清肠化湿方治疗溃疡性结肠炎的临床疗效及对ESR,PLT,D-二聚体的影响

Influence of Qingchang Huashi Fang on ESR,PLT and D-dimer in Treatment of Patients with Ulcerative Colitis

目的:观察清肠化湿方治疗溃疡性结肠炎的临床疗效及治疗前后血沉(ESR)、血小板(PLT)、D-二聚体等指标的变化情况,评价其诱导缓解及对凝血指标的改善作用。方法:将59例确诊为轻、中度活动期溃疡性结肠炎且中医辨证属湿热内蕴证的患者分为中药治疗组和美沙拉嗪对照组。中药组予清肠化湿方口服及中药灌肠;美沙拉嗪组活动期予美沙拉嗪肠溶片4 g·d-1口服,病情缓解后改为1.5 g·d-1维持治疗。疗程共12周,治疗结束后评价总有效率、主要症状消失率、肠镜疗效及对ESR,PLT,D-二聚体等指标的影响。结果:中药组总有效率高于美沙拉嗪组(93.3%vs 79.3%,P<0.05),主要症状便血及腹泻的消失率均优于美沙拉嗪组消失率(82.8%vs 58.6%,85.7%vs 60.0%,P<0.05),肠镜疗效优于美沙拉嗪组(P<0.05)。中药组对于患者ESR,PLT的改善程度均优于美沙拉嗪组(P<0.05),但是尚不能说明中药对于D-二聚体的改善优于美沙拉嗪组。结论:清肠化湿方是轻、中度溃疡性结肠炎有效且安全的治疗方案,在诱导缓解、改善症状、改善ESR,PLT等相关指标等方面优于美沙拉嗪。但是本研究未能发现中药对于D-二聚体的改善优于美沙拉嗪组。

Objective：To observe the therapeutic effect of Qingchang Huashi fang on patients with ulcerative colitis and the improvements of erythrocyte sedimentation tate （ESR）,platelet （PLT） and D-dimer after treatment,in attempt to evalutate its impact on remission induction and improved coagulation indexes.Method：Fifty-nine patients diagnosed with mild or moderate active ulcerative colitis and belong to Shire Neiyun syndrome were divided into traditional Chinese medicine （TCM） treatment group and Mesalazine control group.Patients were treated by oral and enema with TCM in treatment group,while in control group with Mesalazine.Evaluate the total effective rate,the main symptom disappearance rate,colonoscopy curative effect and ESR,PLT,D-dimer indicators.Result：The total effective rate of Qingchang Huashi fang was higher than mesalazine （93.3％ vs 79.3％,P ＜0.05）,and the disappearance rates of hematochezia and diarrhea in treatment group were higher than those in contol group （82.8％ vs 58.6％,85.7％ vs 60.0％,P ＜0.01）.The improvement of colonoscopy was also superior to Mesalazine （P ＜ 0.05）.The indicators of ESR,PLT were improved much more than those in contol group （P ＜ 0.05）.Conclusion：Qingchang Huashi fang was superior to mesalazine in remission induction,relief of symptoms and improvement of coagulation indexes.But we had not found that Qingchang Huashi fang was better than mesalazine in the improvement of D-dimer.