基于“虚毒”理论观察中西医结合疗法对脾虚湿蕴型溃疡性结肠炎活动期的临床疗效

Based on the Theory of"Deficiency Toxin",to Observe the Clinical Curative Effect of Integrated Traditional Chinese and Western Medicine on the Active Stage of Spleen Deficiency and Dampness retention type Ulcerative Colitis

目的评价安肠愈疡汤联合美沙拉嗪治疗脾虚湿蕴型溃疡性结肠炎(UC)活动期的临床疗效,探讨其作用机制。方法纳入我院脾虚湿蕴型UC活动期患者120例,随机分为两组(对照组、治疗组),每组各60例。对照组给予美沙拉嗪肠溶片口服,治疗组在此基础上给予中药安肠愈疡汤口服,两组患者均持续治疗8周。对比两组患者治疗前后的中医症状积分、证候疗效、Mayo活动指数、组织病理学Geboes评分、IBDQ量表评分及CRP、ESR的变化。结果两组患者治疗后中医症状积分、Mayo活动指数、Geboes评分、IBDQ量表评分及CRP、ESR均较治疗前下降(P<0.01或P<0.05),治疗后两组对比,治疗组更优(P<0.05或P<0.01);治疗组总有效率95.00%,与对照组无明显差异(P>0.05),治疗组显效率31.67%,优于对照组(P<0.05)。两组均未发生严重不良反应。结论安肠愈疡汤联合美沙拉嗪治疗脾虚湿蕴型溃疡性结肠炎活动期患者临床疗效显著且安全,可能是通过控制炎症反应、修复肠粘膜来实现的,值得临床推广。

Objective To evaluate the clinical effect of Anchangyuyang decoction combined with Mesalazine in the treatment of spleen deficiency and dampness retention in active stage of ulcerative colitis,to explore the mechanism of action.Methods 120 patients with UC active stage of spleen deficiency and dampness retention were randomly divided into two groups(Western Medicine Group and Integrated Chinese and Western Medicine Group),each group had 60 cases.The Western medicine group was given mesalazine enteric-coated tablets orally,and the integrated Chinese and Western medicine group was given Anchangyuyang decoction orally.The score of TCM Symptom,the curative effect of Tcm Syndrome,the Mayo activity index,the score of histopathology,the score of IBDQ and the changes of CRP and Esr were compared between the two groups.Results The scores of TCM symptoms,Mayo Activity Index,Geboes score,IBDQ score,CRP and Esr in the two groups were lower than those before treatment(P<0.01 or P<0.05).After treatment,the two groups were better than the combined group(P<0.05 or P<0.01)The total effective rate of integrated Chinese and Western medicine group was 95.00%,with no significant difference(P>0.05).The effective rate of integrated Chinese and Western medicine group was 31.67%,which was better than Western medicine group(P<0.05).No serious adverse reaction occurred in both groups.Conclusion The combination of Anchangyuyang decoction and mesalazine is effective and safe in the treatment of patients with spleen deficiency and Dampness Retention Syndrome in active stage,may be achieved by controlling inflammation and repairing the intestinal Mucosa,which is worthy of clinical promotion.