中药内外合治溃疡性结肠炎62例临床观察

[目的]观察中药内服配合灌肠治疗慢性溃疡性结肠炎的疗效。[方法]内服自拟健脾补肾汤配合清热燥湿解毒中药保留灌肠。[结果]62例中痊愈28例,占45·16%;好转27例,占43·55%;无效7例,占11·29%。总有效率为88·71%。[结论]中药内服配合灌肠治疗慢性溃疡性结肠炎的疗效确切,能加速溃疡面愈合并可促进和调整机体的免疫功能。     

Other imaging techniques: Double-contrast barium enema,endoscopic ultrasonography,multidetector CT enema,and computed tomography colonoscopy

Double-contrast barium enema (DCBE), transrectal endoscopic ultrasonography (REU), multidetector computerized tomography enema (MDCT-e), and computed tomography colonoscopy (CTC) have been successfully used for the diagnosis of bowel endometriosis. DCBE provides a complete overview of the entire colon and allows detecting cecal nodules. The accuracy of DCBE is operator dependent and, thus, it may have low specificity. It does not allow identifying the cause of the mass effect. DCBE requires the administration of barium and exposure to radiation. REU precisely estimates the distance between the rectosigmoid nodule and the anal verge. However, it allows investigating only the distal part of rectosigmoid, it misses anterior pelvic lesions, and it has poor sensitivity for the diagnosis of endometriomas. MDCT-e is accurate and reproducible in diagnosing intestinal endometriosis and in assessing its characteristics: the largest diameter of the nodule, the distance between the distal part of the nodule and the anal verge, and depth of infiltration of endometriosis in the intestinal wall. MDCT-e requires the administration of iodinated contrast medium (CM) and the exposure to radiations. CTC has good performance in the diagnosis of rectosigmoid endometriosis. It allows estimating the degree of intestinal stenosis CTC, and the distance between the intestinal endometriotic nodule and the anal verge. It requires exposure to radiations, and it may require the administration of an iodinated CM.     

Budesonide Enema in Distal Ulcerative Colitis: a Randomized Dose-Response Trial with Prednisolone Enema as Positive Control

The effect of budesonide, 1, 2, and 4mg/l00ml in daily enemas, on active distal ulcerative colitis was compared with that of prednisolone disodium phosphate enemas, 25 mg/100 ml, in a multicentre, randomized, group-comparative trial. A total of 146 patients with active disease were treated for 2 weeks. Data from 139 were valid for statistical analyses. Bowel habits, proctoscopy findings, and histologic pictures were evaluated, and plasma Cortisol was determined for measurement of influence on the hypothalamic-pituitary-adrenal axis. Clinical symptoms and proctoscopy findings improved within all treatment groups. The improvement of these effect variables tended to be less after treatment with the lowest dose of budesonide, 1 mg/100 ml, than after the other treatments. Plasma Cortisol did not change in any of the budesonide groups, whereas a mean reduction of 30% (P = 0.07) was observed after prednisolone. It can be concluded that budesonide enemas of 2 mg/100 ml constitute an attractive alternative to prednisolone enemas for topical treatment of distal ulcerative colitis.     

中药灌肠治疗晚期癌症肠梗阻临床研究

目的：探讨中药灌肠治疗晚期癌症患者肠梗阻临床疗效以及对患者近期生活质量的影响。方法：将68例晚期癌症合并肠梗阻患者分为两组,对照组34例采用常规治疗,治疗组34例在对照组基础上加用加味大承气汤保留灌肠,每天2次,每次100～150 mL;两组均以7 d为1个疗程;治疗前后生活质量评估采用国际通用的SF-36生存量表。结果：治疗组有效10例,好转18例,无效6例,有效率为82.35%;对照组有效6例,好转11例,无效17例,有效率为50.00%。两组比较差异有统计学意义（P〈0.05）;生存量表的6个维度[生理功能（PF）、躯体疼痛（BP）、总体健康（GH）、生命活力（VT）、情感职能（RE）、精神健康（MH）]积分比较,治疗组优于对照组,两组比较差异有统计学意义（P〈0.05）。结论：加味大承气汤灌肠治疗晚期癌症肠梗阻有较好疗效,且能改善患者的近期生活质量。     

