活血化瘀治疗溃疡性结肠炎

The Treatment of Ulcerative Colitis by Promoting Blood Circulation and Removing Blood Stasis

溃疡性结肠炎治疗难度大,西医治疗虽起效快,但不良反应较多,患者耐受性较差;血液高凝状态、血液缓慢、血管壁改变引起血栓并发症已成为死亡三大原因。湿热蕴肠,气滞络瘀为基本病机,瘀血既是UC病理产物,又是重要致病因素,各临床分型中均有血瘀的表现。活血化瘀,分期辨证,急性发作期以凉血止血为先,同时注重活血化瘀药的应用,迅速缓解患者症状,以达止血不留瘀,凉血不凝血之目的;慢性迁延期宜攻补兼施,活血化瘀;临床缓解期宜健脾除湿,活血通络,恪守化瘀通滞不伤正,扶正固本不留邪,虚、瘀同治,化瘀扶正清余邪,降低复发率。以口服、保留灌肠、静脉给药等方式治疗。未来应开展大样本临床研究,寻求循证医学支持。

The treatment of ulcerative colitis is difficult,western medicine treatment has the fast curative effect,but,it has adverse reactions for the patients;high blood coagulation state,Slow blood flow,thrombosis complications caused by the change of blood vessel walls are three major causes of death.The basic pathogenesis are humid-heat accumulated in the intestines and Qi and blood stasis.Blood stasis is not only the pathological product,but also the important pathogenic factor of UC.Blood stasis exists in all clinical classification.Promoting blood circulation and removing blood stasis,syndrome differentiation by phase,In the acute phase,colding blood bleeding must be in the first place,at the same time,it needs to focus on promoting blood circulation to remove blood stasis drugs application to make the patient quickly alleviate the symptoms.Making the blood cold and stop bleeding without blood stasis and clotting is the ultimate goal;In the chronic phase,it needs tonification and purgation in combination,promoting blood circulation and removing blood stasis is also important in this phase;In the clinical remission stage,both invigorating spleen and removing dampness,and promoting blood circulation are necessary,abide by the principle that vital qi has no loss and pathogenic factor be removed by promoting blood circulation and removing blood stasis,and supporting the healthy energy.Reduce the recurrence rate by removing stasis and pathogenic factors.Such as Oral drugs,retention enema,intravenous drugs are the commonly used treatments.Future clinical research should be carried out in the future to seek evidence-based medicine.