消溃愈疡方（灌肠）治疗湿热内蕴型溃疡性结肠炎的临床研究
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摘要
目的:观察消溃愈疡方(灌肠)治疗湿热内蕴型溃疡性结肠炎(UC)的临床疗效,并初步探讨其作用机理。
方法:临床选择符合纳入标准的湿热内蕴型溃疡性结肠炎患者60例,随机分为两组,试验组(30例)给予葛根芩连汤口服、消溃愈疡方灌肠,对照组(30例)给予葛根芩连汤口服、鸦胆子油灌肠,观察两组的临床疗效。
结果:临床研究显示,试验组临床综合疗效、中医证候疗效、肠镜疗效及粘膜病理疗效均优于对照组(p<0.05或p<0.01)。试验组能明显改善脓血便、腹泻、腹痛、里急后重等症状,其疗效优于对照组(p<0.05或p<0.01)。两组临床治疗期间未发现明显不良反应。
结论:消溃愈疡方(灌肠)是治疗湿热内蕴型UC的有效方剂,能够消除或改善临床症状,促进肠道黏膜溃疡面愈合,迅速缓解患者的痛苦。
Objective: To observe the effect of Xiaokuiyuyangfang(XKYYF)(Enem.) on the Ulcerative colitis (UC) and explore the mechanism of it.
Methods: 60 patients with UC were diveded into two groups at random :the treatment group and the control group. The treatment group was given XKYYF (Enem.) and GGQLT (p.o), the control group was given Brucea javanica oil emulsion injection (Enem.) and GGQLT (p.o). Symptoms and signs of each group were observed before and after the treatment, including enteroscopy and pathologic observing.
Results:The treatment group’s synthesis effective of clinical the effective of syndrome of TCM、enteroscopy and pathologic observing are better than the control group’s (p<0.05 or p<0.01).XKYYF (Enem.) and GGQLT (p.o) canimprove more significantly the symptoms such as diarrhea、mucopurulent bloody stool and abdominal pain than Brucea javanica oil emulsion injection (Enem.) and GGQLT (p.o)(p<0.05 or p<0.01).
方法:临床选择符合纳入标准的湿热内蕴型溃疡性结肠炎患者60例,随机分为两组,试验组(30例)给予葛根芩连汤口服、消溃愈疡方灌肠,对照组(30例)给予葛根芩连汤口服、鸦胆子油灌肠,观察两组的临床疗效。
结果:临床研究显示,试验组临床综合疗效、中医证候疗效、肠镜疗效及粘膜病理疗效均优于对照组(p<0.05或p<0.01)。试验组能明显改善脓血便、腹泻、腹痛、里急后重等症状,其疗效优于对照组(p<0.05或p<0.01)。两组临床治疗期间未发现明显不良反应。
结论:消溃愈疡方(灌肠)是治疗湿热内蕴型UC的有效方剂,能够消除或改善临床症状,促进肠道黏膜溃疡面愈合,迅速缓解患者的痛苦。
Objective: To observe the effect of Xiaokuiyuyangfang(XKYYF)(Enem.) on the Ulcerative colitis (UC) and explore the mechanism of it.
Methods: 60 patients with UC were diveded into two groups at random :the treatment group and the control group. The treatment group was given XKYYF (Enem.) and GGQLT (p.o), the control group was given Brucea javanica oil emulsion injection (Enem.) and GGQLT (p.o). Symptoms and signs of each group were observed before and after the treatment, including enteroscopy and pathologic observing.
Results:The treatment group’s synthesis effective of clinical the effective of syndrome of TCM、enteroscopy and pathologic observing are better than the control group’s (p<0.05 or p<0.01).XKYYF (Enem.) and GGQLT (p.o) canimprove more significantly the symptoms such as diarrhea、mucopurulent bloody stool and abdominal pain than Brucea javanica oil emulsion injection (Enem.) and GGQLT (p.o)(p<0.05 or p<0.01).
引文
[1] Ouyang Q,Tandon R,Goh K I ,et a1.The emergence of inflam matory bowel disease in the Asian Pacific region[J].Curr Opin Gastroenterol,2005,21(4):408~413.
[2]郑家驹主编.炎症性肠病基础与临床,北京:科学出版社,2001:195.
[3]邓长生,夏冰主编.炎症性肠病,北京:人民卫生出版社,1998:183-189.
[4]郑筱萸.中药新药临床研究指导原则(试行),北京:中国医药科技出版社,2002,第1版:132~134.
[5]中华医学会消化病学分会.对炎症性肠病诊断治疗规范的建议.中华消化杂志,2001;21(4):236~239.
[6] GraefV,BaggenstossAH,SauerWG,etal,Venous thromblsis occurring in nonspecific ulcerative colitis [J].ArchInternMed,1996;117(3):337.
