四神丸合理中丸治疗溃疡性结肠炎（脾肾阳虚型）的临床研究
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摘要
溃疡性结肠炎(Ulcerative Colitis,UC)是一种主要累及直肠、结肠黏膜的慢性非特异性炎症,以腹痛、腹泻、黏液血便、里急后重为主要临床表现,病程迁延不愈,长达十几年甚至几十年,亦有发生癌变的可能。目前,对该病的确切发病机制尚不清楚,现代医学多从环境、免疫、遗传等方面进行阐述。治疗上,多采用氨基水杨酸类制剂、抗生素、局部或全身应用糖皮质激素、免疫调节剂等药物,但个体疗效差异性较大;祖国医学通过四诊合参,辨病与辨证相结合的方法,具有治疗方法多样,副作用少,疗效确切等优势,使诊疗更为客观而具体。
本论文主要从中西医两方面对文献综述部分进行阐述,中医部分概括总结了近年来中医药对溃疡性结肠炎的临床治疗进展,并介绍了祖国医学对本病病因病机的认识、临床辨证分型、内服及外用药物等治疗手段方面的进展,同时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。西医部分则从近期对该病的流行病学研究、诊断分型标准、药物治疗等方面进行了深入探究。
临床研究方面,西医诊断标准是依据中华医学会消化病学分会2000年成都“全国炎症性肠道疾病学术研讨会”制定的有关溃疡性结肠炎(UC)的诊断标准及疗效评价标准。中医诊断在符合西医诊断标准的基础上参照《中医内科学》第五版“泄泻”、“痢疾”等章节有关内容进行辨证分型。将符合脾肾阳虚型标准的70例UC患者随机分为治疗组和对照组,治疗组每日给予四神丸合理中丸联合运用口服,对照组每日单纯给予固本益肠片口服。40天为一个疗程,观察并记录一个疗程治疗前后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:治疗组总有效率97.14%,对照组总有效率82.86%。
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,对四神丸合理中丸联合运用治疗本病的疗效进行了评价。
Ulcerative colitis(Ulcerative Colitis,UC) is a major involving the rectum and colon mucosa of chronic non-specific inflammation,abdominal pain,diarrhea,bloody mucus, Lijihouchong as the main clinical manifestations,deferred Fuyu course,as long as 10 years or even several 10 years,the cancer may have occurred.At present,the exact pathogenesis of the disease mechanism is not clear,more from the environment of modern medicine,immunology, genetics,and other aspects described.Treatment,the use of amino acid preparations, antibiotics,local or systemic application of glucocorticoid hormones,immune regulation drug agent,but individual differences of great motherland through four medical consultation with the Senate,and distinguish the disease and combine Syndrome the method with various treatment methods,less side effects,the exact effect of such advantages,clinics more objective and concrete.
This paper mainly from Western medicine both part of the literature review on,the Chinese part of a summary of recent years in traditional Chinese medicine on the treatment of ulcerative colitis clinical progress,and introduced the medicine to the etiology and pathogenesis of this disease awareness of Clinical Syndromes,Oral and topical drug treatment means the progress of the clinical effect at the same time an analysis pointed out that the existing problems,and look at the prospects of this disease.Western medicine part from the recent epidemiological studies of the disease,diagnostic classification standards,in areas such as drug treatment explore in depth.
Clinical research,diagnostic standard Western medicine is based on the Chinese Medical Association of Gastroenterology 2000 Chengdu,the "National Seminar on inflammatory bowel disease" of the related ulcerative colitis(UC) and the diagnostic criteria of evaluation criteria.Chinese medicine with Western medicine in the diagnosis of diagnostic criteria on the basis of reference "Chinese science," the fifth edition of "Diarrhea" and "diarrhoea" and other sections of the content-type of syndrome.Spleen deficiency will be consistent with the standards of 70 cases of UC patients were randomly divided into treatment and control groups, the treatment group God pill daily for four Nakamaru reasonable use of oral joint control group daily Gubenyichang simply give oral tablets.40 days for a course of treatment, observation and recording a course of treatment before and after the change of testimony,after the end of follow-up treatment follow-up to be in effect for six months.The results showed that treatment:The total efficiency of 97.14%,the control group,the total efficiency 82.86%.
In the discussion of the etiology and pathogenesis of ulcerative colitis machines Syndrome Types and treatment methods were discussed,the four God pill reasonable Nakamaru joint use of the efficacy of this treatment were evaluated.
