【作者】 杜瑜；

【导师】 沈洪；

【作者基本信息】 南京中医药大学 ， 中医内科学， 2011， 硕士

【摘要】 目的观察清肠化湿法治疗溃疡性结肠炎(UC)活动期的临床疗效,并从中医理论和现代医学观点两个方面系统探讨清肠化湿法治疗UC活动期的作用机制。方法采用随机阳性药物对照方法研究,将90例经肠镜检查确诊为溃疡性结肠炎活动期及中医辨证为湿热内蕴证的患者,分成三组。口服中药加灌肠组30例,予清肠化湿法口服结合灌肠方保留灌肠治疗。口服中药组30例,予清肠化湿方口服。美沙拉嗪组(对照组)30例,予口服美沙拉嗪片治疗。三组均三个月为一疗程,疗程结束后分别进行安全性观察和疗效性观察。结果口服中药加灌肠组总有效率93.3%,口服中药组为80.0%,美沙拉嗪组为83.3%。口服中药加灌肠组分别与其他两组进行比较,差异均具有统计学意义(P<0.05),认为口服中药加灌肠治疗本病临床疗效优于其他两组。中药口服组与美沙拉嗪组比较差异不具有统计学意义(P>0.05),认为中药口服治疗本病不优于美沙拉嗪。治疗后三组肠镜像积分、临床症状积分较治疗前均有明显改善,口服中药加灌肠组分别与其他两组进行比较,差异均具有统计学意义(P<0.05),中药口服组与美沙拉嗪组比较差异不具有统计学意义(P>0.05),认为口服中药加灌肠治疗本病的肠镜疗效优于其他两组,中药口服治疗本病的肠镜疗效不优于美沙拉嗪。结论采用清肠化湿法口服结合保留灌肠治疗溃疡性结肠炎活动期患者的疗效优于单纯口服中药和美沙拉嗪缓释颗粒,尤其在改善患者临床症状及结肠黏膜病变方面。清肠化湿法为治疗溃疡性结肠炎活动期的安全有效方剂。更多还原

【Abstract】 Objective:The aim of this study is to observe the clinical effect of QingChangHuaShi method treating ulcerative colitis(UC), and to explore the mechanism of this method from the point of traditional Chinese medicine and Western medicine.Method:90 patients who were diagnosed as in active stage of UC by colonoscopy and diagnosed as the syndrome of internal stasis of dampness and heat by syndrome differentiation of traditional Chinese medicine were divided into three groups. In the first treatment group,30patients were treated with taking QingChangHuaShi prescription; in the second treatment group,30 patients were treated with taking QingChangHuaShi prescription in combination with retention with enema prescription; the other30 patients in the control group were treated with particle release mesalazine (5-ASA). Three months later when the treatment is over, compare the clinical curative effect and monitor the safety index.Results:The total effective rate of the first treatment group is 80.0%, the total effective rate of the second treatment group is 93.3%, while that of the control group is 83.3%. The effective rate of the second treatment group is superior to the other 2 groups(P<0.05), and there is no statistic difference in comparison of the first group and the control group (P>0.05). The integration of colonoscopy and symptoms has improved after treatment, compare the results of colonoscopy and symptoms of these groups and find that the second group is superior to the other 2 groups (P<0.05). The first treatment group is not superior to the control group(P>0.05).Conclusion:The curative effect of taking QingChangHuaShi prescription in combination with retention enema treating ulcerative colitis patients in active stage is superior to that of 5-ASA, and is also superior to that of taking QingChangHuaShi prescription alone, especially in improving TCM or clinical syndrome、intestinal mucous membrane. And the QingChangHuaShi method of traditional Chinese medicine is safe.更多还原