半夏泻心汤合桃红四物汤加减治疗UC（寒热错杂型）的临床观察
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摘要
溃疡性结肠炎(Ulcerative Colitis,UC)是一种病因不明的慢性特异性炎症疾病,主要侵犯远端结肠及直肠粘膜与粘膜下层,可累及整个结肠甚至末端回肠。该病以血性粘液便、腹痛、里急后重为主要症状,病情轻重悬殊,有反复发作的趋势;UC的发病机理尚未明确,现代医学认为主要与环境因素、免疫因素及遗传因素三个方面有关;在治疗上,多应用5-氨基水杨酸、糖皮质激素、免疫抑制剂等药物,个体疗效差异性较大。近年来,中医药治疗溃疡性结肠炎有了很大的进展,具有治疗方法多样,副作用少,疗效确切等优势。
本论文的文献综述对近年来中医药对溃疡性结肠炎的临床治疗进展进行了总结,介绍了中医对本病的病因病机认识、临床辨证分型、内服及外用药物和针灸等治疗手段方面的进展,并对临床疗效进行了分析,指出目前存在的问题,并展望了本病的研究前景。
临床研究方面,西医诊断标准采用2000年成都会议溃疡性结肠炎诊断标准,中医诊断在符合西医诊断标准的基础上,参照中华人民共和国卫生部制定发布的《中药新药临床研究指导原则中国医药科技出版社.2004》的有关部分进行辨证分型。将符合寒热错杂型标准的80例UC患者随机分为治疗组和对照组,治疗组每日给予半夏泻心汤合桃红四物汤加减口服,对照组每日单纯给予美沙拉嗪(5-氨基水杨酸)口服。20天为一个疗程,共二个疗程,治疗前后记录各项临床见证变化情况,疗程结束后随访追踪6个月评定疗效。治疗结果表明:治疗组完全缓解率47.50%,总有效率87.50%,对照组完全缓解率30.00%,总有效率70.00%。
在讨论部分,对溃疡性结肠炎的病因病机、辨证分型和治疗方法进行了探讨,对加味半夏泻心汤治疗本病的疗效进行了评价。
Ulcerative colitis (Ulcerative Colitis, UC), a specificity of unknown etiology of chronic inflammatory diseases, and major violations of distal colon mucosa and submucosa, involving the entire colon and even terminal ileum. The disease is a bloody mucus, abdominal pain, Lijihouchong as the main symptoms, the severity of the poor, a trend repeated attack; the pathogenesis of UC have not yet clear, and modern medicine believe that the major environmental factors, immune and genetic factors related to three factors; treatment, the application of 5 - aminosalicylic acid, glucocorticoid, such as immunosuppressant drugs, and individual differences of greater efficacy. In recent years, Chinese medicine treatment of ulcerative colitis with a lot of progress with various treatment methods, less side effects, the exact effect of such advantages.
This paper reviewed the literature in recent years in traditional Chinese medicine on the treatment of ulcerative colitis a summary of progress on the Chinese to the etiology and pathogenesis of disease awareness, clinical syndrome type, Oral and topical drugs and acupuncture, and other means of treatment progress, and clinical effects in the analysis, pointing out that the existing problems, and look at the prospects of this disease.
Clinical research, Western medicine diagnostic criteria used in 2000 in Chengdu meeting diagnostic criteria for ulcerative colitis, Chinese medicine with Western medicine in the diagnosis of diagnostic criteria on the basis of reference issued by the People's Republic of China Ministry of Health develop "new Chinese medicine clinical study of the guiding principles of Chinese Medicine Technology and Publishing She .2004 "the relevant part of a syndrome. Will be consistent with the standards of cold and heat Cuza 80 cases of UC patients were randomly divided into treatment and control groups, the treatment group to the daily Banxiaxiexin Tang Taohongsiwu Decoction oral, and the control group a day to the United States alone salad triazine (5 -- aminosalicylic acid) Oral. 20 days for a course of treatment, a total of three courses, the clinical record before and after treatment witnessed changes in the course of follow-up after the end of six months of follow-up evaluated. The results showed that treatment: the treatment group complete remission rate of 47.50%, 87.50% total efficiency of the control group, the complete remission rate of 30.00%, the total efficiency of 70.00%.
In the discussion of the etiology and pathogenesis of ulcerative colitis machines Syndrome Types and treatment methods discussed in Modified Banxiaxiexin soup of the efficacy of this treatment were evaluated.
