本文關鍵詞： 潰瘍性結腸炎 清腸化濕 活動期 中藥灌腸　出處：《南京中醫(yī)藥大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的選用臨床、對照研究方法,通過與西醫(yī)治療組對照,評價徐景藩教授清腸化濕灌腸方治療活動期輕中度潰瘍性結腸炎(ulcerative colitis)的療效,從而為制定輕中度潰瘍性結腸炎患者的治療方案奠定基礎。方法選擇江蘇省中醫(yī)院脾胃病科收治的輕中度UC活動期病人進行研究,中醫(yī)證型均符合濕熱內蘊證,共60例,將其分為治療組30例,對照組30例。治療組予徐景藩教授清腸化濕灌腸方聯(lián)合西藥治療;對照組予西藥治療�？偗煶虨�12周,研究其臨床緩解率、中醫(yī)癥狀療效、粘膜組織學積分、Mayo評分等。結果本研究表明:在臨床緩解率方面,治療組中臨床緩解25例;對照組中臨床緩解17例,治療組臨床緩解率83.33%,對照組臨床緩解率56.66%;經(jīng)X2檢驗比較(P0.05),證實治療組療效優(yōu)于對照組。在臨床有效率方面,治療組中臨床有效29例;對照組中臨床有效23例,治療組臨床有效率96.66%,對照組臨床有效率76.66%,經(jīng)X2檢驗比較(P＜0.05),證實治療組療效優(yōu)于對照組。同時在中醫(yī)證候療效方面,治療組的總有效率96.66%;對照組的總有效率80%,經(jīng)卡方檢驗比較(P0.05),治療組療效優(yōu)于對照組。治療組治療結束復查腸鏡腸粘膜愈合18例,對照組復查腸鏡腸粘膜愈合10例,經(jīng)x2檢驗(P＜0.05),表明治療組的粘膜愈合率優(yōu)于對照組。治療組在腸鏡積分、Mayo評分、粘膜組織學積分三個方面的療效上優(yōu)于對照組(P0.05)。組內比較,兩組在改善患者中醫(yī)臨床癥狀均有療效(P0.05)。組間比較,兩組在緩解腹痛、膿液血便癥狀方面無統(tǒng)計學差異(P0.05);但是在緩解腹瀉、口干口苦、里急后重、小便短赤、肛門灼熱癥狀方面存在差異性(P0.05),表明治療組改善腹瀉、口干口苦、里急后重、小便短赤、肛門灼熱癥狀的療效優(yōu)于對照組。兩組在生存質量分析方面存在差異性(P0.05),表明治療組療程結束后生存質量優(yōu)于對照組。結論經(jīng)過系統(tǒng)評價,本研究中徐景藩教授清腸化濕灌腸方聯(lián)合西藥治療輕中度潰瘍性結腸炎活動期的治療方案臨床療效證實優(yōu)于單用西藥治療,有臨床進一步研究及推廣應用的必要性。
[Abstract]:Objective to evaluate the therapeutic effect of Professor Xu Jingfan's Qingchang Hua Shi enema recipe in the treatment of mild and moderate ulcerative colitis in active stage by using clinical and comparative study methods and comparing with western medicine treatment group, and to evaluate the therapeutic effect of Professor Xu Jingfan on the treatment of ulcerative colitis in active stage. Methods A total of 60 patients with mild to moderate ulcerative colitis were selected from the Department of spleen and stomach Disease of Jiangsu Provincial traditional Chinese Medicine to study the active stage of mild and moderate UC. The TCM syndromes were all consistent with the internal syndrome of dampness and heat. The treatment group was divided into treatment group (n = 30) and control group (n = 30). The treatment group was treated with Professor Xu Jingfan Qingchang Huashi enema prescription combined with western medicine; the control group was treated with western medicine. The total course of treatment was 12 weeks. The clinical remission rate and the curative effect of TCM symptoms were studied. Results in the clinical remission rate, there were 25 cases of clinical remission in the treatment group and 17 cases in the control group. The clinical remission rate of the treatment group was 83.33 and the clinical remission rate of the control group was 56.66.The X2 test showed that the curative effect of the treatment group was superior to that of the control group. In terms of clinical effective rate, 29 cases were clinically effective in the treatment group and 23 cases in the control group. The clinical effective rate of the treatment group was 96.66, and the clinical effective rate of the control group was 76.66. The X2 test showed that the curative effect of the treatment group was better than that of the control group (P < 0.05). At the same time, the curative effect of TCM syndromes was better than that of the control group. The total effective rate of the treatment group was 96.666.The total effective rate of the control group was 80%, compared with that of the control group by chi-square test. The curative effect of the treatment group was better than that of the control group. The results of x2 test (P < 0.05) showed that the rate of mucosal healing in the treatment group was better than that in the control group, and the curative effect in the treatment group was better than that in the control group in three aspects: the score of endoscopy and the score of mucosal histology. There was no statistical difference between the two groups in relieving abdominal pain and blood stool symptoms of pus. However, there was no significant difference in relieving diarrhea, dry mouth and bitter mouth, severe after acute, short red urine, and no statistical difference was found between the two groups in improving the clinical symptoms of traditional Chinese medicine (TCM) in the two groups, and there was no statistical difference between the two groups in alleviating abdominal pain and blood stool symptoms. There were differences in anal burning symptoms (P 0.05), which indicated that the treatment group could improve diarrhea, dry mouth and bitter mouth, severe after acute, short red urine, The results showed that the quality of life in the treatment group was better than that in the control group after the end of the course of treatment, and the quality of life in the treatment group was better than that in the control group. In this study, Professor Xu Jingfan Qingchang Huashishenchang prescription combined with western medicine in the treatment of mild to moderate ulcerative colitis in active stage of clinical efficacy proved superior to the treatment of western medicine alone, clinical further research and application of the necessity.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R249;R259

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