口服美沙拉嗪加中药灌肠方白头翁汤加减治疗活动期溃疡性结肠炎（湿热内蕴证）的临床疗效观察

发布时间：2018-01-22 12:40

本文关键词： 溃疡性结肠炎湿热内蕴证灌肠白头翁汤　出处：《西南医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:口服美沙拉嗪加中药灌肠方白头翁汤加减治疗活动期溃疡性结肠炎(湿热内蕴证)与单纯口服美沙拉嗪治疗的临床疗效对比,通过对比治疗后中医症候疗效、血清细胞因子IL-6及IL-13值、改良的Mayo评分的差异,为治疗活动期溃疡性结肠炎(湿热内蕴证)治疗方式的选择及推广提供一定的循证学依据。方法:病例来源我院肛肠科于2014年9月-2015年9月收治的活动期溃疡性结肠炎(湿热内蕴证)患者60例,根据随机数字表法将所有患者分为两组,即灌肠组30例(口服美沙拉嗪加白头翁汤加减灌肠组),对照组30例(单纯口服美沙拉嗪组),记录并观察两组患者的中医症候疗效、对血清细胞因子IL-6及IL-13值的影响以及改良的Mayo评分情况。使用统计学软件SPSS 20.0对数据进行处理,符合正态的计量资料用(均数±标准差)表示,两组间的比较采用t检验;不符合正态的计量资料用中位数和四分位数表示,两组间的比较采用秩和检验;计数资料用百分比表示,两组间对比采用卡方检验。设检验标准为α=0.05,P0.05具有统计学差异性。结果:灌肠组与对照组患者年龄、性别、病程、病情严重程度的差异均无统计学意义(P0.05),具有可比性;分别在治疗前后对灌肠组及对照组进行中医症候疗效统计及评分(评分细则见“资料与方法”),结果见表2及表3,灌肠组患者在中医症候疗效及评分方面,总的有效率高于对照组,且差异显著,具有统计学意义(P0.05)。治疗前后组内比较,两组的中医症候评分均下降(P0.05),而灌肠组的改善优于对照组,差异具有统计学意义(P0.05)。经过3个疗程治疗后,60名患者抽取静脉血,再一次进行血清细胞因子IL-6及血清细胞因子IL-13的测定。对比结果见表4和表5,治疗前后组内比较,两组的血清细胞因子IL-6水平均下降(P0.05),两组的血清细胞因子IL-13水平均上升(P0.05);而两组间比较,灌肠组在血清细胞因子水平的改善优于对照组,差异具有统计学意义(P0.05)。分别于治疗前后对60名患者进行改良的Mayo评分,对比结果如表6所示,治疗前后组内比较,两组的改良的Mayo评分水平均下降(P0.05);组间比较,灌肠组的改善优于对照组,差异具有统计学意义(P0.05)。结论:口服美沙拉嗪加中药灌肠(白头翁汤加减)与单纯口服美沙拉嗪治疗均为活动期溃疡性结肠炎(湿热内蕴证)行之有效的治疗方式,口服美沙拉嗪加中药灌肠(白头翁汤加减)在中医症候疗效、对血清细胞因子IL-6及IL-13值的影响以及改良的Mayo评分方面的改善优于单纯口服美沙拉嗪治疗。
[Abstract]:Objective: to compare the clinical efficacy of oral mesalazine plus traditional Chinese medicine enema decoction in the treatment of active ulcerative colitis (damp-heat accumulation syndrome) and oral mesalazine alone. The difference of TCM symptom curative effect, serum cytokine IL-6 and IL-13 value, modified Mayo score after treatment were compared. To treat active ulcerative colitis (damp-heat accumulation syndrome). The selection and promotion of treatment methods provide some evidence-based basis. Methods: the patients came from the active ulcerative colitis (dampness and heat accumulation syndrome) in our department of anus and intestines from September 2014 to September 2015. There were 60 patients. All the patients were randomly divided into two groups: the enema group (30 cases) and the control group (30 cases). To record and observe the curative effect of TCM symptoms in the two groups. The effect of IL-6 and IL-13 on serum cytokines and the improved Mayo score were evaluated. The data were processed with the statistical software SPSS 20.0. The measurement data in accordance with normal distribution were expressed by mean 卤standard deviation. T test was used to compare the two groups. The nonconformities were expressed by median and quartile, and the comparison between the two groups was performed by rank sum test. Counting data was expressed as percentage, the contrast between the two groups was chi-square test. The standard of test was 伪 -0.05P05. Results: the age and sex of the patients in the enema group and the control group were higher than those in the control group. There was no significant difference in the course of disease and the severity of the disease (P 0.05), which was comparable. Before and after treatment, the patients in the enema group and the control group were treated with TCM symptom statistics and scores (see "data and methods" for the scoring details, the results are shown in tables 2 and 3), and the patients in the enema group are treated with TCM symptom efficacy and score. The total effective rate was higher than that of the control group, and the difference was significant (P 0.05). Compared with the control group before and after treatment, the TCM symptom scores of the two groups were decreased (P 0.05). The improvement of the enema group was better than that of the control group, and the difference was statistically significant (P 0.05). After three courses of treatment, 60 patients were taken from venous blood. Serum cytokine IL-6 and serum cytokine IL-13 were measured again. The results are shown in tables 4 and 5. The level of serum cytokine IL-6 decreased in both groups (P 0.05), and the level of serum cytokine IL-13 increased in both groups (P 0.05). The improvement of serum cytokine level in the enema group was better than that in the control group, and the difference was statistically significant (P 0.05). The improved Mayo score was obtained in 60 patients before and after treatment. As shown in Table 6, the improved Mayo scores in both groups were significantly lower than those in the control group before and after treatment (P 0.05). The improvement of enema group was better than that of control group. The difference was statistically significant (P 0.05). Conclusion: oral mesalazine plus traditional Chinese medicine enema (P0.05) and oral mezalazine alone are active ulcerative colitis (damp-heat accumulation syndrome). An effective treatment. Oral mezalazine plus traditional Chinese medicine enema (decoction of Pak Tou Weng reduced) in Chinese medicine symptoms curative effect. The effect on serum cytokine IL-6 and IL-13 and the improvement of modified Mayo score were better than that of oral mezalazine alone.
【学位授予单位】：西南医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R574.62

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