[7]赵辉,周建中.益气活血法治疗非特异性结肠炎的临床和实验研究.中西医结杂志1989:(9):529.
[8]陈灏珠,实用内科学[M].北京:人民卫生出版社,2005,第12版:1915.
[9]邓长生,夏冰炎症性肠病[M].人民卫生出版社,1998,133-134.
[10]焉鹏,陈双峰,梁爱军等,人巨细胞病毒感染和溃疡性结肠炎关系的研究.山东医药,2005,45(22):36-37.
[11] Cottonnem,Pietzosi G.Prevalence of cytomegalovirus infection in sever refractor ulcerative and Crohns colitis[J].AM J Gastroenterol,2001,96(3):773-775.
[12] TyskC,LindergE,JarnerotG,etal.Ulcerative colitis and Crohndis ea seinanun selected population of monozygotic and dizygotictwins:study of heritability and the influence of smoking[J].Gut,1988;29:990~996.
[13]国家中医药管理局科技教育司.中药药理学[M].北京:中国中药出版社,1997,15.
[14]张金炎.败酱草为主治疗慢性溃疡性结肠炎[ J ] .中医杂志, 2002,43( 1 2 ):892.
[15]将惠娣,黄夏琴,杨怡等.九种护肝中药抗脂质过氧化作用的研究[ J].中药材,1997,20(12) :624 .
[16]严梅桢.白矾对小白鼠肠道菌群的影响[J].中国中药杂志,1998,239 (12) :743
[17]严梅桢.白矾对小鼠肠道微生态平衡的影响[J].中国中西结合杂志,1999,19 (9):54.
[18]李冠烈.三七的现代研究与进展[J].世界中西医结合杂志.2008;3(11):687-691.
[19] Dong TX,Cui XM,Song ZH,etal.Chemical assessment of roots of Panax notoginseng in China regional and seas onal variations in its active constituents[J].J Agric Food Chen,2003;51:4617-4623.
[20] Dong TX,Cui XM,Song ZH,etal.Chemical assessment of roots of Panax notoginseng in China regional and seas onal variations in its active constituents[J].J Agric Food Chen,2003;51:4617-4623.
[21] Li SH Chu Y.Anti-inflammatory effects of total saponins of Panax notoginseng [J].Acta Pharmacologica Sinica,1999;20(6):551-554.
[22]耿志国,郑世玲,王遵琼.白及对盐酸引起的大鼠胃粘膜损伤的保护作用[J].中草药, 1990,21 ( 2 ):24.
[23]焦一鸣,王放.论白及的致瘀功用.时珍国医国药,2001;12(5):458.
[24]南京药学院.中药药学(下册)1980:1380.
[25] Li ZX,Wang XH,Yue YS,etal.Study on the antibacteial activity out of the body of Catechuin 308 individual clinical bacteria by new method [J].Chin J Infor Tradit Chin Med(中国中医药信息杂志),2001,8(1):38-40.
[26] Arts ICW,Hollman PCH,Feskens EJM,etal.Catechin intake and associated dietary and lifestyle factors in a representative sample of Dutch men and women [J].Eur J Clin Nutr,2001,55:76-81.
[27]龚纯贵,张国庆,王希营等.仙鹤草提取物镇痛抗炎试验的实验研究[ J ].药学实践杂志。2006,24(6):339—342.
[28]廖晖, Banbury L K, Leach D N.12味止血中药对脂多糖诱导小鼠巨噬细胞产生一氧化氮的抑制作用[ J ].中国药房, 2007,18 (9):649-651.
[29]范尚坦,李金兰,姚振华.仙鹤草降血糖的实验研究[ J ] .福州总医院学报,2005,12(4/5):270-282.
[30]常雅萍,毕无邪,杨贵贞.甘草多糖抗病毒作用研究[J].中国中药杂志,1989;14(4):44.
[31]陈红.甘草药理作用概述[J].海峡药学.2005;17(4)83.
[32]于辉,李春香,宫凌涛,甘庆贤.甘草的药理作用概述[J].现代生物医学进展.2006;6(4):77.
[1]张志明.贝复济保留灌肠治疗慢性非特异性溃疡性结肠炎临床观察[J].中国肛肠杂志,2004,24 (7):17.
[2]周仲英.中医内科学[M].北京:中国中医药出版社,2003:245-260.
[3]周丽英,王长禄.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.
[4]张学明,贾桂荣,王爱磊.振脾胶囊治疗UC缓解期远期疗效观察[J].北京中医药大学学报,2007,30(7):503-4.
[5]谭丹.溃疡性结肠炎辨证分型浅析[J].药学刊, 2001,12(6):555.
[6]赵树平.溃疡性结肠炎中医药治疗进展[J].临床研究进展,2004,21(6):6-7.
[7]苑述刚,宫健伟.慢性非特异性溃疡性结肠炎的中医研究进展[J].河南中医学院学报,2004,19(12):81-2.
