翁连解毒汤治疗浊毒内蕴型溃疡性结肠炎临床疗效研究
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摘要
目的:研究翁连解毒汤治疗溃疡性结肠炎(UC)活动期的疗效。方法:将60例确诊为UC活动期且属于浊毒内蕴型的患者随机分为中药组、西药组和结合组,西药组给予美沙拉嗪肠溶片口服,中药组给予翁连解毒汤汤剂口服,结合组在口服美沙拉嗪肠溶片的基础上加服翁连解毒汤。3组连续治疗8周,观察主要症状、内镜下黏膜情况、血沉变化及临床疗效。结果:临床疗效3组对比,差异无显著性(P> 0. 05),但结合组有效率要高于中药组和西药组。治疗2周后主要症状积分3组相比差异无显著性(P> 0. 05);疗程结束后3组均较治疗前明显下降(P <0. 05),差异有显著性,结合组和中药组、西药组分别对比,差异有显著性(P <0. 05),中药组和西药组对比,差异无显著性(P> 0. 05),但中药组有效率高于西药组。内镜下黏膜病变,3组治疗后均较治疗前肠镜评分明显下降(P <0. 05),治疗后结合组和中药组、西药组分别对比,差异有显著性(P <0. 05),中药组和西药组对比,差异无显著性(P> 0. 05)。血沉变化3组前后相比差异均有显著性(P <0. 05)。结论:翁连解毒汤联合美沙拉嗪治疗活动期浊毒内蕴型UC疗效显著,优于单独应用美沙拉嗪或单独应用翁连解毒汤。
Objective: To study the therapeutic effect of Wenglian Jiedu Decoction on ulcerative colitis( UC) in active stage.Methods: Sixty patients with UC were randomly divided into Chinese medicine group,western medicine group and combination group.Western medicine group was given Mesalazine enteric-coated tablets orally,Chinese medicine group was given Wenglian Jiedu Decoction orally,and combination group was given Wenglian Jiedu Decoction on the basis of Mesalazine enteric-coated tablets. The three groups were treated for 8 weeks before the main symptoms,endoscopic mucosa,erythrocyte sedimentation rate( ESR) and clinical efficacy were observed. Results: There was no significant difference in clinical efficacy among the three groups( P > 0. 05),but the effective rate of the combination group was higher than that of the other two groups. After 2 weeks of treatment,there was no significant difference in the scores of main symptoms among the three groups( P > 0. 05); after the end of treatment,the scores of the three groups were significantly lower than those before treatment( P < 0. 05),and the difference was significant( P < 0. 05) when the combination group was compared respectively with Chinese medicine group and Western medicine group. There was no significant difference between the Chinese medicine group and the western medicine group( P > 0. 05),but the effective rate of the Chinese medicine group was higher than that of the western medicine group. Endoscopic mucosal lesions in the three groups after treatment were significantly lower than those before treatment( P < 0. 05). After treatment,there was a significant difference when the combination group was compared respectively with Chinese medicine group and Western medicine group( P < 0. 05). There was no significant difference between the Chinese medicine group and the western medicine group( P > 0. 05). There were significant differences in ESR between the three groups before and after treatment( P < 0. 05). Conclusion: Wenglian Jiedu Decoction combined with Mesalazine has a significant therapeutic effect on turbid toxic UC in active stage,which is better than using Mesalazine alone or Wenglian Jiedu Decoction alone.
