清凉止血灌肠方联合美沙拉嗪治疗溃疡性结肠炎的回顾性分析

Observation of the curative effect of Qingliangzhixue decoction plus mesalazine on ulcerative colitis

目的:探讨清凉止血灌肠方对轻中度溃疡性结肠炎(UC,E1型或E2型)的疗效。方法:收集2016年1月~2019年12月在芜湖市中医医院就诊的UC患者,基于符合本次研究标准,最终筛选出160例患者,根据是否使用清凉止血方灌肠,分为西药组82例和中药灌肠组78例,治疗3周为1个疗程。对比两组患者改良Mayo评分、中医证候总疗效、中医证候积分、炎症性结肠病问卷(IBDQ)评分、血红蛋白水平、白蛋白水平、血沉、CRP以及1年后随访复发情况,记录不良反应情况,评价疗效及安全性。结果:与西药组相比,中药灌肠组在改善平均腹泻次数、便血评分、改良Mayo评分、中医证候积分、Baron评分、CRP上效果更优(P<0.05);与中药灌肠组比较,西药组改善血红蛋白效果更优(P<0.05);而两组在内镜评分、医师评分改善、IBDQ评分、血沉、白蛋白水平上差异无统计学意义(P>0.05)。中药灌肠组复发率为15.38%;西药组复发率为21.95%,差异无统计学意义(P>0.05)。结论:轻中度溃疡性结肠炎(E1型或E2型)使用清凉止血灌肠方联合美沙拉嗪口服治疗,能够改善症状,降低炎症指标CRP水平,疗效显著。

Objective:To investigate the curative effect of traditional Chinese medicine Qingliangzhixue decoction on mild-moderate ulcerative colitis(UC,type E1 or type E2).Methods:Cases of UC treated in our hospital were initially included from January 2016 to December 2019.Finally 166 eligible cases were screed according to the criteria of this study,and divided into Western medication group(n=82)and Chinese medicine therapy group(n=78,treated by Qingliangzhixue decoction).The medication course was 3 weeks.Then the two groups were compared concerning modified Mayo score,total efficacy of TCM syndromes,scoring on TCM syndrome and Inflammatory Bowel Disease Questionnaire(IBDQ)as well as levels of hemoglobin and albumin,erythrocytic sedimentation rate,C-reactive protein(CRP),recurrence after 1 year follow-up.The adverse reactions were recorded and the efficacy and safety were evaluated for the two groups.Results:Patients in the Chinese medicine therapy group had better improvement in average frequency of diarrhea,hematochezia score,modified Mayo score,TCM syndrome score,Baron score and CRP than those in western medication group(P<0.05),yet patients treated by western medicine had better improvement in hemoglobin level than those treated by Qingliangzhixue decoction(P<0.05).There were no significant differences in endoscopic score,improvement by physician score,IBDQ score,erythrocytic sedimentation rate and albumin level between the two groups(P>0.05).The recurrence rate was 15.38%in Chinese medicine therapy group,and 21.95%in western medication group.The difference was insignificant(P>0.05).Conclusion:Mild to moderate ulcerative colitis(type E1 or type E2)can be treated with traditional Chinese medicine Qingliangzhixue decoction combined with oral mesalazine.This therapy regimen can be curative effect because it improves the symptoms,reduces the level of CRP indicative of inflammation.