溃疡性结肠炎的中医药治疗进展

Progress of Traditional Chinese Medicine Treatment for Ulcerative Colitis

溃疡性结肠炎具有难治性、迁延性、反复性的特点,且存在肠穿孔、中毒性巨结肠、癌变的风险,临床常表现为腹痛、腹泻、食欲下降、消瘦等,病程长,常反复发作,对患者日常生活和工作带来极大困扰。迄今为止西医尚缺乏远期疗效肯定的根治手段,中医药在改善临床症状、减轻肠黏膜炎症、促进肠黏膜愈合等方面有其独到之处。中医认为,湿热、痰浊、气滞、血瘀为本病的基本病理因素,日久则变生浊毒、痈疡,根据疾病发展过程中气血、寒热、虚实、表里的演变,并基于"肺与大肠相表里""脾病及肾"的生理病理特点,将溃疡性结肠炎临床常用治法分为清肠化湿法、调气和血法、寒热并调法、温脾暖肾法、疏利肺气法、逆流挽舟法、消痈生肌法、化浊解毒法。文章归纳总结近年来有关溃疡性结肠炎中医病因病机及常见治法,以期更好地指导及应用于临床。

Ulcerative colitis has the characteristic ofbeing refractory,persistent and repetitive.Meanwhile,there is a certain risk of intestinal perforation,toxic megacolonand canceration.The clinical manifestations of ulcerative colitisare abdominal pain,diarrhea,decreased appetite,weight loss,etc,with a long course of disease and frequent recurrence,which brings great troubles to patients’ daily life and work.Till now,western medicine still lacks the means of radical treatment with definite long-term curative effect.The traditional Chinese medicine is unique in improving clinical symptoms,reducing intestinal mucosal inflammation and promoting intestinal mucosal healing.Traditional Chinese medicine believes that damp-heat,phlegm,Qi stagnationand blood stasis are the basic pathological factors of this disease.It would become turbidity or carbunclein the course of time.According to the evolution of Qi and blood,cold and heat,deficiency and consolidation,and inside and outside during the development of the disease,and based on the physiological and pathological characteristics of "lung and large intestine being related" and "spleendiseaseaffecting the kidney",the commonly-used clinical treatment methods for ulcerative colitis are divided into clearingthe intestines and removing dampness,regulating Qi and blood,regulating bothcold and heat,warming the spleen and kidney,dredging the lung Qi,drawing the boat by running against thewater,eliminating carbuncle and promoting muscle growth,and clearing the turbidity and detoxification.This paper summarized the etiology andpathogenesis as wellas common treatment of ulcerative colitis in recent years,in order to better guide and apply in clinic.