黄土汤合四神丸加味口服治疗脾肾阳虚型溃疡性结肠炎的临床疗效

Orally Administering Modified Sishen Wan plus Huangtu Tang for Treating Ulcerative Colitis in Pattern of Yang Deficiency of Spleen and Kidney

为观察黄土汤合四神丸加味口服治疗脾肾阳虚型溃疡性结肠炎(UC)的临床疗效,并探讨其可能作用机制,将68例脾肾阳虚型UC患者随机分为观察组和对照组,各34例。观察组予黄土汤合四神丸加味口服,对照组予美沙拉嗪肠溶片口服。对比2组患者总体疗效,治疗前后中医证候改善情况、血沉(ESR)及C反应蛋白(CRP)水平,以及复发情况和不良反应等。结果显示,观察组总有效率(94.12%,32/34)明显高于对照组(79.41%,27/34),P<0.05。2组治疗后中医证候评分、ESR和CRP含量均明显降低,P<0.05或P<0.01;其中观察组治疗后更低,P<0.05。治疗后随访6个月,观察组复发率(9.38%,3/32)明显低于对照组(29.63%,8/27),P<0.05。2组患者治疗期间血常规、尿常规、肝肾功能检查均未见异常;观察组患者未出现不良反应,对照组仅1例出现恶心、上腹轻微胀痛感,未予特殊处理,自行缓解。结果表明,黄土汤合四神丸加味口服可明显改善脾肾阳虚型UC患者的临床症状,促进肠黏膜恢复,不良反应少,复发率低,其治疗机制可能与调节机体免疫、胃肠功能等作用有关。

This study was to investigate the clinical effect of orally administering modified Sishen Wan（a Chinese formula） plus Huangtu Tang（a Chinese formula） for treating ulcerative colitis（UC） in the pattern of yang deficiency of spleen and kidney,and to explore its possible mechanism,enrolled 68 cases of this UC and randomly divided them into observation group and control group,34 cases for each,which the former adopted above-mentioned combined medication, meanwhile the latter was given alone Mesalazine entericcoated tablets orally; then compared both group＇s following indexes as whole effect, TCM syndrome improvement after treatment than before treatment,the level of erythrocyte sedimentation rate（ESR） and Creactive protein（CRP）,and recurrence status as well side reaction,etc.As results,in total effective rate the former was significantly higher than the latterE94.12%（32/34） vs 79.41%（27/34）, P 〈0.05];in TCM syndrome score,in the level of ESR and CRP both groups were all significantly declined （ P 〈0.05 or P 0.01） after treatment,but the former was more lower（ P 〈0.05）;the follow-up of 6 months showed the recurrence rate of the former was significantly lower than that of the latter[9.38%（3/32） vs 29.63% （8/ 27）, P 〈0.05] ;during treatment both group＇s blood common exam., urine common exam.,liver and kidney function exam. were in normal;in the former patients all did not have side reaction, in the latter only one case suffered from nausea,mild distending pain sensation at epigastrium then which dofft special treatment were all relieve automatically.Results show that the Tang plus the Wan（decoction ＋ pill） can significantly improve the clinical symptoms of this pattern of UC patients,promote intestinal mucosa inflammation removed, and with less side reaction and low recurrence rate, which its mechanism could be related to the regulation role of body immunity and gastro-intestinal function.