[8]罗文纪,陈波.王福仁主任医师治疗溃疡性结肠胃炎临床经验[J].福建中医药,2006,37(2):22-23.
[9]王幼,孟昭彦,王春霞,等.溃疡性结肠炎的中医辨证治疗[J].中国中医药信息杂志,2002,9(12):401.
[10]李乾构.溃疡性结肠炎的辨证论治体会[J].北京中医, 2000,1:5-6.
[11]李万铮.辨证治疗慢性结肠炎体会[J].四川中医,1999,17(6):13-4.
[12]张怡,康正祥.健脾清热化湿方治疗脾虚湿热型溃疡性结肠炎30例.江西中医药,2007,,38(6):42-43.
[13]刘利,李妮芝,苗寒梅.健脾疏肝散治疗溃疡性结肠炎88例.现代中医药,2008,,28 (1):16-17.
[14]张勇,邹世光.四君半夏泻心合方治疗慢性非特异性溃疡性结肠炎141例.实用中医药杂志,2009,25(9):598-599.
[15] Liu Gang,Zhu Yehua.Clinical observation on treating ulcerative colitis with Shengti Zhixue decoction.Chinese Journal of the Practical Chiese with Modern Medicine,2009,22(20):1550-1554.
[16]胡卫海.清肠益脾汤治疗溃疡性结肠炎40例.江西中医药,2006,37(11)28-29.
[17]赵少英,王静军.中药保留灌肠治疗溃疡性结肠炎22例临床观察[J].中医药研究,2000,16(3):30-31.
[18]韩新华,王孝斌.自拟秦苦汤灌肠治疗溃疡性结肠炎108例[J].时珍国医国药,2000,11(10):923.
[19]刘桂琴.中药溃结1号治疗溃疡性结肠炎60例疗效观察[J].中华消化内科杂志,2002,,19 (2):115-116.
[20]李向辉,毛秉豫,韩珂.溃疡性结肠炎的中医辨证分型综合治疗[J].中华实用中西医杂志,2004,4(17):23.
[21]黄春燕.中药口服及保留灌肠治疗慢性溃疡性结肠炎疗效观察[J].现代中西医结合杂志,2008,17(10):1507-1508.
[22]张贤良,李敏,刘芳.活斑化瘀法治疗溃疡性结肠炎的临床应用[J].中医药指南,2009,24 (5):468-470.
[23]黄东挺.针剌加盒灸治疗溃疡性结肠炎32例[J].中国民间疗法,1999, 7(2):10.
[24]方向明,许能贵,肖永俭.艾灸治疗溃疡性结肠炎5 8例疗效观察[J].针刺研究,1999,24 (1):66-67.
[25]付宝庚.针灸治疗溃疡性结肠炎50例疗效观察.中国医药指南,2009,7(12): 283-284.
[26]梅笑玲,葛宝和.肠炎栓治疗慢性溃疡性结肠炎临床观察[J].山东中医药大学学报,2004,28(6): 430-431.
[2]郑家驹主编.炎症性肠病基础与临床,北京:科学出版社,2001:195.
[3]邓长生,夏冰主编.炎症性肠病,北京:人民卫生出版社,1998:183-189.
[4]郑筱萸.中药新药临床研究指导原则(试行),北京:中国医药科技出版社,2002,第1版:132~134.
[5]中华医学会消化病学分会.对炎症性肠病诊断治疗规范的建议.中华消化杂志,2001;21(4):236~239.
[6] GraefV,BaggenstossAH,SauerWG,etal,Venous thromblsis occurring in nonspecific ulcerative colitis [J].ArchInternMed,1996;117(3):337.
[7]赵辉,周建中.益气活血法治疗非特异性结肠炎的临床和实验研究.中西医结杂志1989:(9):529.
[8]陈灏珠,实用内科学[M].北京:人民卫生出版社,2005,第12版:1915.
[9]邓长生,夏冰炎症性肠病[M].人民卫生出版社,1998,133-134.
[10]焉鹏,陈双峰,梁爱军等,人巨细胞病毒感染和溃疡性结肠炎关系的研究.山东医药,2005,45(22):36-37.
[11] Cottonnem,Pietzosi G.Prevalence of cytomegalovirus infection in sever refractor ulcerative and Crohns colitis[J].AM J Gastroenterol,2001,96(3):773-775.
[12] TyskC,LindergE,JarnerotG,etal.Ulcerative colitis and Crohndis ea seinanun selected population of monozygotic and dizygotictwins:study of heritability and the influence of smoking[J].Gut,1988;29:990~996.
[13]国家中医药管理局科技教育司.中药药理学[M].北京:中国中药出版社,1997,15.
[14]张金炎.败酱草为主治疗慢性溃疡性结肠炎[ J ] .中医杂志, 2002,43( 1 2 ):892.