本论文的文献综述对近年来中医药对溃疡性结肠炎的临床治疗进展进行了总结,介绍了中医对本病的病因病机认识、临床辨证分型、内服及外用药物和针灸等治疗手段方面的进展,并对临床疗效进行了分析,指出目前存在的问题,并展望了本病的研究前景。
临床研究方面,西医诊断标准采用2000年成都会议溃疡性结肠炎诊断标准,中医诊断在符合西医诊断标准的基础上,参照中华人民共和国卫生部制定发布的《中药新药临床研究指导原则中国医药科技出版社.2004》的有关部分进行辨证分型。将符合寒热错杂型标准的80例UC患者随机分为治疗组和对照组,治疗组每日给予半夏泻心汤合桃红四物汤加减口服,对照组每日单纯给予美沙拉嗪(5-氨基水杨酸)口服。20天为一个疗程,共二个疗程,治疗前后记录各项临床见证变化情况,疗程结束后随访追踪6个月评定疗效。治疗结果表明:治疗组完全缓解率47.50%,总有效率87.50%,对照组完全缓解率30.00%,总有效率70.00%。
在讨论部分,对溃疡性结肠炎的病因病机、辨证分型和治疗方法进行了探讨,对加味半夏泻心汤治疗本病的疗效进行了评价。
Ulcerative colitis (Ulcerative Colitis, UC), a specificity of unknown etiology of chronic inflammatory diseases, and major violations of distal colon mucosa and submucosa, involving the entire colon and even terminal ileum. The disease is a bloody mucus, abdominal pain, Lijihouchong as the main symptoms, the severity of the poor, a trend repeated attack; the pathogenesis of UC have not yet clear, and modern medicine believe that the major environmental factors, immune and genetic factors related to three factors; treatment, the application of 5 - aminosalicylic acid, glucocorticoid, such as immunosuppressant drugs, and individual differences of greater efficacy. In recent years, Chinese medicine treatment of ulcerative colitis with a lot of progress with various treatment methods, less side effects, the exact effect of such advantages.
This paper reviewed the literature in recent years in traditional Chinese medicine on the treatment of ulcerative colitis a summary of progress on the Chinese to the etiology and pathogenesis of disease awareness, clinical syndrome type, Oral and topical drugs and acupuncture, and other means of treatment progress, and clinical effects in the analysis, pointing out that the existing problems, and look at the prospects of this disease.
Clinical research, Western medicine diagnostic criteria used in 2000 in Chengdu meeting diagnostic criteria for ulcerative colitis, Chinese medicine with Western medicine in the diagnosis of diagnostic criteria on the basis of reference issued by the People's Republic of China Ministry of Health develop "new Chinese medicine clinical study of the guiding principles of Chinese Medicine Technology and Publishing She .2004 "the relevant part of a syndrome. Will be consistent with the standards of cold and heat Cuza 80 cases of UC patients were randomly divided into treatment and control groups, the treatment group to the daily Banxiaxiexin Tang Taohongsiwu Decoction oral, and the control group a day to the United States alone salad triazine (5 -- aminosalicylic acid) Oral. 20 days for a course of treatment, a total of three courses, the clinical record before and after treatment witnessed changes in the course of follow-up after the end of six months of follow-up evaluated. The results showed that treatment: the treatment group complete remission rate of 47.50%, 87.50% total efficiency of the control group, the complete remission rate of 30.00%, the total efficiency of 70.00%.
In the discussion of the etiology and pathogenesis of ulcerative colitis machines Syndrome Types and treatment methods discussed in Modified Banxiaxiexin soup of the efficacy of this treatment were evaluated.
引文
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[3]赵唯贤.浅谈慢性溃疡性结肠炎发病过程的标本虚实[J].河南职工医学院学报,2002,14(2):1612162.
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[5]范恒,邱明义,段雪云等.理肠四方治疗溃疡性结肠炎病机探讨[J].贵阳中医学院学报,2004,26(4):17.
[6]张正利等.溃疡性结肠炎中医治疗及理论探讨[J].陕西中医,2001,22(7):405
[7]金纯.中医对溃疡性结肠炎的认识与研究[J].浙江中西医结合杂志.2002,12(11):688
[8]李乾构.中医药治疗溃疡性结肠炎的思路.北京中医.2004,23(3):149
[9]中国中西医结合学会消化系统疾病专业委员会,中国中西医结合消化杂志.2005,13(2):133
[10]张苏颖.溃疡性结肠炎中医辨治浅析.山东中医杂志2003,22(10):579
[11]朱叶珊等.中医药治疗溃疡性结肠炎的临床体会.Chinese Journal of the Practical Chinese with Modern Medicine 2004 VOL.4(17):2442
[12]华荣等,李振华教授健脾温肾法治疗溃疡性结肠炎经验.2006,26(8):18
[13]柳文,沈琳.乌梅丸合痛泻药方治疗溃疡性结肠炎30例[J].上海中医药杂志,2003,37(1):35-36
[14]王丽娜.溃疡性结肠炎的辨证施治[J].实用中医内科杂志,2003,17(4):182
[15]宫险峰.化瘀肠炎汤治疗溃疡性结肠炎42例疗效观察[J].职业与健康,2002,18(10):153-154.
[16]江馨,程东红.四神丸加减治疗脾肾阳虚溃疡性结肠炎40例[J].吉林中医药,2002,22(6):71
[17]李素芬.自拟补脾止泻汤治疗慢性结肠炎30例[J].河南中医药学 刊,2000,15(2):20221.
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