难治性溃疡性结肠炎患者临床诊断与治疗研究

Clinical diagnosis and treatment in patients with refractory ulcerative colitis

目的探讨难治性溃疡性结肠炎患者的临床诊断、治疗方法及治疗效果。方法将广东省东莞市企石医院消化内科收治的86例难治性溃疡性结肠炎患者,随机分为对照组(n=43)和观察组(n=43),对照组采用柳氮磺胺吡啶联合奥沙拉嗪治疗,观察组在对照组的基础上加用中药保留灌肠治疗。比较两组治疗前后主要临床症状改善情况、不良反应发生情况及导致难治的原因等,参考陈先社等的相关标准分析比较两组治疗效果。结果对照组总有效率81.4%;观察组总有效率97.7%。观察组显效率及总有效率显著高于对照组,差异有统计学意义(χ2=12.35,P<0.05)。观察组与对照组治疗前脓血便、腹痛、腹泻、腹胀、里急后重等临床症状积分比较,差异无统计学意义(t=2.920,P>0.05)。观察组治疗后脓血便、腹痛、腹泻、腹胀、里急后重等临床症状积分显著低于对照组,差异有统计学意义(t=4.303,P<0.05)。观察组不良反应发生率显著低于对照组,差异有统计学意义(χ2=5.99,P<0.05)。难治原因为:担心药物不良反应而中断治疗;经济因素;出院后无法坚持用药;患者认识偏差;治疗方案单一。结论采用中西医结合治疗难治性溃疡性结肠炎,治疗效果优于西医治疗,不良反应少,临床症状改善显著,值得临床推广应用。

Objective To explore the clinical diagnosis and treatment methods and therapeutic effect of patients with refractory ulcerative colitis. Methods Eighty-six cases of patients with refractory ulcerative colitis in department of gimedicine,Qishi people's Hospital of Dongguan in Guangdong Province were randomly divided into control group and observation group. The control group used willow nitrogen-pyridine with salad clomipramine treatment, the observation group added traditional Chinese medicine. Then the curative effect,main clinical symptoms adverse reaction and the cause of the two groups were analysed. Results The total efficiency of the control group was 81. 4%,the observation group' s was 97. 7%. The observation group showed that the efficiency and the total effective rate were significantly higher than the control group,the difference had statistical significance( χ2= 12. 35,P < 0. 05). The purulent blood,abdominal pain,diarrhea,abdominal distension,tenesmus symptoms integral of the two groups before treatment were compared and there was no statistically significant difference( t = 2. 920,P > 0. 05). The purulent blood, abdominal pain, diarrhea, abdominal distension, tenesmus symptoms integral of the observation group after treatment was significantly lower than the control group' s,and the difference had statistical significance( t = 4. 303,P < 0. 05). The incidence of adverse of the observation group was significantly lower than control group,the difference has statistical significance( χ2= 5. 99,P < 0. 05). Is reason to worry about: drug side effects and interruption of treatment,economic factors,being unble to adhere to the drug treatment after discharge from hospital,patients understanding deviation,a single treatment. Conclusion That traditional Chinese and western medicine integrated is better than western medicine in treatment of refractory ulcerative colitis,treatment effect,less adverse reaction,the clinical symptoms improved significantly,worthy of clinical application.