加味玉屏风散维持溃疡性结肠炎缓解疗效评价研究

发布时间：2018-03-04 01:31

本文选题：溃疡性结肠炎　切入点：加味玉屏风散　出处：《南京中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的采用随机、对照临床设计方法,评价加味玉屏风散维持溃疡性结肠炎缓解的临床疗效及安全性,制定溃疡性结肠炎缓解期治疗方案方法选取江苏省中医院收治的溃疡性结肠炎缓解期患者,并且中医证型符合肺脾气虚证,共60例,将其分为治疗组30例,对照组30例。治疗组予加味玉屏风散联合西药治疗,对照组予西药治疗。48周为总疗程,观察复发率、中医证候疗效、肠镜评分、Mayo评分等。结果在复发率方面,治疗组30例中4例复发,复发率为13.33%,对照组30例中有13例复发,复发率为43.33%。两组经卡方检验比较(P0.05),治疗组优于对照组。在中医证候疗效方面,治疗组总有效率86.67%；对照组总有效率56.67%,两组经卡方检验有统计学意义(P0.05),治疗组疗效优于对照组。在肠镜积分、黏膜组织学积分、Mayo评分方面,治疗组疗效均优于对照组(P0.05)。中医症状疗效方面,两组在治疗前后对改善畏风自汗、腹胀、食欲减退、神疲乏力、气短懒言比较有统计学差异(P0.05),表明治疗组与对照组对于缓解患者临床症状均有疗效。组间比较,两组在改善食欲减退、气短懒言症状方面均无明显差异(P0.05)；但在腹泻、脓血便,腹痛、畏风自汗、腹胀、里急后重、神疲乏力症状方面存在差异性(P0.05),表明治疗组改善腹痛、畏风自汗、腹胀、里急后重、神疲乏力症状的疗效优于对照组,在维持大便次数正常,减少脓血便发生方面疗效优于对照组。生存质量方面治疗组疗效优于对照组(P0.05)。两组安全性指标在治疗前后无差异(P0.05)。结论加味玉屏风散维持溃疡性结肠炎缓解具有一定的临床疗效和安全性,临床疗效优于单用西药治疗,值得临床进一步研究及推广应用。
[Abstract]:Objective to evaluate the clinical efficacy and safety of modified Yupingfeng Powder in maintaining the remission of ulcerative colitis by randomized, controlled clinical design. 60 cases of ulcerative colitis were divided into two groups: 30 cases in the treatment group, 60 cases in accordance with the syndrome of deficiency of lung and spleen qi, and 30 cases in the treatment group, which were selected from Jiangsu Provincial Hospital of traditional Chinese Medicine to treat ulcerative colitis in remission stage. There were 30 cases in the control group. The treatment group was treated with Jiawei Yupingfeng powder combined with western medicine, while the control group was treated with western medicine for a total course of 48 weeks. The recurrence rate, the curative effect of TCM syndromes, the score of endoscopy and Mayo were observed. In the treatment group, 4 cases recurred and the recurrence rate was 13.33%, while in the control group, 13 cases recurred and the recurrence rate was 43.33%. The treatment group was superior to the control group in the curative effect of TCM syndrome. The total effective rate of the treatment group was 86.67 and the total effective rate of the control group was 56.67. The two groups had statistical significance by chi-square test. The curative effect of the treatment group was better than that of the control group. The curative effect of the treatment group was better than that of the control group (P 0.05). In terms of the effect of TCM symptom, the two groups were better than the control group before and after treatment on the improvement of fear of wind and sweating, abdominal distention, loss of appetite and fatigue. There was significant difference in the comparison of Qi-short and lazy speech (P 0.05), which indicated that both the treatment group and the control group had curative effect on relieving the clinical symptoms of the patients. Compared between the two groups, there was no significant difference in the improvement of appetite and the symptoms of shortness of breath, but there was no significant difference between the two groups in the symptoms of diarrhea, pus and blood. There were differences in symptoms of abdominal pain, fear of wind and sweating, abdominal distension, acute and severe, fatigue symptoms in the treatment group (P 0.05), which indicated that the treatment group was better than the control group in improving abdominal pain, fear of wind and sweating, abdominal distension, acute and severe, and fatigue symptoms, and the effect of the treatment group was better than that of the control group. While maintaining a normal number of bowel movements, The curative effect of the treatment group is better than that of the control group in reducing the occurrence of pus and blood stool, and the curative effect of the treatment group is better than that of the control group in terms of quality of life. There is no difference in the safety index between the two groups before and after treatment. Conclusion the modified Yupingfeng Powder can maintain the remission of ulcerative colitis. Certain clinical efficacy and safety, The clinical effect is better than that of western medicine alone, which is worthy of further clinical study 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】：2016
【分类号】：R259

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