韩捷教授运用祛瘀扶正法治疗激素抵抗型溃疡性结肠炎经验

Professor Han Jie’s experience in the treatment of hormone-resistant ulcerative colitis by the method of removing blood stasis and strengthening healthy Qi

近年来,临床中激素抵抗型溃疡性结肠炎发病率逐渐上升,目前该病病因及发病机制尚不明确,内科基础治疗效果差强人意。韩捷教授认为,激素抵抗型溃疡性结肠炎反复发作致使肠道血络受损,败血流注肠道,日久化瘀入络,导致气血津液运行失常,脏腑经脉失于濡润,病久体虚,耗损正气。故本病的病机为瘀血壅滞肠中,正气虚损。临床治疗以"通"为主、以"补"为辅,祛瘀以除标实,扶正以补体虚,方药选断下渗湿汤合三仙汤加减以活血化瘀、扶正固本,如此,机体虽受逐瘀之药但恢复能力不减。根据激素抵抗型溃疡性结肠炎患者的临床表现,采用"夺食止泻法"结合肠外营养以减少对胃肠道的刺激,取得较好临床疗效。

Recent years,the incidence of hormone-resistant ulcerative colitis is gradually increasing in clinic.At present,the etiology and pathogenesis of the disease are not clear,and the effect of basic internal medical treatment is not satisfactory.Professor Han Jie believes that repeated attacks of hormone-resistant ulcerative colitis cause damage to the intestinal blood collaterals,and sepsis flows into the intestinal tract,dissolving stasis into the collaterals for a long time,resulting in abnormal circulation of Qi,blood,and body fluid.Lacking of moisture in meridian of zang-fu organs,the body is weak for a long time,and the vital Qi is consumed.Therefore,the pathogenesis of this disease is blood stasis in the intestine and deficiency of healthy Qi.In clinical treatment,it is mainly based on"dredging",supplemented by"tonifying",removing blood stasis to eliminate excess in the superior,and strengthening body resistance to complement deficiency.The prescriptions consist of Duanxia Shenshi Decoction and modified Sanxian Decoction are selected to promote blood circulation,remove blood stasis,and strengthen body resistance.In this way,although the body receives the medicine to expel blood stasis,its recovery ability does not decrease.According to the clinical manifestations of patients with hormone-resistant ulcerative colitis,the method of"controlling food to stop diarrhea"combined with parenteral nutrition was adopted to reduce the stimulation to gastrointestinal tract,and good clinical efficacy was achieved.