清热利湿方联合美沙拉嗪治疗溃疡性结肠炎的临床效果

Observation and Evaluation of the Curative Effect of Heat and Damp Recipe Combined With Mesalazine in Treating Ulcerative Colitis

目的:观察清热利湿方联合美沙拉嗪治疗活动期轻中度溃疡性结肠炎大肠湿热证的疗效。方法:选取活动期轻中度溃疡性结肠炎大肠湿热证患者60例,随机均分为2组,每组各30例。对照组予美沙拉嗪口服,治疗组在对照组基础上加予清热利湿方(黄连、黄芩、葛根、薏苡仁、马齿苋、煨木香、白芍、败酱草、红藤、炙甘草)为主方临证加减治疗。治疗后评价两组临床缓解率及有效率、改良Mayo评分及内镜亚评分、内镜下黏膜愈合率、中医证候疗效等,并监测用药安全性。结果:治疗后治疗组临床缓解率(77%)高于对照组(43%),临床有效率(97%)高于对照组(70%),肠黏膜愈合率(77%)高于对照组(50%);中医证候疗效总有效率高于(97%)对照组(73%);改良Mayo评分及内镜亚评分均优于对照组;差异有统计学意义(P<0.05)。治疗后组内对比发现,治疗组可有效缓解中医各个主症与次症(P<0.05),对照组可有效缓解腹泻、黏液脓血便、腹痛、里急后重、小便短赤(P<0.05),但对口干口苦、肛门灼热无明显疗效(P>0.05)。两组治疗期间均未出现不良反应。结论:清热利湿方联合美沙拉嗪治疗活动期轻中度溃疡性结肠炎大肠湿热证有明显疗效,优于单用美沙拉嗪。

Objective To observe and evaluate the curative effect of Heat and Damp Recipe combined with Mesalazine in treating(active phase)mild and moderate ulcerative colitis with large intestine damp-heat syndrome.Methods 60 cases of mild and moderate ulcerative colitis(active phase)patients with large intestine damp-heat syndrome were randomly divided into two groups with 30 cases in each group.The control group was treated with Mesalazine enteric-coated tablets orally,while the treatment group was treated with Heat and Damp Recipe(Coptis chinensis,Scutellceria baicalensis,Pueraria Lobata,Coix seed,Purslane,Stewed Radix Aucklandiae,Radix Paeoniae Alba,Patrinia villosa,Rattan,Liquorice)as main clinical addition and subtraction therapy on the basis of using Mesalazine.After treatment,clinical remission rate and effective rate,Mayo score and Mayo score endoscopic sub-score,healing rate of intestinal mucosa,TCM syndrome curative effect of the two groups were evaluated and the medication safety was monitored.Results The study showed that the clinical remission rate of the treatment group was 77%,which was better than that of the the control group(43%).The clinical effective rate was 97%,which better than the control group(70%).The healing rate of intestinal mucosa was 77%,which better than the control group(50%).In terms of TCM syndrome curative effect,the total effective rate was 97%,which better than the control group(73%).The Mayo score and Mayo score endoscopic sub-score were better than those of the control groupχ^(2) test(P<0.05).Compared with the TCM symptom curative effect score group, the treatment group has curative effects in improving diarrhea, mucouspus and bloody stool, abdominal pain, tenesmus, burning pain in anus, dry throat with bitter taste and scanty darkurine (P <0.05). The control group was effective in improving diarrhea, mucous pus and bloody stool, abdominalpain, tenesmus and burning pain in anus (P <0.05), but there were no significant differences in xerostomia, bittertaste and burning pain in anus before and after treatment (P >0.05). Conclusion Heat and Damp Recipecombined with Mesalazine is better than Mesalazine alone in treating (active phase) mild and moderate ulcerativecolitis with large intestine damp-heat syndrome.