溃疡性结肠炎的病因探讨及中药灌肠治疗的临床观察

Study on the cause of ulcerative colitis and clinical observation of enema with traditional Chinese medicine

目的探讨溃疡性结肠炎的发病原因,探索中医方剂仙翁愈疡合剂治疗溃疡性结肠炎的疗效及机制。方法选取2013年10月至2014年3月来自聊城市人民医院肛肠科住院的经中医辨证为大肠湿热型溃疡性结肠炎患者60例,所有病例均进行纤维结肠镜检查,随机分为治疗组和对照组,每组30例。分别给予仙翁愈疡合剂50 ml和锡类散2 g+0.9%生理盐水50 ml,每晚睡前1次保留灌肠,疗程20天。比较两组治疗前后症状改善情况及证候积分。结果临床症状缓解情况,治疗组腹痛、腹泻、黏液血便及里急后重症状改善明显优于对照组(u=2.44,2.77,2.52,2.40,P<0.05),两组中医证候积分比较,组内治疗前后比较均有效(t=7.645,t=4.295,P<0.05),治疗后两组之间比较治疗组证候积分的改善明显优于对照组(t=2.942,P<0.05)。结论溃疡性结肠炎发病原因为脾胃虚弱为本,大肠湿热为标,气滞血瘀贯穿整个病程,湿、热、瘀、虚是溃疡性结肠炎发病的重要机制。仙翁愈疡合剂治疗早中期溃疡性结肠炎安全有效。

Objective To investigate the pathogenesis of ulcerative colitis and explore the curative effect and mechanism of TCM prescription seno Yuyang mixture in the treatment of ulcerative colitis. Methods From October 2013 to March 2014, Sixty cases of hospital patients from Anorectal Department of Liaocheng People＇s Hospital were differentiated by TCM as damp heat ulcerative colitis, all cases were performed colonoscopy, and randomly divided into treatment group and control group, Thirty cases in each group. The seno Yuyang mixture was given 50 ml and Xileisan 2 g ＋ 0.9% saline 50 ml, once retention enema every night before going to bed, treatment course was 20 days. We compared the symptom improvement and syndrome scores between the two groups before and after treatment. Results The clinical symptoms, treatment group, abdominal pain, diarrhea, mucous bloody stool and tenesmus symptoms were improved significantly better than the control group （u=2.44, 2.77, 2.52, 2.40, P〈0.05）, symptoms quantification before and after the treatment and TCM syndrome integral comparison of the two groups, before and after treatment in the group were both effective （t=7.645, t=4.295, P 〈 0.05）, the syndrome score of the treatment group was significantly better than the control group after treatment （t=2.942, P 〈 0.05）. Conclusion The pathogenesis of ulcerative colitis is the weakness of the spleen and stomach, the large intestine damp heat as the standard, gas stagnation and blood stasis runs through the whole course of disease. Dampness, heat, blood stasis and deficiency are important mechanisms of ulcerative colitis. The Seno Yuyang mixture treatment of early stage of ulcerative colitis is effective and safty.