白头翁汤加减保留灌肠治疗溃疡性结肠炎临床观察

Clinical Observation on Treatment of Ulcerative Colitis with Retention Enema of Baitouweng Decoction(白头翁汤)

目的观察益生菌联合美沙拉嗪及白头翁汤加减保留灌肠治疗轻、中度溃疡性结肠炎的临床疗效。方法将确诊的45例轻、中度溃疡性结肠炎患者按随机数字表法分为3组,美沙拉嗪联合治疗组15例,给予美沙拉嗪肠溶片和双歧杆菌乳杆菌三联活菌片治疗,白头翁汤联合治疗组15例,给予白头翁汤加减保留灌肠和双歧杆菌乳杆菌三联活菌片治疗,对照组15例,仅给予美沙拉嗪肠溶片治疗,治疗6周后比较3组治疗前后临床疗效。结果(1)治疗后美沙拉嗪联合治疗组总有效例数14例(93.3%,14/15),白头翁汤联合治疗组总有效例数14例(93.3%,14/15),对照组总有效例数12例(80.0%,12/15)。(2)3组患者的改良Mayo评分较治疗前有明显下降,差异均有统计学意义(P<0.05)。(3)3组患者治疗前后的改良Mayo评分具有组间差异,部分指标差异有统计学意义(P<0.05)。结论(1)白头翁汤加减保留灌肠联合益生菌治疗轻、中度溃疡性结肠炎疗效最佳,优于其余两组,美沙拉嗪联合益生菌治疗轻、中度溃疡性结肠炎疗效与单独应用美沙拉嗪无统计学意义。(2)白头翁汤加减保留灌肠联合益生菌治疗轻、中度溃疡性结肠炎中,对于改善肠黏膜损伤,提高内镜评分方面效果最佳,优于其余两组。(3)联用益生菌的治疗组对于改善排便次数具有显著疗效,优于单独应用美沙拉嗪。

Objective To observe the clinical effect of probiotics combined with mesalazine or retention enema of Baitouweng Decoction(白头翁汤)in the treatment of mild and moderate ulcerative colitis.Methods Forty-five patients with mild and moder⁃ate ulcerative colitis were randomly divided into three groups:Mesalazine combination treatment group(15 cases,treatment with mesalazine enteric coated tablets and Bifidobacterium Lactobacillus triple viable tablets),retention enema of Baitouweng Decoc⁃tion combination treatment group(15 cases,treatment of Baitouweng Decoction with retention enema and Bifidobacterium Lactoba⁃cillus triple viable tablet)and control group(15 cases,treatment with mesalazine enteric coated tablets only).After 6 weeks of treatment,the clinical effects of three groups before and after treatment were compared.Results(1)After treatment,the total effec⁃tive cases of Mesalazine combination treatment group,retention enema of Baitouweng Decoction combination treatment group and control group were 93.3%(14/15),93.3%(14/15)and 80.0%(12/15)respectively.(2)The modified Mayo scores of the three groups were significantly lower than those before treatment(P<0.05).(3)The modified Mayo scores of the three groups before and after treatment had significant difference,and some indexes had statistical significance(P<0.05).Conclusion(1)The effect of retention enema of Baitouweng Decoction combination treatment group in the treatment of mild and moderate ulcerative colitis was the best,better than the other two groups.(2)In the treatment of mild and moderate ulcerative colitis,retention enema of Bai⁃touweng Decoction combination treatment group has the best effect on improving intestinal mucosa damage and endoscopic score,better than the other two groups.(3)In the treatment of mild and moderate ulcerative colitis,probiotics combination treatment has a significant effect on improving defecation times,better than the control group.