中西医结合诱导克罗恩病缓解的临床疗效评价研究

发布时间：2018-05-29 21:34

本文选题：克罗恩病 + 中西医结合　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的采用对照方法,通过与西医治疗组进行对照,观察和评价清热化湿、活血解毒法联合西药诱导克罗恩病缓解是否比单用西药具有更好的临床疗效和安全性,从而为中西药联合治疗克罗恩病提供依据。方法选取40例江苏省中医院收治的克罗恩病轻、中度活动期患者,并且中医证型符合湿热内蕴、瘀毒搏结证,分为试验组和对照组各20例。试验组采用西医标准治疗+清化湿热、活血解毒法方,对照组采用西药标准治疗。12周为总疗程,观察临床缓解率;临床有效率;内镜应答率等。结果在临床缓解率方面,治疗组17例缓解,缓解率为85.00%,对照组11例缓解,缓解率为55.00%。两组经χ 2检验比较(P0.01),治疗组疗效优于对照组。在临床有效率方面,治疗组临床有效率为90.00%,对照组临床有效率为60.00%。两组经χ2检验比较(P0.01),治疗组疗效优于对照组。在中医证候疗效方面,治疗组总有效率80.00%;对照组总有效率65.00%,两组经χ 2检验有统计学意义(P0.05),治疗组疗效优于对照组。在内镜应答方面,治疗组疗效优于对照组(P0.01)。中医症状疗效方面,治疗结束时两组均能改善腹痛、腹泻、血便症状,组间比较,两组在腹痛、血便、腹胀、腹部包块方面均无明显差异(P0.05),但在腹泻、纳差方面有差异性(P0.05),表明治疗组在改善腹泻、增进食欲的疗效优于对照组。生存质量治疗组疗效优于对照组(P0.01)。两组安全性指标在治疗前后无差异(P0.05)。结论经过系统评价,本研究中叶柏教授经多年临床实践及研究的清化湿热、活血解毒方联合西药治疗轻中度克罗恩病的治疗方案临床疗效证实优于单用西药治疗,有临床进一步研究及推广应用的必要性。
[Abstract]:Objective to observe and evaluate the clinical efficacy and safety of western medicine combined with western medicine in inducing Crohn's disease relief by contrast with western medicine and western medicine in order to observe and evaluate the clinical efficacy and safety of clearing heat and removing dampness and activating blood circulation and detoxification combined with western medicine. So as to provide the basis for the combined treatment of Crohn's disease with Chinese and western medicine. Methods A total of 40 patients with Crohn's disease at mild and moderate active stage were selected from Jiangsu traditional Chinese Medicine Hospital. The TCM syndromes were consistent with dampness and heat accumulation and blood stasis toxin syndrome. The patients were divided into two groups: experimental group (n = 20) and control group (n = 20). The experimental group was treated with western medicine standard for clearing dampness-heat and activating blood circulation and detoxifying method, while the control group was treated with western medicine standard for .12 weeks as the total course of treatment to observe the clinical remission rate, clinical effective rate, endoscopic response rate and so on. Results in the clinical remission rate, 17 cases in the treatment group were relieved, the remission rate was 85.00, and 11 cases in the control group were relieved, the remission rate was 55.00. The curative effect of the treatment group was better than that of the control group by 蠂 2 test. The clinical effective rate was 90.00g in the treatment group and 60.00g in the control group. The curative effect of the treatment group was better than that of the control group by 蠂 2 test. The total effective rate of the treatment group was 80.000.The total effective rate of the control group was 65.00 and the two groups had statistical significance by 蠂 2 test (P 0.05). The curative effect of the treatment group was better than that of the control group. In terms of endoscopic response, the therapeutic effect in the treatment group was better than that in the control group (P 0.01). At the end of treatment, there was no significant difference in abdominal pain, blood stool, abdominal distension, abdominal mass and abdominal pain between the two groups, but in diarrhea, there was no significant difference between the two groups in abdominal pain, blood stool, abdominal distension and abdominal mass. The difference in anorexia showed that the therapeutic effect of the treatment group was better than that of the control group in improving diarrhea and improving appetite. The quality of life in the treatment group was better than that in the control group (P 0.01). There was no difference in safety index between the two groups before and after treatment (P 0.05). Conclusion after a systematic evaluation, the clinical effect of the treatment scheme of Huoxue jiedu prescription combined with western medicine in the treatment of mild and moderate Crohn's disease has been proved to be superior to that of western medicine alone after many years of clinical practice and research on clearing dampness and heat, activating blood circulation and detoxification of Chinese medicine in the treatment of mild and moderate Crohn disease. It is necessary for further clinical research and application.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R574.62

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