本论文主要从中西医两方面对文献综述部分进行阐述,中医部分概括总结了近年来中医药对溃疡性结肠炎的临床治疗进展,并介绍了祖国医学对本病病因病机的认识、临床辨证分型、内服及外用药物等治疗手段方面的进展,同时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。西医部分则从近期对该病的流行病学研究、诊断分型标准、药物治疗等方面进行了深入探究。
临床研究方面,西医诊断标准是依据中华医学会消化病学分会2000年成都“全国炎症性肠道疾病学术研讨会”制定的有关溃疡性结肠炎(UC)的诊断标准及疗效评价标准。中医诊断在符合西医诊断标准的基础上参照《中医内科学》第五版“泄泻”、“痢疾”等章节有关内容进行辨证分型。将符合脾肾阳虚型标准的70例UC患者随机分为治疗组和对照组,治疗组每日给予四神丸合理中丸联合运用口服,对照组每日单纯给予固本益肠片口服。40天为一个疗程,观察并记录一个疗程治疗前后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:治疗组总有效率97.14%,对照组总有效率82.86%。
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,对四神丸合理中丸联合运用治疗本病的疗效进行了评价。
Ulcerative colitis(Ulcerative Colitis,UC) is a major involving the rectum and colon mucosa of chronic non-specific inflammation,abdominal pain,diarrhea,bloody mucus, Lijihouchong as the main clinical manifestations,deferred Fuyu course,as long as 10 years or even several 10 years,the cancer may have occurred.At present,the exact pathogenesis of the disease mechanism is not clear,more from the environment of modern medicine,immunology, genetics,and other aspects described.Treatment,the use of amino acid preparations, antibiotics,local or systemic application of glucocorticoid hormones,immune regulation drug agent,but individual differences of great motherland through four medical consultation with the Senate,and distinguish the disease and combine Syndrome the method with various treatment methods,less side effects,the exact effect of such advantages,clinics more objective and concrete.
This paper mainly from Western medicine both part of the literature review on,the Chinese part of a summary of recent years in traditional Chinese medicine on the treatment of ulcerative colitis clinical progress,and introduced the medicine to the etiology and pathogenesis of this disease awareness of Clinical Syndromes,Oral and topical drug treatment means the progress of the clinical effect at the same time an analysis pointed out that the existing problems,and look at the prospects of this disease.Western medicine part from the recent epidemiological studies of the disease,diagnostic classification standards,in areas such as drug treatment explore in depth.
Clinical research,diagnostic standard Western medicine is based on the Chinese Medical Association of Gastroenterology 2000 Chengdu,the "National Seminar on inflammatory bowel disease" of the related ulcerative colitis(UC) and the diagnostic criteria of evaluation criteria.Chinese medicine with Western medicine in the diagnosis of diagnostic criteria on the basis of reference "Chinese science," the fifth edition of "Diarrhea" and "diarrhoea" and other sections of the content-type of syndrome.Spleen deficiency will be consistent with the standards of 70 cases of UC patients were randomly divided into treatment and control groups, the treatment group God pill daily for four Nakamaru reasonable use of oral joint control group daily Gubenyichang simply give oral tablets.40 days for a course of treatment, observation and recording a course of treatment before and after the change of testimony,after the end of follow-up treatment follow-up to be in effect for six months.The results showed that treatment:The total efficiency of 97.14%,the control group,the total efficiency 82.86%.
In the discussion of the etiology and pathogenesis of ulcerative colitis machines Syndrome Types and treatment methods were discussed,the four God pill reasonable Nakamaru joint use of the efficacy of this treatment were evaluated.
引文
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[2]谢俊范.中西医结合治疗慢性非特异性结肠炎132例.国医论坛,1994,(2):27
[3]江学良,崔慧裴.溃疡性结肠炎.中国医药科技出版社,2004,11:489
[4]危北海.慢性溃疡性结肠炎的中西医结合防治.中西医结合杂志,1993,13(4);199-201
[5]张永峰.活血健脾补肾法对结肠炎小鼠结肠组织TNF-α及其mRNA表达的影响.世界华人消化杂志,2005,13(19):2377
[6]马剑海.黄土汤治疗慢性溃疡性结肠炎疗效观察.Chinese Journal of Informat ion on TCM Aug,2006,1(13):864
[7]邓长生,夏冰.炎症性肠病,人民卫生出版社,2006,2:557
[8]史宁广,单书健,当代名医临证精华.慢性腹泻专辑[M].北京:中医古籍出版社,1992 160-163
[9]周丽英,干长禄.辨证治疗慢性非特异性溃疡性结肠炎45例[J].国医论坛,2003,18(1):28
[10]郭建鹏.溃疡性结肠炎的中医药治疗进展.时珍国医国药,2006,17(8):1576
[11]张传儒,调肝理脾法治疗慢性非特异性溃疡性结肠炎30例报告[J].中医杂志,1990(3)36-37
[12]陈国权.教授治疗溃疡性结肠炎经验.中医研究,2006,5(7):35
[13]杨保芳.溃疡性结肠炎的中医诊治体会.中华现代中医学杂志,2006,2(2):120
[14]黄伟明.溃疡性结肠炎辨治经验[J].中国肛肠病杂志,1997,17(1):41-42
[15]华荣.李振华教授健脾温肾法治疗溃疡性结肠炎经验.河南中医,2006,26(8):17
[16]季雁浩,邵荣世治疗慢性溃疡性结肠炎的经验.江西中医药,2004,35(12):7
[17]劳国平.中医辨证加化瘀药治疗慢性非特异性溃疡性结肠炎的疗效观察.广西医科大学学报,2000,17(5):889-890
[18]刘谦民,毕峰,周绍娟,中西药联合灌肠治疗溃疡性结肠炎.新消化病学杂志,1995,3(2):115-116
[19]李磊.白头翁汤加减灌肠治疗溃疡性结肠炎.医药论坛杂志,2006,27(15):100
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