黄葵敛肠方灌肠治疗远端溃疡性结肠炎临床观察

Clinical observation of Huangkui Lianchang prescription enema in the treatment of distal ulcerative colitis

目的观察黄葵敛肠方灌肠治疗远端溃疡性结肠炎(UC)的临床疗效。方法将62例远端UC患者按随机数字表法分为2组。治疗组31例予黄葵敛肠方灌肠治疗;对照组31例予美沙拉秦灌肠液灌肠治疗。2组分别统计临床疗效及黏膜病变疗效,比较2组治疗前及治疗4、8周后改良Mayo评分、医师整体评估法(PGA)评分及炎症性肠病生存质量问卷(IBDQ)评分变化情况,比较2组治疗前及治疗4、8周后红细胞沉降率(ESR)、超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、白细胞介素(IL)6及IL-4水平变化情况,并统计2组治疗期间不良反应发生情况。结果2组临床疗效及黏膜病变疗效比较差异均无统计学意义(P>0.05),疗效相当。2组治疗4、8周后与本组治疗前比较,改良Mayo评分均减少(P<0.05),IBDQ评分均增加(P<0.05);2组治疗8周后与本组治疗4周后比较,改良Mayo评分及PGA评分均降低(P<0.05),IBDQ评分均增加(P<0.05),但2组治疗4、8周后各评分组间比较差异均无统计学意义(P>0.05)。2组治疗4、8周后与本组治疗前比较,ESR、hs-CRP、PCT及IL-6水平均降低(P<0.05),IL-4水平均升高(P<0.05);2组治疗8周后与本组治疗4周后比较,ESR、hs-CRP、PCT及IL-6水平均降低(P<0.05),IL-4水平均升高(P<0.05),但2组治疗4、8周后各指标组间比较差异均无统计学意义(P>0.05)。治疗组治疗期间不良反应发生率30.0%,对照组不良反应发生率77.8%,治疗组不良反应发生率低于对照组(P<0.05)。结论黄葵敛肠方灌肠治疗远端UC疗效确切,其效果与美沙拉秦灌肠液相当,可明显改善患者临床症状,抑制炎性反应,提高生活质量,且不良反应少,经济优势大。

Objective To observe the clinical efficacy of Huangkui Lianchang prescription enema on distal ulcerative colitis (UC). Method 62 patients with distal UC were divided into two groups according to random number table method. 31 cases in treatment group were treated by Huangkui Lianchang prescription enema. 31 cases in control group were treated by mesalazine enema. The clinical efficacy and the effect of mucosal lesions in two groups were counted. The modified Mayo score, the physician's overall assessment (PGA) score and the inflammatory bowel disease quality of life questionnaire (IBDQ) scores in two groups were compared before and after 4 and 8 weeks of treatment. The changes of erythrocyte sedimentation rate (ESR), hypersensitive C-reactive protein (hs-CRP), procalcitonin (PCT), interleukin (IL) 6 and IL-4 levels were compared before and after 4 and 8 weeks of treatment in the two groups, and the occurrence of adverse reactions during treatment in the two groups was counted. Results There was no significant difference in clinical efficacy and mucosal lesions between the two groups ( P >0.05), and the curative effect was similar. Compared with the group before treatment, after 4 and 8 weeks of treatment in both groups, the modified Mayo score was decreased in both goups ( P <0.05), and the IBDQ score was increased ( P <0.05). Compared with the group after 4 weeks of treatment, the modified Mayo score and PGA score in both groups were decreased after 8 weeks of treatment ( P <0.05), and the IBDQ score was increased ( P <0.05), but there was no significant difference between the two groups after 4 and 8 weeks of treatment ( P >0.05). Compared with the group before treatment, the levels of ESR, hs-CRP, PCT and IL-6 in both groups were decreased after 4 and 8 weeks of treatment ( P <0.05), while the level of IL-4 was increased ( P <0.05). Compared with the group at 4 weeks after treatment, the levels of ESR, hs-CRP, PCT and IL-6 in the two groups were decreased after 8 weeks of treatment ( P <0.05), and the level of IL-4 was increased ( P <0.05), but there was no significant difference in each index between the two groups after 4 and 8 weeks of treatment ( P >0.05). The incidence of adverse reactions was 30.0% in the treatment group and 77.8% in the control group. The incidence of adverse reactions in the treatment group was lower than that in the control group ( P < 0.05 ). Conclusion Huangkui Lianchang prescription enema is effective in treating distal UC. Its effect is similar to that of mesalazine enema. It can significantly improve the clinical symptoms, inhibit inflammation and improve the quality of life of patients with fewer adverse reactions.