痛泻要方联合美沙拉嗪肠溶片治疗肝郁脾虚型溃疡性结肠炎的临床观察

Clinical Study of Tongxieyaofang Combined with Mesalazine Enteric-Coated Tablets in the Treatment of Hepatic Stagnation and Spleen-Type Ulcerative Colitis

目的:观察痛泻要方联合美沙拉嗪肠溶片治疗肝郁脾虚型溃疡性结肠炎(UC)患者的疗效。方法:将江西中医药大学附属医院2021年1~10月收治的40例肝郁脾虚型溃疡性结肠炎患者,按随机数字表法分为对照组和治疗组,各20例。对照组口服美沙拉嗪肠溶片,治疗组在对照组基础上加服痛泻要方。治疗前后各进行1次中医证候评分、肠镜、黏膜组织学检查、炎症因子、凝血指标检测和焦虑抑郁量表评价。评估肠镜评分、黏膜组织学评价、临床疗效、疾病活动度及心理状态,同时记录不良反应发生情况。结果:治疗组总有效率为95.00%,显著高于对照组的70.00%(P<0.05);治疗组中医证候评分、疾病活动度、肠镜评分、黏膜组织学评分较对照组显著降低(P<0.05);治疗组C反应蛋白(CRP)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(FBG)、D-二聚体(D-D)和焦虑、抑郁评分的改善明显优于对照组(P<0.05);两组不良反应发生率差异不显著(P>0.05)。结论:痛泻要方联合美沙拉嗪肠溶片可以减轻肝郁脾虚型UC患者的症状,加快黏膜修复,临床疗效确切且优于单纯西药治疗。

Objective:To analyze the effect of Tongxieyaofang combined with mesalazine enteric-coated tablets on patients with hepatic stagnation and spleen-type ulcerative colitis(UC).Methods:40 UC patients with hepatic stagnation and spleen-type were enrolled and randomly divided into control group and treatment group.Each group consisted of 20 patients.The control group took mesalazine enteric-coated tablets orally.On the basis of the control group,the treatment group was treated with Tongxieyaofang.Before and after treatment,TCM syndromescore,colonoscopy,mucosal histology examination,inflammatory factors,coagulation indexes detection and hospital anxiety and depression scale evaluation were performed once.The colonoscopy score,mucosal histological evaluation,clinical efficacy,disease activity and psychological status were evaluated,and the incidence of adverse reactions was recorded.Results:The total efficiency of the treatment group was 95%,signficantly higher than 70%in the control group(P<0.05);The TCM syndrome score,disease activity,colonoscopy score,mucosal histology score in the treatment group was significantly lower than the control group(P<0.05);The improvement of C-reactive protein(CRP),prothrombin time(PT),activated partial prothrombin time(APTT),fibrinogen(FBG),D-dimer(D-D),anxiety and depression scores in the treatment group were significantly better than those in the control group(P<0.05);The difference of the two groups in the incidence of adverse reactions was not statistically significant(P>0.05).Conclusion:Tongxieyaofang combined with mesalazine enteric-coated tablets can relieve the symptoms of UC patients with hepatic stagnation and spleen-type and promote mucosal healing.And the clinical efficacy is significantly better than that of single western medicine treatment.