人参联合全胃肠外营养治疗重度溃疡性结肠炎30例疗效观察

A study on effect of Renshen （人参） combined with total parenteral nutrition in treatment of 30 cases with severe ulcerous colonitis

目的观察人参联合全胃肠外营养（TPN）治疗重度溃疡性结肠炎（SUC）的临床疗效。方法将58例患者随机分为两组。治疗组30例，在解痉、止痛、输血和血浆、纠正低蛋白血症，改善水、电解质、酸碱失衡以及抗感染等治疗基础上，采用人参开水泡服加TPN治疗；对照组28例仅采用基础治疗。两组以15d为1个疗程，观察临床疗效及治疗前后血电解质及二氧化碳结合力（COzCP）的变化。结果治疗组完全缓解4例，基本缓解22例，无好转4例，总缓解率为86．7％；对照组完全缓解1例，基本缓解11例，无好转16例，总缓解率为42．8％；治疗组总缓解率明显高于对照组（P〈0．05），且病死率（13．3％，4／30）明显低于对照组（53．6％，15／28，P〈0．01）。治疗组治疗后血电解质K＋、Na＋、Cl-、Mg2＋、Ca2＋、P2＋及CO2CP均较治疗前明显改善，且明显优于对照组（P均〈0．05）。结论人参联合TPN治疗能有效改善SUC临床症状，对营养供给，改善贫血，纠正低蛋白血症及水、电解质、酸碱失衡，增强免疫功能，阻断并发症的发生发展，提高生存率具有重要意义。

Objective To explore the clinical efficacy of Renshen （人参） combined with total parenteral nutrition （TPN） in treatment of severe ulcerous colonitis （SUC）. Methods Fifty-eight cases with SUC were randomly divided into two groups： treatment group （30 cases） and control group （28 cases）. In the control group, basic measures for relief of pain and spasm, blood or plasma transfusion, correction for hypo- proteinemia, imbalance of water, electrolytes and acid-base, and anti-infection drugs were applied. In the treatment group, beside the basic treatment in the control group, Renshen immersed in boiling water was taken orally and TPN was administered. The therapeutic course in both groups was 15 days. The clinical efficacy and the changes of blood-electrolyte and carbon dioxide combining power （CO2CP） before and after treatment were observed. Results In the treatment group, there were 4 cases with complete relief, 22 cases relieved basically, and 4 cases without any relief, the total effective rate being 86.7%. In the control group, the cases with complete, basic and no relief were 1, 11 and 16 respectively, the total effective rate being 42.8% that was markedly lower than that in the treatment group （P〈0.05）. Death rate of treatment group [53.6%（15/28）] was significantly higher than that of control group [13.3% （4/30）, P〈0. 01]. After treatment in the treatment group, the blood electrolytes including K＋, Na＋, Cl-, Mg2＋, Ca2＋, P2＋ and COzCP were obviously improved, the improvement being superior to those in the control group （all P〈0. 05）. Conclusion Renshen combined with TPN for treatment of SUC can effectively improve the clinical symptoms, supply nutrition, improve anemia, correct hypoproteinemia, water, electrolytes and acid-base imbalance, enhance immunization, block the occurrence and development of complications and increase survival rate, thus the therapy possesses important significance.