中西医结合治疗溃疡性直肠炎的临床研究

Clinical study on treatment of ulcerative proctitis with combination of traditional Chinese medicine and western medicine

目的观察常规西医联合康复新液加锡类散混合液保留灌肠治疗溃疡性直肠炎的临床疗效。方法将90例溃疡性直肠炎患者随机分为A组、B组和C组,每组30例。3组均予美沙拉嗪缓释颗粒剂(艾迪莎,每次0. 5 g,每天3次)和枯草杆菌二联活菌肠溶胶囊(美常安,每次500 mg,每天2次)口服。在上述基础上,A组予甲硝唑注射液100m L加地塞米松10 mg混合液保留灌肠,B组予生理盐水100 m L加锡类散6 g混合液保留灌肠,C组予康复新液100 m L加锡类散6 g混合液保留灌肠。3组均以15 d为1个疗程,间隔2 d后进入下个疗程,共治疗2个疗程。比较3组治疗前后主要症状(腹泻、腹痛、黏液脓血便、里急后重)评分及肠黏膜病变评分,观察治疗过程中不良反应发生情况,统计6个月后复发情况。结果 3组治疗后主要症状评分及肠黏膜病变评分均明显降低(P均<0. 05),且C组明显低于A组和B组(P均<0. 05),A组和B组比较差异均无统计学意义(P均> 0. 05); 3组均无明显不良反应发生;随访C组复发率明显低于A组和B组(P均<0. 05),A组和B组比较差异均无统计学意义(P均> 0. 05)。结论在口服美沙拉嗪缓释颗粒剂及枯草杆菌二联活菌肠溶胶囊基础上联合康复新液加锡类散混合液保留灌肠治疗溃疡性直肠炎疗效更好,值得临床推广应用。

Objective It is to observe the clinical efficacy of conventional western medicine combined with retention enema with Kangfuxin fluid and Xileisan mixed liquid in the treatment of ulcerative proctitis. Methods Ninety patients with ulcerative proctitis were randomly divided into group A, group B and group C, 30 cases in each group. All groups were given mesalazine sustained-release granules （Adisa, 0.5 g each time, 3 times a day） and Bacillus subtilis enteric-coated capsules （Meichangan, 500 mg each time, twice a day）. On the basis of the above treatment, group A was given metronidazole injection 100 mL plus dexamethasone 10 mg mixed solution for retention enema, group B was given normal saline 100 mL plus Xileisan mixed solution for retention enema, group C was given Kangfuxin fluid 100 mL plus Xileisan 6 g mixed solution for retained enema. All the 3 groups were treated for 15 days as a course of treatment. After 2 days, they were treated for the next course. All the groups were treated for 2 courses. The main symptoms （diarrhea, abdominal pain, mucus pus and bloody stool, urgency and weight） and intestinal mucosal lesion scores were compared before and after treatment. The incidence of adverse reactions during the treatment was observed, and the recurrence after 6 months was counted. Results The main symptom scores and intestinal mucosal lesion scores of the three groups were significantly decreased （ P 〈0.05）, and the scores in group C were the lowest （ P 〈0.05）, no significant difference was found between group A and group B （ P 〉0.05）. There were no obvious adverse reactions in the three groups. The reoccurrence rate of the follow-up in group C was significantly lower than that of group A and group B （ P 〈0.05）, but there was no significant difference in the rate between group A and group B（ P 〉0.05）. Conclusion Kangfuxin fluid combined with Xileisan mixed solution based on oral mesalazine sustained-release granules and Bacillus subtilis enteric-coated capsules is more effective in the treatment of ulcerative proctitis and is worthy of clinical application.