健脾清肠方对溃疡性结肠炎患者生活质量作用的随机对照试验（英文）
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摘要
目的:探讨健脾清肠方(JQD)对脾虚湿热证型溃疡性结肠炎(UC)患者生活质量的影响。方法:120例脾虚湿热证型活动期UC患者,随机分为试验组(60例)与对照组(60例),分别予以JQD、5-ASA治疗。治疗8周后,评价2组患者在炎症性肠病生活质量问卷(IBDQ)、健康调查简表(SF-36)积分、Sutherand DAI积分、证候与症状疗效方面的差异,并以此来评价患者的生活质量。结果:治疗后,两组的Sutherand DAI积分均有下降(P<0.01),但两组间比较差异无统计学意义。治疗后两组患者在IBDQ量表的肠道症状、全身症状的维度及总分,SF-36量表的生理机能、躯体疼痛、精力、精神健康4个维度及总分,腹痛、乏力的临床症状改善方面均有显著性差异(P<0.05,P<0.01)。结论:JQD可以作为一种补充和替代疗法治疗轻-中度活动期脾虚湿热型UC,并可以改善患者的生活质量。
To determine the effects of the Jianpi Qingchang Decoction(JQD) on the quality of life(QOL) in ulcerative coltis(UC) patients with spleen deficiency and dampness-heat syndrome. Methods: A total of 120 active UC patients with spleen deficiency and dampness-heat syndrome, were selected and randomly divided into test and control groups, 60 cases in each group. Patients in the test group were treated with JQD, while patients in the control group were treated with 5--aminosalicylic acid(5--ASA). After treatment for 8 weeks, the differences in the IBDQ, SF--36 score, Sutherland DAI score and clinical symptoms were compared between the two groups to assess the QOL of patients. Results: The Sutherland DAI score decreased for both the groups after the treatment(P<0.01), but the difference was not statistically significant between two groups. However, the two groups were significantly differenced with respect to the bowel symptoms, systemic symptoms and total score of IBDQ, four dimensions of SF--36, including physical functioning, bodily pain, vitality, and mental health, total score, and the clinical symptoms of abdominal pain and weakness(P<0.05, P<0.01). Conclusion: JQD can be used as supplementary and alternative therapy to relieve clinical symptoms of patients with mild to moderate active UC in the syndrome of spleen deficiency and dampness-heat, and consequently improve their QOL.
To determine the effects of the Jianpi Qingchang Decoction(JQD) on the quality of life(QOL) in ulcerative coltis(UC) patients with spleen deficiency and dampness-heat syndrome. Methods: A total of 120 active UC patients with spleen deficiency and dampness-heat syndrome, were selected and randomly divided into test and control groups, 60 cases in each group. Patients in the test group were treated with JQD, while patients in the control group were treated with 5--aminosalicylic acid(5--ASA). After treatment for 8 weeks, the differences in the IBDQ, SF--36 score, Sutherland DAI score and clinical symptoms were compared between the two groups to assess the QOL of patients. Results: The Sutherland DAI score decreased for both the groups after the treatment(P<0.01), but the difference was not statistically significant between two groups. However, the two groups were significantly differenced with respect to the bowel symptoms, systemic symptoms and total score of IBDQ, four dimensions of SF--36, including physical functioning, bodily pain, vitality, and mental health, total score, and the clinical symptoms of abdominal pain and weakness(P<0.05, P<0.01). Conclusion: JQD can be used as supplementary and alternative therapy to relieve clinical symptoms of patients with mild to moderate active UC in the syndrome of spleen deficiency and dampness-heat, and consequently improve their QOL.
引文
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[23]Wu P T.What should be kept in mind in the TCM differential treatment for ulcerative colitis?.J Tradit Chin Med,2008,28(4):308-309
[24]郭艳,孙春锋,万橱根,等.黄芪多糖对实验性溃疡性结肠炎大鼠Th17相关细胞因子的影响.中华中医药学刊,2013,31(6):1375-1377
[25]孙立群,梁金花,高月娟.探讨纳米级中药黄芪对溃疡性结肠炎大鼠肠道菌群失调的调整作用.中国中医急症,2012,21(8):1263-1265
[26]贺海辉,沈洪,朱宣宣,等.黄芪对三硝基苯磺酸诱导的大鼠结肠炎的作用.中华中医药杂志,2013,28(10):3082-3085
[27]李晓冰,崔利宏,陈玉龙,等.参苓白术散对溃疡性结肠炎小鼠肠道调节性T细胞免疫调节作用.中成药,2014,36(6):1295-1297