RE‐EPITHELIALIZATION OF SQUAMOUS EPITHELIUM FOR A RADIATION‐INDUCED RECTAL ULCER WHILE GIVING AN ECABET SODIUM ENEMA

The present patient developed a severe rectal ulcer more than 1 month after having received external beam radiation therapy for prostate cancer. Surveillance endoscopy every 3 months demonstrated healing of this rectal ulcer using a novel therapy. He was given enemas with ecabet sodium, which provides physical protection and promotes healing by increasing prostaglandin E₂, and this process induced squamous metaplasia that halted the progression of the ulcer of radiation proctitis as a late‐phase reaction. Intrapapillary capillary loops were visualized with magnified narrow band imaging at the healing ulcer site as seen via the esophagus and, moreover, demonstrated histologically.     

狗皮膏(改进型)质量标准研究

目的:修订提高狗皮膏(改进型)的质量标准。方法:用薄层色谱法对狗皮膏(改进型)中当归进行定性鉴别;用气相色谱法对狗皮膏(改进型)中冰片、薄荷脑及水杨酸甲酯进行定性鉴别,并测定处方中冰片、薄荷脑及樟脑的含量;用高效液相色谱法测定处方中盐酸苯海拉明的含量。结果:当归的薄层色谱鉴别斑点清晰,重现性好,无干扰;龙脑在0.03~0.26μg,薄荷脑在0.07~0.71μg,樟脑在0.05~0.46μg,盐酸苯海拉明在0.56~5.59μg范围内线性关系良好,各成分平均回收率分别为99.74%(龙脑)、99.10%(薄荷脑)、99.08%(樟脑)、96.95%(盐酸苯海拉明)。结论:修订后的质量标准简便易行,可有效控制狗皮膏(改进型)的质量。     

中药灌肠治疗胃肠术后腹胀疗效观察

目的观察中药灌肠治疗胃肠术后腹胀的临床疗效。方法 90例胃肠术后腹胀患者随机两组。治疗组采用中药灌肠治疗,对照组口服西沙比利,连续治疗5d后评定疗效。结果治疗组总有效率明显优于对照组(P0.01)。结论中药灌肠治疗胃肠术后腹胀疗效可靠。     

药物保留灌肠治疗溃疡性结肠炎的临床护理方法及效果

目的：探讨药物保留灌肠治疗溃疡性结肠炎的疗效观察及护理措施。方法：回顾性分析2012年3月－2014年4月我院62例溃疡性结肠炎采取利多卡因、地塞米松、锡类散加入生理盐水保留灌肠治疗患者的临床病历,分析临床疗效和护理措施。结果：62例灌肠过程中出现便急3例,灌肠后出现轻度腹痛1例,所有患者未影响正常治疗和护理干预;治愈34例,有效24例,无效4例,总有效率93.55％。结论：护理干预能够明显提高药物灌肠治疗溃疡性结肠炎的临床疗效,在改善溃疡性结肠炎患者的临床疗效和促进患者早期康复方面具有非常重要的意义。     

中医综合疗法治疗输卵管阻塞性不孕症

目的 探讨输卵管阻塞性不孕症患者术后给予中药方剂灌肠及口服的治疗效果及机制.方法 将就诊的输卵管阻塞术后再通患者88例,随机分为2组,治疗组50例给予中药灌肠并予中药自拟助孕汤(红藤、败酱草、蒲公英、路路通等)口服;对照组38例仅给予中药灌肠,治疗6个月经周期后观察怀孕情况及输卵管再通情况.结果 宫内妊娠率治疗组为32.00％,对照组为13.16％,2组比较,差异有统计学意义(P＜0.05).结论 中药灌肠联合汤剂口服可帮助输卵管阻塞性不孕术后患者疏通输卵管,减少输卵管再次阻塞的发生,增加受孕概率.