参苓白术散加减保留灌肠联合美沙拉嗪肠溶片治疗慢性直肠炎的疗效及安全性

Efficacy and safety of Shenling Baizhu Powder by retention enema combined with mesalazine enteric-coated tablets in the treatment of chronic proctitis

目的观察参苓白术散加减保留灌肠联合美沙拉嗪肠溶片治疗慢性直肠炎的疗效及安全性。方法将90例慢性直肠炎患者随机分为观察组和对照组。对照组45例给予西药美沙拉嗪肠溶片治疗,观察组45例在对照组基础上联合中药参苓白术散加减保留灌肠治疗。治疗4周后,比较2组治疗前后主要症状积分(腹泻积分、肛门坠胀感积分、黏液血便积分、肠镜表现积分)变化和治疗期间不良反应发生状况,于治疗结束后随访6个月,比较分析2组治愈病例的临床复发情况,并统计2组临床疗效。结果观察组治疗后总有效率显著高于对照组(P<0.05);2组治疗后腹泻积分、肛门坠胀感积分、黏液血便积分、肠镜表现积分均显著降低(P均<0.05),且观察组上述临床症状积分均显著低于对照组(P均<0.05);观察组治疗后临床复发率均显著低于对照组(P<0.05);2组治疗期间均未出现任何严重不良反应。结论参苓白术散加减保留灌肠联合美沙拉嗪肠溶片治疗慢性直肠炎能够明显改善患者临床症状,提高临床疗效,降低复发率,安全有效,值得在临床推广。

Objective It is to observe the efficacy and safety of Shenling Baizhu Powder by retention enema combined with mesalazine enteric-coated tablets in the treatment of chronic proctitis. Methods Ninety patients with chronic proctitis were randomly divided into observation group and control group. The control group(n=45) were treated with western medicine mesalazine enteric-coated tablets, and the observation group(n=45) were treated with traditional Chinese medicine Shenling Baizhu Powder by retention enema on the basis of treatment in the control group. After 4 weeks of treatment, the changes of main symptom scores(diarrhea, anal bulge, mucosanguineous feces, colonoscopy expression) and the incidence of adverse reactions during treatment were compared between the two groups. After the treatment, the patients were followed up for 6 months. The clinical recurrence of the cases and the clinical efficacy of the two groups were counted. Results The total effective rate of the observation group was significantly higher than that of the control group(P<0.05). The scores of diarrhea, diarrhea, anal bulge, mucosanguineous feces, colonoscopy expression were significantly decreased in the 2 groups(P<0.05), the clinical symptom scores of the observation group were significantly lower than those of the control group(P<0.05). The clinical recurrence rate of the observation group was significantly lower than that of the control group(P<0.05). There was no serious adverse reactions during the treatment. Conclusion Shenling Baizhu Powder by retention enema combined with mesalazine enteric-coated tablets can significantly improve the clinical symptoms, improve clinical efficacy, reduce recurrence rate in the treatment of chronic proctitis, it is safe and effective, and is worthy of clinical promotion.