芍药汤加减加美沙拉嗪灌肠联合美沙拉嗪口服治疗溃疡性结肠炎临床观察

Modified Shaoyao Decoction Plus Mesalazine Suppository Enema and Oral Administration for Treating Ulcera- tive Colitis： Clinical Observation

为了观察芍药汤加减方加美沙拉嗪栓灌肠联合美沙拉嗪片口服治疗中远端溃疡性结肠炎（Duc）的疗效，将70例轻、中、重度活动期DUC患者随机分为观察组和对照组，每组各35例。观察组采用芍药汤加减方加美沙拉嗪栓保留灌肠1周，同时给予美沙拉嗪肠溶片口服8周，对照组仅给予美沙拉嗪肠溶片口服，2组均治疗8周。治疗结束后比较2组患者治疗后的临床疗效、主要症状消失率、内镜肠黏膜变化情况，观察不良反应的发生情况及治疗后复发情况。结果显示，治疗8周后观察组总有效率（94．3％，33／35）显著高于对照组（80．0％，28／35），P〈0．05。主要症状腹泻、便血的消失率均优于对照组（P〈0．05）。2组用药后均无明显不良反应。治疗3个月后随访，观察组复发率5．7％，对照组复发率14．3％，差异有统计学意义（P〈0．05）。结果表明，芍药汤加减方加美沙拉嗪栓保留灌肠联合美沙拉嗪片口服可明显改善DUC患者临床症状（腹泻、腹痛、血便）及内镜下肠黏膜病变（水肿充血、黏膜溃疡、黏膜糜烂），有效安全，且近期临床疗效优于单用美沙拉嗪。

This study was to observe the efficacy of modified Shaoyao decoction plus Mesalazine suppository enema and tablets oral administration for treating middle-distal ulcerative colitis （DUC）, divided 70 cases with mild,moderate and severe DUC of active stage into observation group and control one,35 cases for each.The former was treated with modified Shaoyao decoction plus Mesalazine suppository retention enema for a week and at the same time with oral Mesalazine enteric coated tablets for 8 weeks while the latter was only treated with oral Mesalazine enteric coated tablets for 8 weeks. After treatment of the both groups, the clinical efficacy,main symptoms＇ disappearing rate ＆ change condition of endoscopic intestinal mucosa were compared and the occurrence of adverse reaction ＆ the reccurrenee were observed.Results show that after the 8 weeks＇ treatment, the total effective rate of the former （94.3 %, 33/35） was obviously higher than that of the latter （80.0%,28/35）（ P〈0.05）. And in the main symptoms＇ disappearing rate such as diarrhea and hematochezia,the former was superior to the latter （ P〈0.05）. After using drugs of the two groups,there was all no obvious adverse reaction. According to the follow-up after 3 months after treatment,the reccurrence rate of the former was 5.7 % and the latter was 14.3%.There was statistically significance in difference （ P〈0.05）.In conclusion, modified Shaoyao decoction plus Mesalazine suppository retention enema and its tablets oral administration can obviously improve the clinical symptoms such as diarrhea,abdominal pain ＆ bloody stool of DUC patients and intestinal mucosa disease showed by endoscopy such as edema ＆ hyperemia,mucosa ulcer,mucosa erosion,which is effective and safe,what＇s more,its recent clinical efficacy is superior to alone using Mesalazine.