溃疡性结肠炎中医辨证的相关指标研究进展

Research progress on related indicators of syndrome differentiation classification of ulcerative colitis

溃疡性结肠炎(UC)是以腹泻、黏液脓血便、腹痛为主要临床表现的反复发作、长期迁延的非特异慢性肠道炎症性疾病。中医药治疗该病具有独特的优势,其中辨证论治是中医学诊治疾病之重要法则,是取得临床疗效之关键。目前,UC证候诊断已存在一系列中医证候诊断标准,其辨证分型多为大肠湿热证、热毒炽盛证、脾虚湿蕴证、寒热错杂证、肝郁脾虚证、脾肾阳虚证、阴血亏虚证等。然而,UC证名的不规范性和证候分类的多元性在一定程度上导致了中医诊断以及疗效评价标准无法统一。本文通过对UC中医证型与临床症状、内镜和病理表现、肠道菌群、免疫指标、凝血指标及其他指标之间的关系进行文献综述,以期将微观的生物化学指标与宏观的中医认识相结合运用于UC辨证论治,进而为不同UC中医证型的临床治疗提供理论依据,有助于提高其临床治疗效果。

Ulcerative colitis(UC)is a non-specific chronic intestinal inflammatory disease characterized by recurrent and prolonged clinical manifestations including diarrhea,mucopurulent bloody stool,and abdominal pain.Traditional Chinese medicine(TCM)holds unique advantages in treating this condition,with syndrome differentiation and treatment being a fundamental principle.This approach is pivotal in achieving clinical efficacy in the diagnosis and treatment of diseases.Currently,there exist several TCM syndrome criteria for diagnosing and treating UC.The syndrome differentiation types of UC include large intestine damp-heat syndrome,heat and toxin exacerbation syndrome,spleen deficiency and dampness accumulation syndrome,cold and heat mixed syndrome,liver stagnation and spleen deficiency syndrome,spleen and kidney Yang deficiency syndrome,Yin and blood deficiency syndrome,etc.However,the lack of standardization in UC syndrome names and the diversity in syndrome classification contribute to some degree of inconsistency in TCM diagnosis and efficacy evaluation standards.This article reviews the correlation between UC TCM syndrome types and various clinical manifestations such as symptoms,endoscopic and pathological manifestations,intestinal flora,immune indicators,coagulation indicators and others.By integrating microscopic biochemical indicators with macroscopic TCM comprehension in UC syndrome differentiation and treatment,it aims to furnish a theoretical foundation for the clinical treatment of different UC TCM syndrome types.Such an approach is instrumental in enhancing clinical treatment outcomes.