健脾化湿经验方治疗脾虚湿蕴型溃疡性结肠炎的临床研究

发布时间：2018-01-21 17:15

本文关键词： 健脾化湿经验方(肠健平) 溃疡性结肠炎脾虚湿蕴证临床研究　出处：《河南中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的通过临床应用我院名老中医张东岳教授的经验方健脾化湿经验方(肠健平),治疗脾虚湿蕴型溃疡性结肠炎,并与目前临床常用的西药美沙拉秦肠溶片治疗溃疡性结肠炎相比较,观察对比中西医治疗的不同,总结健脾化湿经验方临床治疗中的优势,为溃疡性结肠炎的临床治疗及进一步的实验研究提供参考。方法挑选在2015年4月至2015年10月期间,于河南中医药大学第一附属医院肛肠病诊疗中心就诊的60例溃疡性结肠炎患者,所选病例符合纳入标准,中医证型为脾虚湿蕴型,自愿参加本研究,随机分为两组。治疗组给予我院名老中医张东岳教授的经验方,健脾化湿经验方(肠健平),具体方药成分为:薏苡仁30g、党参20g、焦白术20g、茯苓15g、白扁豆30g、陈皮12g、乌药10g、砂仁15g、山药30g、桔梗12g、莲子30g、甘草6g;河南中医药大学第一附属医院中草药房提供上方并在院煎好,统一包装,每付水煎滤药液400ml,分两袋封装,每袋200ml,早晚餐后各温服1袋;对照组给予目前临床常用的氨基水杨酸类药物,美沙拉秦肠溶片(商品名称:惠迪化学名称:5-氨基水杨酸、5-ASA)(生产公司:葵花药业之佳木斯鹿灵制药),口服,每次0.5g/次,每日3次。每组以15天为1个治疗周期,共治疗4个周期,结束后每月随访1次,共随访4次,观察并记录整个实验过程中,两组的疗效、不良反应等。结果实验结束后,两组所得数据经SPSS19.0统计软件分析,结果显示,两组在综合疗效,肠镜下黏膜表现、病理疗效,中医症状疗效及复发率等方面均有不同程度的改善,但具体比较,两组有不同程度的差异。在综合疗效总有效率方面,两组分别为治疗组93.10%,对照组65.52%,相比于对照组,治疗组的综合疗效更优(P0.05);在肠镜下黏膜表现、病理疗效方面,治疗组的疗效均优于对照组(P0.05);中医症状的比较方面,治疗组能够更好的改善患者腹泻、腹痛、腹胀、黏液便、里急后重感、饮食、肢体倦怠、神疲懒言等(P0.05),但在脓血便、胸胁刺痛等方面的改善两组无明显差别(P0.05),4个月随访期间的复发率治疗组为6.90%,对照组为34.48%,两组复发率的比较差异明显(P0.05)。结论健脾化湿经验方和美沙拉嗪肠溶片对于脾虚湿蕴型溃疡性结肠炎均有一定的临床疗效。但两者治疗相比,健脾化湿经验方的整体疗效更佳,复发率更低,值得临床进一步的研究和探索。
[Abstract]:Objective to treat ulcerative colitis of spleen deficiency and dampness accumulation type by clinical application of the experience prescription of Professor Zhang Dongyue of our hospital. And with the Western medicine commonly used in the treatment of ulcerative colitis, compared with the western medicine, observe and contrast the different treatment of traditional Chinese and western medicine, and summarize the advantages of the experience of strengthening spleen and resolving dampness in clinical treatment. To provide reference for clinical treatment and further experimental study of ulcerative colitis. Methods selected from April 2015 to October 2015. Sixty patients with ulcerative colitis in the first affiliated Hospital of Henan University of traditional Chinese Medicine (Henan University of traditional Chinese Medicine) were selected to meet the inclusion criteria. The TCM syndrome type was spleen deficiency and dampness accumulation type, which volunteered to participate in this study. The treatment group was divided into two groups randomly. The treatment group was given the experience prescription of Professor Zhang Dongyue of our hospital, and the prescription of strengthening spleen and removing dampness (Changjian Ping Li), the specific ingredients of the prescription were: Coix seed 30g, Codonopsis 20g, Jiao Atractylodes 20g. Poria cocos 15g, white lentils 30g, old peel 12g, black medicine 10g, Amomum villosum 15g, yam 30g, Platycodon grandiflorum 12g, lotus seed 30g, licorice 6g; The Chinese herbal medicine room of the first affiliated Hospital of Henan University of traditional Chinese Medicine provides the above and is well fried and packaged in the hospital, 400 ml for each set of frying and filtering liquid, divided into two bags, 200 ml for each bag, and 1 bag for warm clothes after morning and evening meal. The control group was given the commonly used aminosalicylic acid drug, Mesalazine enteric-coated tablets (commodity name: Wheidi chemical name: 5- aminosalicylic acid). 5-ASAN (production company: Jiamusi Luling Pharmaceutical Company, Sunflower Pharmacy, oral, 0.5 g / time, 3 times a day. Each group takes 15 days as one treatment cycle, for a total of 4 cycles. After the end of the follow-up once a month, a total of 4 follow-up, observe and record the entire experimental process, the two groups of curative effects, adverse reactions, etc. Results after the end of the experiment. The data of the two groups were analyzed by SPSS19.0 software, the results showed that the two groups in the comprehensive efficacy, endoscopic mucosal manifestations, pathological results. The curative effect and recurrence rate of TCM symptoms were improved in different degrees, but compared with each other, there were different degrees of difference between the two groups. In the total effective rate of comprehensive curative effect, the two groups were 93.10% respectively. Compared with the control group, the comprehensive curative effect of the treatment group was better than that of the control group (P 0.05). The effect of the treatment group was better than that of the control group (P 0.05). Traditional Chinese medicine symptom comparison, the treatment group can better improve the patient diarrhea, abdominal pain, abdominal distension, mucus stool, after a sense of urgency, diet, body burnout, fatigue, such as P0.05, but in the purulent blood stool. There was no significant difference in the improvement of thorax and hypochondriac pain between the two groups. The recurrence rate was 6.90 in the treatment group and 34.48% in the control group during the 4-month follow-up. Conclusion the prescription of invigorating spleen and transforming dampness and mesalazine enteric-coated tablets have certain clinical curative effect on ulcerative colitis with spleen deficiency and dampness accumulation. The experience prescription of invigorating spleen and transforming dampness has better overall curative effect and lower recurrence rate, which is worthy of further clinical study and exploration.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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