.05),并且研究组治疗后第84天各生存质量评分明显高于对照组(P＜0.05).结论 中医药分期治疗能有效改善轻、中度UC患者的临床症状,治疗中后期疗效优于西药,且能够改善患者的生存质量.

Clinical Study on TCM Staging Treatment for Ulcerative Colitis : a Report on 27 Cases

Objective To evaluate the effect of TCM staging treatment on ulcerative colitis (UC). Methods Fifty-three UC cases were randomized into study group of 27 cases and control group of 26 cases. In the study group, the patients in the active stage was administered Qingchang Huashi Formula (Formula for clearing intestines and dissolving damp) and Guanchang Formula (Formula for enema) for enema, and those in the remission stage were treated with Fuzheng Qingchang Fomula (Formula for reinforcing anti-pathogenic qi and clearing intestines) for oral taking, in case the pathological condition relapsed, the Guanchang Formula for enema was added. In the control group, the patients were given oral Mesalazine Slow Release Tablets. The course of treatment was of 84 days. Before treatment, on the 28th day, the 56th day, and the 84th day of the treatment, the score of symptoms and quality of life of the patients were recorded for comparison. Results The comparison of before and after treatment showed that the study group was significantly improved in the overall symptom scores, and the improvement of the overall symptoms on the 56th day of treatment was superior to that of the control group (P<0.05). In the different stages of treatment, the study group could improve the scores of diarrhea, pus and blood stool, abdominal pain, burning pain in the anus, tenesmus, and fatigue, and its scores of diarrhea and pus and blood stool on the 56th day of treatment and scores of diarrhea, pus and blood stool, and fatigue on the 84th day of treatment were significantly lower than those of the control group (P<0.05). On the 84th day of treatment, the scores of all dimensions including gastrointestinal symptoms, whole body symptoms, emotional ability, and social ability in the IBD-Q scale of the two groups were significantly increased, compared with before treatment (P<0.05). All indices of survival quality of the study group were significantly higher than those of the control group (P<0.05). Conclusion The staging treatment of TCM is effective in improving the clinical symptoms of mild to moderate UC patients. The effect of TCM treatment of middle and late stages is better than that of chemial drugs. It benefits the patients in improving their survival quality too.