Objective: To study the therapeutic effect of Wenglian Jiedu Decoction on ulcerative colitis( UC) in active stage.Methods: Sixty patients with UC were randomly divided into Chinese medicine group,western medicine group and combination group.Western medicine group was given Mesalazine enteric-coated tablets orally,Chinese medicine group was given Wenglian Jiedu Decoction orally,and combination group was given Wenglian Jiedu Decoction on the basis of Mesalazine enteric-coated tablets. The three groups were treated for 8 weeks before the main symptoms,endoscopic mucosa,erythrocyte sedimentation rate( ESR) and clinical efficacy were observed. Results: There was no significant difference in clinical efficacy among the three groups( P > 0. 05),but the effective rate of the combination group was higher than that of the other two groups. After 2 weeks of treatment,there was no significant difference in the scores of main symptoms among the three groups( P > 0. 05); after the end of treatment,the scores of the three groups were significantly lower than those before treatment( P < 0. 05),and the difference was significant( P < 0. 05) when the combination group was compared respectively with Chinese medicine group and Western medicine group. There was no significant difference between the Chinese medicine group and the western medicine group( P > 0. 05),but the effective rate of the Chinese medicine group was higher than that of the western medicine group. Endoscopic mucosal lesions in the three groups after treatment were significantly lower than those before treatment( P < 0. 05). After treatment,there was a significant difference when the combination group was compared respectively with Chinese medicine group and Western medicine group( P < 0. 05). There was no significant difference between the Chinese medicine group and the western medicine group( P > 0. 05). There were significant differences in ESR between the three groups before and after treatment( P < 0. 05). Conclusion: Wenglian Jiedu Decoction combined with Mesalazine has a significant therapeutic effect on turbid toxic UC in active stage,which is better than using Mesalazine alone or Wenglian Jiedu Decoction alone.
引文
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[12]张文远,韩盛玺,杨红.白头翁醇提取物对葡聚糖硫酸钠诱导大鼠结肠炎肥大细胞致炎作用的抑制研究[J].西部医学,2005,17(2):99-101
[13]李丹丹、江培,杨书美,等.黄柏的化学成分、药理作用及临床应用研究进展[J].黑龙江中医药,2014,27(3):601-605
[14]陈玉杰.蒲公英水提取物对大鼠溃疡性结肠炎的实验研究[J].中国实验方剂学杂志,2012,18(8):205-208
[15]穆甲骏,王卫国,侯启昌.苦参生理活性物质研究现状与展望[J].河南师范大学学报(自然科学版),2014,42(6):131-137
[16]肖迅,刘明华,赵革,等.苦参总碱对溃疡性结肠炎模型大鼠的影响[J].中药药理与临床,2017,33(2):82-86
[2]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(2018年·北京)[S].中华消化杂志,2018,38(5):292-311
[3]郑筱萸.中药新药临床研究指导原则(试行)[S].北京:中国医药科学技术出版社,2002. 129-134
[4]张瑞芳,陈朝晖,刘漪沦,等.溃疡性结肠的发病机制及其研究进展[J].生命的化学,2018,38(2):241-249
[5]程晓华,张秋丽,巩小琳,等.四神丸联合美沙拉嗪治疗溃疡性结肠炎的临床研究[J].现代药物与临床,2018,33(5):1 085-1 088
[6]吕根法,张文惠,吴玉章,等.前列腺素E2抑制T细胞活化的机制[J].免疫学杂志,2002,18(3):224
[7]于伟.美沙拉嗪不同给药方式对溃疡性结肠炎患者疗效与安全性的影响分析[J].中国医药指南,2016,14(8):138-139
[8]张军,叶玉伟.中医药治疗溃疡性结肠炎研究进展概况[J].西部中医药,2013,26(12):150-152
[9]裴林,曹东义,刘启泉,等.浊毒浅识[J].河北中医,2010,32(1):24-25
[10]张纨,李博林,王志坤,等.从浊毒理论探讨溃疡性结肠炎证治规律[J].新中医,2017,49(1):158-160
[11]吴骏,郑军状,陶方泽,等.从“浊毒论治”环境污染相关疾病理论初探[J].甘肃中医药大学学报,2018,35(4):21-23
[12]张文远,韩盛玺,杨红.白头翁醇提取物对葡聚糖硫酸钠诱导大鼠结肠炎肥大细胞致炎作用的抑制研究[J].西部医学,2005,17(2):99-101
[13]李丹丹、江培,杨书美,等.黄柏的化学成分、药理作用及临床应用研究进展[J].黑龙江中医药,2014,27(3):601-605
[14]陈玉杰.蒲公英水提取物对大鼠溃疡性结肠炎的实验研究[J].中国实验方剂学杂志,2012,18(8):205-208
[15]穆甲骏,王卫国,侯启昌.苦参生理活性物质研究现状与展望[J].河南师范大学学报(自然科学版),2014,42(6):131-137
[16]肖迅,刘明华,赵革,等.苦参总碱对溃疡性结肠炎模型大鼠的影响[J].中药药理与临床,2017,33(2):82-86