膝胸位中药保留灌肠治疗湿热下注型溃疡性结肠炎的临床研究

Clinical study of retention enema with traditional Chinese medicine at knee-chest position in the treatment of damp-heat type ulcerative colitis

目的探讨膝胸位中药保留灌肠治疗湿热下注型溃疡性结肠炎的应用价值。方法选取2021年1月至2022年11月江西中医药大学附属医院接诊的80例湿热下注型溃疡性结肠炎患者作为研究对象,采用随机数字表法将其分为对照组和观察组,每组各40例。对照组采用侧卧位保留灌肠,观察组采用膝胸位保留灌肠,持续治疗8周。比较两组患者的临床疗效、中医证候评分、炎症因子[C反应蛋白(CRP)肿瘤坏死因子-α(TNF-α)]及凝血指标[D-二聚体(D-D)活化部分凝血酶原时间(APTT)、纤维蛋白原(FIB)],比较两组患者治疗期间不良反应发生情况。结果观察组患者的总有效率高于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后的中医证候评分低于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后的CRP、TNF-α、D-D、FIB均低于对照组,APTT高于对照组,差异有统计学意义(P<0.05)。两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。结论膝胸位中药保留灌肠治疗湿热下注型溃疡性结肠炎患者效果显著,可有效减轻患者临床症状,下调炎症指标,改善凝血功能。

Objective To investigate the application value of retention enema with traditional Chinese medicine at knee-chest position in the treatment of damp-heat type ulcerative colitis.Methods A total of 80 patients with damp-heat type ulcerative colitis admitted to the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from January 2021 to November 2022 were selected as the study objects,and were divided into control group and observation group by random number table method,with 40 cases in each group.The control group received retention enema at lateral position,while the observation group received retention enema at knee-chest position,for 8 weeks of continuous treatment.The clinical efficacy,traditional Chinese medicine syndrome scores,inflammatory factors(C-reactive protein[CRP],tumor necrosis factor-α[TNF-α]) and coagulation indexes(D-dimer[D-D],activated partial prothrombin time[APTT],fibrinogen[FIB])of the two groups were compared,and the occurrence of adverse reactions during treatment was compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).The traditional Chinese medicine syndrome score of observation group was lower than that of control group after treatment,and the difference was statistically significant(P<0.05).After treatment,CRP,TNF-α,D-D and FIB in observation group were lower than those in control group,and APTT was higher than that in control group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion The retention enema with traditional Chinese medicine at knee-chest position has a significant effect on the treatment of patients with damp-heat type ulcerative colitis,which can effectively relieve clinical symptoms,downregulate inflammatory indicators,and improve coagulation function.