溃疡性结肠炎活动期和缓解期中医症状分布特点的临床调查

Clinical Investigation on Characteristics of TCM Symptom and Sign of UC in Acute Stage and Stable Stage

目的:通过全国多中心、大样本的临床调查,探讨溃疡性结肠炎中医症状分布特点。方法:采用课题组制定的溃疡性结肠炎临床信息采集表对符合病例选择标准的患者进行调查,建立Epidata 2.0临床调查资料数据库,运用SPSS 15.0软件对溃疡性结肠炎中医症状的频次、频率进行统计分析。结果:临床调查共收集溃疡性结肠炎951例,其中活动期829例,缓解期122例。症状分布特点:出现频率≥35%的症状在活动期有35个,缓解期有21个。活动期消化系统常见症状为泄泻、脓血便(血多于脓)、腹痛、腹胀、里急后重、肠鸣增多、矢气增多、肛门气坠、排便不爽、肛门灼热、泻下急迫;肠外症状为:乏力、神疲、畏寒、少气懒言、腰部酸软、下肢酸软、口苦、口咽干燥、纳呆、失眠、多梦、急躁易怒、烦躁、精神抑郁、胖大舌、齿痕舌、黄苔、腻苔、厚苔、燥苔、脉细、脉弦、脉滑。缓解期消化系统常见症状为腹痛、泄泻、里急后重、腹胀、排便不爽、肠鸣增多;肠外症状:齿痕舌、脉细、乏力、腻苔、胖大舌、口咽干燥、急躁易怒、白苔、淡白舌、畏寒、腰部酸软、神疲、脉沉、精神抑郁、少气懒言。结论:溃疡性结肠炎活动期和缓解期均以泄泻、腹痛、腹胀等为最常见,但全身症状的出现频率以活动期为多;本病的病机特点是虚实夹杂,但活动期以湿热蕴结大肠为主,兼有阳气不足之象,缓解期以脾肾阳气不足为主,兼有湿邪内阻之象。

Objective ： To sum up the distribution characteristics of TCM symptoms of UC by a clinical investigation with large samples and different national centers. Methods ： By investigating the UC patients who comply with the case selection criteria by the ciinical information collection table established by RCPE, and establishing a literature data - base of terms of TCM symptoms, then analyze them by SPSS 15.0 software. Results ：951 cases altogether, included 829 cases of acute stage, and 122 cases in stable stage. The distribution characteristics of TCM Symptoms： frequency of symptoms is equal or greater and equal to 35% in active period has 35, and in remission there are 21. In acute stage, the common symptoms of digestive system are diarrhea, pus and blood stools （blood more than pus）, abdominal pain, abdominal distension, tenesmus, borborygmus increased, fart increased, dropping of the anus, unsmooth defecation, burning sensation in the anus, urgent diarrhea. The parenteral symptoms ： fatigue, shenpi, chills, disinclination to talk, weak waist, lower limb weakness, bitter taste in mouth, oropharynx drying, inappetence, insomnia, dreaminess, irritable and agitated, depression, fat tongue, tooth marks tongue, yellow coating, greasy coating, thick coating, dry coating, fine pulse, string pulse, slippery pulse. In stable stage, the common symptoms of digestive system are abdominal pain, diarrhea, tenesmus, abdominal distension, unsmooth defecation, borborygmus： increased. The parenteral symptoms ： tooth marks tongue, fine pulse, fatigue, greasy coating, fat tongue, oropharynx drying, irritable and agitated, white coating, shallow white tongue, chills, weak waist, shenpi, sink pulse, depression, disinclination to talk. Conclusion：The common symptoms of the patients with UC in both acute and stable stages are diarrhea, abdominal pain, abdominal distension. And frequency of the symptoms＇occurence of acute stage is higher. But the frequency of entire symptoms mainly appears at acute stage ; the main characteristic of pathological mechanism of UC is mixed with excessiveness and deficiency, which include damp - heat focusing in large intestine as excess syndrome with yang - qi deficiency symptoms, and comparasively, spleen and kidney yang -qi deficiency syndrome as deficiency with dampness obstruction symptoms.