[15]将惠娣,黄夏琴,杨怡等.九种护肝中药抗脂质过氧化作用的研究[ J].中药材,1997,20(12) :624 .
[16]严梅桢.白矾对小白鼠肠道菌群的影响[J].中国中药杂志,1998,239 (12) :743
[17]严梅桢.白矾对小鼠肠道微生态平衡的影响[J].中国中西结合杂志,1999,19 (9):54.
[18]李冠烈.三七的现代研究与进展[J].世界中西医结合杂志.2008;3(11):687-691.
[19] Dong TX,Cui XM,Song ZH,etal.Chemical assessment of roots of Panax notoginseng in China regional and seas onal variations in its active constituents[J].J Agric Food Chen,2003;51:4617-4623.
[20] Dong TX,Cui XM,Song ZH,etal.Chemical assessment of roots of Panax notoginseng in China regional and seas onal variations in its active constituents[J].J Agric Food Chen,2003;51:4617-4623.
[21] Li SH Chu Y.Anti-inflammatory effects of total saponins of Panax notoginseng [J].Acta Pharmacologica Sinica,1999;20(6):551-554.
[22]耿志国,郑世玲,王遵琼.白及对盐酸引起的大鼠胃粘膜损伤的保护作用[J].中草药, 1990,21 ( 2 ):24.
[23]焦一鸣,王放.论白及的致瘀功用.时珍国医国药,2001;12(5):458.
[24]南京药学院.中药药学(下册)1980:1380.
[25] Li ZX,Wang XH,Yue YS,etal.Study on the antibacteial activity out of the body of Catechuin 308 individual clinical bacteria by new method [J].Chin J Infor Tradit Chin Med(中国中医药信息杂志),2001,8(1):38-40.
[26] Arts ICW,Hollman PCH,Feskens EJM,etal.Catechin intake and associated dietary and lifestyle factors in a representative sample of Dutch men and women [J].Eur J Clin Nutr,2001,55:76-81.
[27]龚纯贵,张国庆,王希营等.仙鹤草提取物镇痛抗炎试验的实验研究[ J ].药学实践杂志。2006,24(6):339—342.
[28]廖晖, Banbury L K, Leach D N.12味止血中药对脂多糖诱导小鼠巨噬细胞产生一氧化氮的抑制作用[ J ].中国药房, 2007,18 (9):649-651.
[29]范尚坦,李金兰,姚振华.仙鹤草降血糖的实验研究[ J ] .福州总医院学报,2005,12(4/5):270-282.
[30]常雅萍,毕无邪,杨贵贞.甘草多糖抗病毒作用研究[J].中国中药杂志,1989;14(4):44.
[31]陈红.甘草药理作用概述[J].海峡药学.2005;17(4)83.
[32]于辉,李春香,宫凌涛,甘庆贤.甘草的药理作用概述[J].现代生物医学进展.2006;6(4):77.
[1]张志明.贝复济保留灌肠治疗慢性非特异性溃疡性结肠炎临床观察[J].中国肛肠杂志,2004,24 (7):17.
[2]周仲英.中医内科学[M].北京:中国中医药出版社,2003:245-260.
[3]周丽英,王长禄.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.
[4]张学明,贾桂荣,王爱磊.振脾胶囊治疗UC缓解期远期疗效观察[J].北京中医药大学学报,2007,30(7):503-4.
[5]谭丹.溃疡性结肠炎辨证分型浅析[J].药学刊, 2001,12(6):555.
[6]赵树平.溃疡性结肠炎中医药治疗进展[J].临床研究进展,2004,21(6):6-7.
[7]苑述刚,宫健伟.慢性非特异性溃疡性结肠炎的中医研究进展[J].河南中医学院学报,2004,19(12):81-2.
[8]罗文纪,陈波.王福仁主任医师治疗溃疡性结肠胃炎临床经验[J].福建中医药,2006,37(2):22-23.
[9]王幼,孟昭彦,王春霞,等.溃疡性结肠炎的中医辨证治疗[J].中国中医药信息杂志,2002,9(12):401.
[10]李乾构.溃疡性结肠炎的辨证论治体会[J].北京中医, 2000,1:5-6.
[11]李万铮.辨证治疗慢性结肠炎体会[J].四川中医,1999,17(6):13-4.
[12]张怡,康正祥.健脾清热化湿方治疗脾虚湿热型溃疡性结肠炎30例.江西中医药,2007,,38(6):42-43.
[13]刘利,李妮芝,苗寒梅.健脾疏肝散治疗溃疡性结肠炎88例.现代中医药,2008,,28 (1):16-17.
[14]张勇,邹世光.四君半夏泻心合方治疗慢性非特异性溃疡性结肠炎141例.实用中医药杂志,2009,25(9):598-599.
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