国医大师徐景藩清肠化湿灌肠方治疗轻中度溃疡性结肠炎活动期的疗效评价

发布时间：2018-03-02 09:14

本文关键词： 溃疡性结肠炎清肠化湿活动期中药灌肠　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的选用临床、对照研究方法,通过与西医治疗组对照,评价徐景藩教授清肠化湿灌肠方治疗活动期轻中度溃疡性结肠炎(ulcerative colitis)的疗效,从而为制定轻中度溃疡性结肠炎患者的治疗方案奠定基础。方法选择江苏省中医院脾胃病科收治的轻中度UC活动期病人进行研究,中医证型均符合湿热内蕴证,共60例,将其分为治疗组30例,对照组30例。治疗组予徐景藩教授清肠化湿灌肠方联合西药治疗;对照组予西药治疗。总疗程为12周,研究其临床缓解率、中医症状疗效、粘膜组织学积分、Mayo评分等。结果本研究表明:在临床缓解率方面,治疗组中临床缓解25例;对照组中临床缓解17例,治疗组临床缓解率83.33%,对照组临床缓解率56.66%;经X2检验比较(P0.05),证实治疗组疗效优于对照组。在临床有效率方面,治疗组中临床有效29例;对照组中临床有效23例,治疗组临床有效率96.66%,对照组临床有效率76.66%,经X2检验比较(P＜0.05),证实治疗组疗效优于对照组。同时在中医证候疗效方面,治疗组的总有效率96.66%;对照组的总有效率80%,经卡方检验比较(P0.05),治疗组疗效优于对照组。治疗组治疗结束复查肠镜肠粘膜愈合18例,对照组复查肠镜肠粘膜愈合10例,经x2检验(P＜0.05),表明治疗组的粘膜愈合率优于对照组。治疗组在肠镜积分、Mayo评分、粘膜组织学积分三个方面的疗效上优于对照组(P0.05)。组内比较,两组在改善患者中医临床症状均有疗效(P0.05)。组间比较,两组在缓解腹痛、脓液血便症状方面无统计学差异(P0.05);但是在缓解腹泻、口干口苦、里急后重、小便短赤、肛门灼热症状方面存在差异性(P0.05),表明治疗组改善腹泻、口干口苦、里急后重、小便短赤、肛门灼热症状的疗效优于对照组。两组在生存质量分析方面存在差异性(P0.05),表明治疗组疗程结束后生存质量优于对照组。结论经过系统评价,本研究中徐景藩教授清肠化湿灌肠方联合西药治疗轻中度溃疡性结肠炎活动期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 evaluate the therapeutic effect of Professor Xu Jingfan's Qingchang Hua Shi enema recipe in the treatment of mild and moderate ulcerative colitis in active stage by using clinical and comparative study methods and comparing with western medicine treatment group, and to evaluate the therapeutic effect of Professor Xu Jingfan on the treatment of ulcerative colitis in active stage. Methods A total of 60 patients with mild to moderate ulcerative colitis were selected from the Department of spleen and stomach Disease of Jiangsu Provincial traditional Chinese Medicine to study the active stage of mild and moderate UC. The TCM syndromes were all consistent with the internal syndrome of dampness and heat. The treatment group was divided into treatment group (n = 30) and control group (n = 30). The treatment group was treated with Professor Xu Jingfan Qingchang Huashi enema prescription combined with western medicine; the control group was treated with western medicine. The total course of treatment was 12 weeks. The clinical remission rate and the curative effect of TCM symptoms were studied. Results in the clinical remission rate, there were 25 cases of clinical remission in the treatment group and 17 cases in the control group. The clinical remission rate of the treatment group was 83.33 and the clinical remission rate of the control group was 56.66.The X2 test showed that the curative effect of the treatment group was superior to that of the control group. In terms of clinical effective rate, 29 cases were clinically effective in the treatment group and 23 cases in the control group. The clinical effective rate of the treatment group was 96.66, and the clinical effective rate of the control group was 76.66. The X2 test showed that the curative effect of the treatment group was better than that of the control group (P < 0.05). At the same time, the curative effect of TCM syndromes was better than that of the control group. The total effective rate of the treatment group was 96.666.The total effective rate of the control group was 80%, compared with that of the control group by chi-square test. The curative effect of the treatment group was better than that of the control group. The results of x2 test (P < 0.05) showed that the rate of mucosal healing in the treatment group was better than that in the control group, and the curative effect in the treatment group was better than that in the control group in three aspects: the score of endoscopy and the score of mucosal histology. There was no statistical difference between the two groups in relieving abdominal pain and blood stool symptoms of pus. However, there was no significant difference in relieving diarrhea, dry mouth and bitter mouth, severe after acute, short red urine, and no statistical difference was found between the two groups in improving the clinical symptoms of traditional Chinese medicine (TCM) in the two groups, and there was no statistical difference between the two groups in alleviating abdominal pain and blood stool symptoms. There were differences in anal burning symptoms (P 0.05), which indicated that the treatment group could improve diarrhea, dry mouth and bitter mouth, severe after acute, short red urine, The results showed that the quality of life in the treatment group was better than that in the control group after the end of the course of treatment, and the quality of life in the treatment group was better than that in the control group. In this study, Professor Xu Jingfan Qingchang Huashishenchang prescription combined with western medicine in the treatment of mild to moderate ulcerative colitis in active stage of clinical efficacy proved superior to the treatment of western medicine alone, clinical further research and application of the necessity.
【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】：R249;R259

【相似文献】