辨证分型与解毒消痈方灌肠联合西药治疗溃疡性结肠炎随机平行对照研究

Differential Treatment and Detoxification Carbuncle Party Enema Combined with Western Medicine Randomized Parallel Group Study of Ulcerative Colitis

[目的]观察辨证分型与解毒消痈方灌肠联合西药治疗溃疡性结肠炎疗效。[方法]使用随机平行对照方法,将58例住院及门诊患者按抽签法简单随机分为两组。对照组28例硫氮磺吡啶,2.0g/次,3次/d,口服;蒙脱石散,3g/次,3次/d,口服;解毒消痈方(红藤20g,败酱草30g,鱼腥草20g,马齿苋30g,白芷、丹参各15g,地丁草20g,益母草15g;脾胃虚弱加党参20g,白术、茯苓各15g;湿热蕴脾加黄芩、苦参各20g,黄柏15g;肾阳虚衰加附子、肉桂、巴戟天各15g),1剂/d,加水1000mL浓煎成250mL,每晚临睡前保留灌肠。治疗组30例1脾胃虚弱,参苓白术散(党参20g,白术15g,茯苓12g,山药、白扁豆各15g,砂仁、陈皮各10g,桔梗9g,薏米仁15g,大枣5枚;腹痛明显加白芍15g,小茴香10g);2湿热蕴脾,葛根芩连汤(葛根20g,黄芩12g,黄连、甘草各10g,金银花15g,茯苓、泽泻、枳壳各10g,桔梗6g;湿邪偏重加厚朴12g,陈皮、白术各10g;热邪偏重加苦参、黄柏、车前子各10g);3肾阳虚衰,四神丸(补骨脂15g,吴茱萸10g,肉豆蔻20g,五味子、附子、干姜各15g;气虚加党参20g,白术15g,黄芪20g;血瘀加当归10g,川芎12g,赤芍15g);上方均1剂/d,水煎200mL,早晚口服;西药及解毒消痈方灌肠治疗同对照组。连续治疗56d为1疗程。观测临床症状、结肠镜检查、不良反应。连续治疗2疗程,判定疗效。随访6个月,观测复发率。[结果]治疗组痊愈16例,有效11例,无效3例,总有效率90.00%。对照组痊愈13例,有效8例,无效7例,总有效率75.00%。治疗组疗效优于对照组(P<0.05)。[结论]辨证分型与解毒消痈方灌肠联合西药治疗溃疡性结肠炎疗效显著,值得推广。

[ Objective ] Differential Treatment ＋ detoxification carbuncle party enema combined with western medicine ulcerative colitis. [ Methods ] Random parallel control method, 58 cases of hospitalized and outpatients were randomly divided into two groups. Sulfur and sulfur control group 28 cases pyridine tablets, 2.0g / time, 3 times / d, orally ; montmorillonite powder, 3g / time, 3 times / d, orally ; detoxification carbuncle Party （Hongteng 20g, Baijiangcao 30g, Yuxingcao 20g, Machixian 30g, Baizhi, Danshen 15g, Didingcao 20g, Yimucao 15g;spleen and stomach plus Danshen 20g, Baizhu, Fuling 15g;damp plus Huangqin, Kushen each 20g, Huangbo 15g;Kidney failure plus Fuzi, Rougui, Bajitian each 15g ）, 1 does/ d, water 1000mL thick pan 250mL, retention enema night before going to sleep. Treatment group of 30 patients （1） weak stomach, Shenlingbaizhu scattered （Danshen 20g, Baizhu 15g, Fuling 12g, Shanyao, Baihiandou each 15g, Sharen, Chenpi 10g, Jiegen 9g, Yimiren 15g, Dazao 5 ;abdominal pain significantly plus Baishao 15g, Xiaohuixiang 10g）; （2） damp, Gegenqinlian （Gegen 20g, Huangqin 12g, Huanglian, Gancao lOg, Jinyinhua 15g, Fuling, Zexie, Jike 10g, Jiegen 6g;dampness emphasis added Houbu 12g, Chenpi, Baizhu 10g; emphasis added heat evil Hushen, Huangbo, Cheqianzi each 10g ）; （3） Kidney failure, Shishenwan （ Buguzhi 15g, Wuyu 10g, 20g Roudoukou, Wuweizi, Fuzi, Ganjiang each 15g ginger and qi Danshen 20g, Baizhu 15g, Huangqi 20g; and blood stasis plus Dangui 10g, Chuanxiong 12g, Chishao 15g ） ;these prescriptions are 1 does / d, decoction 200mL, sooner or later oral ; medicine and detoxification carbuncle party enema with the control group. 56d is a continuous course of treatment. Observing clinical symptoms of adverse reactions. 2 courses of continuous treatment, to determine efficacy. Followed up for six months, observing the recurrence rate. [ Results ]The cure in 16 cases, effective in 11 cases, 3 cases, the total efficiency of 90.00%. The control group healed in 13 cases, 8 cases, 7 cases, the total efficiency of 75.00%. Treatment group than the control group （ P〈0.05 ） . [ Conclusion ] Differential Treatment ＋ detoxification carbuncle enema combined western side effect is remarkable treatment of ulcerative colitis, worthy of promotion.