中医分期治疗溃疡性结肠炎临床研究

The Clinical Research into Ulcerative Colitis Treated with TCM Staging Treatment

摘要：目的：观察中医分期治疗溃疡性结肠炎的}临床疗效。方法：收集2011年6月-2013年6月在本院消化内科治疗的UC患者68例。根据随机数字表法分为观察组和对照组各34例。对照组应用柳氮磺胺吡啶肠溶片治疗，活动期、恢复期每次1．5g，日3～4次；缓解期每次1．0g，每日3～4次；病位在直肠、乙状结肠的患者用柳氮磺胺吡啶栓剂，每次1g，日2次。观察组根据不同时期病机特点辨证施治，同时根据病位应用中药保留灌肠治疗。比较两组患者临床疗效及不同时间点的症状总积分和IL-8、TNF-的变化情况。结果：观察组完全缓解率、有效率明显高于对照组（P〈0．05）。两组症状总积分、IL-8、TNF-α水平在治疗4周、3个月、随访6个月时均较治疗前明显降低（P〈0．05），但观察组降低程度更明显（P〈0．05）。观察组在随访6个月期间复发率明显低于对照组（19〈0．05）。结论：中医分期治疗能有效改善UC患者的炎症状态，减轻临床症状，降低复发率，提高远期疗效。

Objective：To observe the clinical curative effect of TCM Staging Treatment on ulcerative colitis. Methods：Sixty-eight patients with UC who were treated in the department of gastroenterology of our hospital between June 2011 and June 2013 were chosen as the research subjects, and randomly divided into the observation group and the control group according to random num- ber table method, with 34 cases in each group. The ones in the control group were treated with sulfasalazine enteric coated tablets, 1.5 g each time,3 to 4 times each day during activity and recovery period;1.0 g each time,3 to 4 times each day during the re- mission period;For patients whose disease areas focus on the rectum and sigmoid colon, sulfasalazine suppository were used;1.0 g each time, twice each day. While the ones in the observation group were treated based on syndrome differentiation according to pathogenesis features in different periods, and at the same time they received TCM retention enema according to disease areas. Then the two groups＇ clinical curative effects,the total scores of symptoms in different time points,the changes of IL-8 and TNF were compared. Results ： The complete remission rate and effective rate in the observation group were significantly higher than those in the control group （P 〈 0.05）. The two groups＇ total scores of symptoms, IL-8 and TNF-cdevels were significantly lower than before treatment （P 〈 0.05 ） on the 4th week and the 3rd month after the treatment, and in the 6th months when being fol- lowed up, but reduced degrees of the observation group were more significant （P 〈 0.05 ）. The recurrence rate of the observation group was significantly lower than that of the control group during the 6 months＇ follow-up （P 〈 0.05）. Conclusion ：TCM staging treatment can effectively improve the inflammatory state of UC patients, relieve clinical symptoms, reduce the recurrence rate and improve the long-term curative effect.