[28]Zhou Y X,Xin H L,Rahman K,et al.Portulaca oleracea L.:a review of phytochemistry and pharmacological effects.Biomed Res Int,2015,2015:925631
[29]王倩,范文涛.马齿苋多糖对溃疡性结肠炎相关性结肠癌IL-6/STAT3信号通路的影响.世界中医药,2013,8(10):1256-1260
[30]Yang X,Xiong X,Wang H,et al.Protective effects of panax notoginseng saponins on cardiovascular diseases:a comprehensive overview of experimental studies.Evid Based Complement Alternat Med,2014,2014:204840
[2]Ye L,Cao Q,Cheng J.Review of inflammatory bowel disease in China.Scientific World Journal,2013:296470
[3]李孝镇,唐志鹏,谢建群.溃疡性结肠炎患者的生存质量分析176例.世界华人消化杂志,2013,21(32):3486-3492
[4]Zheng K,Zhang S,Wang C,et al.Health-related quality of life in Chinese patients with mild and moderately active ulcerative colitis.PLoS One,2015,10(4):e0124211
[5]中华医学会消化病学分会炎症性肠病学组.炎症性肠病诊断与治疗的共识意见(2012年·广州).中华内科杂志,2012,51(10):818-831
[6]Wan P,Chen H,Guo Y,et al.Advances in treatment of ulcerative colitis with herbs:from bench to bedside.World J Gastroenterol,2014,20(39):14099-14104
[7]Bernstein C N.Treatment of IBD:where we are and where we are going.Am J Gastroenterol,2015,110(1):114-126
[8]Ke F,Yadav P K,Ju L Z.Herbal medicine in the treatment of ulcerative colitis.Saudi J Gastroenterol,2012,18(1):3-10
[9]Ng S C,Lam Y T,Tsoi K K,et al.Systematic review:the efficacy of herbal therapy in inflammatory bowel disease.Aliment Pharmacol Ther,2013,38(8):854-863
[10]Dai Y C,Tang Z P,Ma G T,et al.A review of Qingchang Shuan for treatment of ulcerative colitis.J Tradit Chin Med,2010,30(3):237-240
[11]柳文,龚雨萍,朱凌宇,等.健脾清肠方对溃疡性结肠炎的临床疗效及对Fas/Fas L的影响.中国中西医结合消化杂志,2008,16(1):32-34
[12]张亚利,郭倩,戴彦成,等.健脾清肠方对脾虚湿热型激素依赖溃疡性结肠炎患者GRα表达的影响.中国中西医结合消化杂志,2014,22(12):706-709
[13]戴彦成,张亚利,唐志鹏.中医药治疗溃疡性结肠炎生存质量评价的现状与展望.世界中医药,2015,10(6):951-953
[14]D’Haens G,Sandborn W J,Feagan B G,et al.A review of activity indices and efficacy end points for clinical trials of medical therapy in adults with ulcerative colitis.Gastroenterology,2007,132(2):763-786
[15]中华中医药学会脾胃病分会.溃疡性结肠炎中医诊疗共识意见.中华中医药杂志,2010,25(6):891-895
[16]Bodger K,Ormerod C,Shackcloth D,et al.Development and validation of a rapid,generic measure of disease control from,the patients perspective:the IBD-control questionnaire.Gut,2014,63(7):1092-1102
[17]陈治水,危北海,张万岱.溃疡性结肠炎中西医结合诊治方案(草案).中国中西医结合杂志,2004,24(11):1052-1055
[18]CFDA.中药新药临床研究指导原则.北京:中国医药科技出版社,2002:133-134
[19]Zhang C K,Hewett J,Hemming J,et al.The influence of depression on quality of life in patients with inflammatory bowel disease.Inflamm Bowel Dis,2013,19(8):1732-1739
[20]Cohen B L,Zo?ga H,Shah S A,et al.Fatigue is highly associated with poor health-related quality of life,disability and depression in newly-diagnosed patients with inflammatory bowel disease,independent of disease activity.Aliment Pharmacol Ther,2014,39(8):811-822
[21]张云云,王志荣.心理因素在溃疡性结肠炎中的作用及机制.世界华人消化杂志,2013,21(19):1823-1827
[22]Probert C S,Dignass A U,Lindgren S,et al.Combined oral and rectal mesalazine for the treatment of mild-to-moderately active ulcerative colitis:rapid symptom resolution and improvements in quality of life.J Crohns Colitis,2014,8(3):200-207
[23]Wu P T.What should be kept in mind in the TCM differential treatment for ulcerative colitis?.J Tradit Chin Med,2008,28(4):308-309
[24]郭艳,孙春锋,万橱根,等.黄芪多糖对实验性溃疡性结肠炎大鼠Th17相关细胞因子的影响.中华中医药学刊,2013,31(6):1375-1377
[25]孙立群,梁金花,高月娟.探讨纳米级中药黄芪对溃疡性结肠炎大鼠肠道菌群失调的调整作用.中国中医急症,2012,21(8):1263-1265
[26]贺海辉,沈洪,朱宣宣,等.黄芪对三硝基苯磺酸诱导的大鼠结肠炎的作用.中华中医药杂志,2013,28(10):3082-3085
[27]李晓冰,崔利宏,陈玉龙,等.参苓白术散对溃疡性结肠炎小鼠肠道调节性T细胞免疫调节作用.中成药,2014,36(6):1295-1297
[28]Zhou Y X,Xin H L,Rahman K,et al.Portulaca oleracea L.:a review of phytochemistry and pharmacological effects.Biomed Res Int,2015,2015:925631
[29]王倩,范文涛.马齿苋多糖对溃疡性结肠炎相关性结肠癌IL-6/STAT3信号通路的影响.世界中医药,2013,8(10):1256-1260
[30]Yang X,Xiong X,Wang H,et al.Protective effects of panax notoginseng saponins on cardiovascular diseases:a comprehensive overview of experimental studies.Evid Based Complement Alternat Med,2014,2014:204840