基于“毒损肠络”的加味五得汤治疗UC（活动期）的临床研究

发布时间：2018-01-02 03:07

本文关键词：基于“毒损肠络”的加味五得汤治疗UC（活动期）的临床研究　出处：《山东中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:根据“毒损肠络”的假说,观察加味五得汤口服联合芩藤愈疡汤保留灌肠治疗活动期溃疡性结肠炎(ulcerative colitis,UC)(轻中度,大肠湿热型)的临床疗效,以期揭示中医药的治疗优势,为临床治疗UC提供新思路。方法:选择符合纳入标准的UC活动期患者60例,随机分为两组:对照组30例给予美沙拉嗪(艾迪莎),1.0g,po,qid;试验组30例,给予加味五得汤口服,日1剂,联合芩藤愈疡汤保留灌肠,每晚1次。2周为一个疗程,每两个疗程间隔2天,两组共治疗3个疗程。结束后记录两组治疗前后单项症状积分、总积分、中医证候、综合疗效、结肠镜下黏膜病变、疾病活动指数,运用SPSS17.0统计软件对所得资料进行分析比较。结果:在腹泻、脓血便、腹胀、里急后重、发热及总症状积分方面试验组优于对照组,两组有统计学差异(p0.05),而在改善肛门灼热、溲赤症状上两组无统计学差异(p0.05);中医证候疗效、综合疗效积分的改变上两组均较前明显改善,且试验组优于对照组,两组有统计学差异(p0.05);在Mayo评分方面两组均较疗前明显改善,且试验组优于对照组,两组有统计学差异(p0.05);治疗后镜下粘膜病变疗效比较中,试验组仍好于对照组,两组有统计学差异(p0.05);两组在受试期间均未出现明显不良反应。结论:基于“毒损肠络”假说,临床上给予活动期UC(轻中度,大肠湿热型)患者加味五得汤口服联合芩藤愈疡汤保留灌肠,在改善患者诸多不适的主观感受及结肠镜下粘膜病变改善等的客观指标方面都具有其独特的优势。提示中医药治疗UC有明显优势,并且临床应用比较安全可靠。
[Abstract]:Objective: according to the hypothesis of "toxic damage to the collaterals", the observation of Jiawei Wude decoction combined with Qinteng Yuyang decoction retention enema treatment of active ulcerative colitis ulcerative colitis. The clinical effect of UCU (mild to moderate, large intestine damp-heat type) in order to reveal the advantages of traditional Chinese medicine (TCM) and provide a new idea for clinical treatment of UC. Methods: 60 patients with UC active stage who met the inclusion criteria were selected. They were randomly divided into two groups: the control group (n = 30) was treated with mezalazine (1. 0 g / kg) and the control group (n = 30); In the experimental group, 30 cases were treated with Jiawei Wudai decoction orally, once a day, combined with Qinteng Yuyang decoction to retain enema, once a night for 2 weeks as a course of treatment, every two courses of treatment interval 2 days. After the two groups were treated for 3 courses of treatment, the single symptom score, total score, TCM syndromes, comprehensive curative effect, mucosal lesion under colonoscopy and disease activity index were recorded before and after treatment. SPSS17.0 statistical software was used to analyze and compare the data. Results: the experimental group was superior to the control group in the aspects of diarrhea, purulent stool, abdominal distension, acute and severe, fever and total symptom score. There was a significant difference between the two groups (P 0.05), but there was no significant difference in the symptoms of Deutzia. The changes of syndromes and integrals of TCM syndrome in the two groups were obviously improved compared with the former, and the experimental group was better than the control group, there was statistical difference between the two groups (P 0.05). The Mayo scores of the two groups were significantly improved compared with those before treatment, and the experimental group was superior to the control group, and the two groups had statistical difference (P 0.05). Compared with the control group, the treatment group was still better than the control group, there was a statistical difference between the two groups (P 0.05). Conclusion: based on the hypothesis of "toxic damage to intestinal collaterals", active UC (mild to moderate) was given clinically. Large intestine damp-heat type) patients with modified Wude decoction oral combined with Qinteng Yuyang decoction retention enema. It has its unique advantage in improving the subjective feeling of many discomfort patients and the objective index of improving mucosal lesions under colonoscopy. It suggests that Chinese medicine has obvious advantages in the treatment of UC. And clinical application is relatively safe and reliable.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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