【摘要】：目的:觀察加味柴胡疏肝散顆粒治療UC氣滯濕阻證的臨床療效,為今后在臨床中應(yīng)用加味柴胡疏肝散治療UC提供客觀依據(jù)。方法:選取廣西中醫(yī)藥大學(xué)第一附屬醫(yī)院2014年11月~2016年8月期間脾胃病科病房及導(dǎo)師門診就診的UC氣滯濕阻證患者。依據(jù)納入標(biāo)準(zhǔn),共選取60例患者,按照就診順序隨機(jī)分組各30例對(duì)照觀察的研究方法。治療組應(yīng)用加味柴胡疏肝散顆粒聯(lián)合美沙拉嗪腸溶片,對(duì)照組單純口服美沙拉嗪腸溶片,兩組療程均為2個(gè)月,療程后觀察兩組治療前后相關(guān)檢測(cè)指標(biāo)的變化,包括患者的總體療效、臨床癥狀積分、舌脈象變化、腸鏡結(jié)果、疾病活動(dòng)度及患者生活質(zhì)量改善情況等方面,并進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:治療組剔除1例,共29例;對(duì)照組脫落1例,共29例。(1)治療組總有效率86.2%,對(duì)照組總有效率68.9%,治療組綜合療效明顯優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P0.05);(2)在改善腹瀉、粘膿血便、腹痛、里急后重、腹部脹悶及不思飲食等癥狀方面,治療組優(yōu)于對(duì)照組,兩組比較有顯著性差異,具有統(tǒng)計(jì)學(xué)意義(P0.05);(3)治療前后中醫(yī)證候療效的比較,治療組總有效率89.7%,其中臨床痊愈10例,顯效9例,有效7例,提示加味柴胡疏肝散顆粒能改善UC中醫(yī)臨床癥狀,具有統(tǒng)計(jì)學(xué)意義(P0.05);(4)治療前后舌脈象變化的比較,治療組較對(duì)照組能改善患者的舌脈象狀況,具有顯著性差異(P0.05);(5)治療前后結(jié)腸鏡情況的比較,治療組的有效率為86.2%,對(duì)照組的有效率為68.9%,經(jīng)統(tǒng)計(jì)學(xué)分析得出P=0.028(P0.05),差異具有統(tǒng)計(jì)學(xué)意義;(6)腸黏膜組織學(xué)病理比較,治療前后差異具有統(tǒng)計(jì)學(xué)意義(P0.05),治療組可明顯減輕腸黏膜組織學(xué)病理分級(jí)狀況;(7)治療前后兩組藥物對(duì)糞便常規(guī)所見(jiàn)紅、白細(xì)胞數(shù)量改善情況,治療組優(yōu)于對(duì)照組,兩組相比有顯著性差異(P0.05);(8)治療2個(gè)月后,共有58例患者復(fù)查腸鏡,對(duì)患者行疾病活動(dòng)度的評(píng)定,治療組治療前:輕度活動(dòng)為17例,中度活動(dòng)為12例;治療后:臨床緩解為15例,輕度活動(dòng)為10例,中度活動(dòng)為4例,治療前后差異具有統(tǒng)計(jì)學(xué)意義(P0.05);(9)隨訪半年復(fù)發(fā)率治療組為4%,明顯低于美沙拉嗪腸溶片治療UC后半年內(nèi)復(fù)發(fā)率45%;(10)治療前后生存質(zhì)量評(píng)分的比較,治療組患者生活質(zhì)量包括腸道癥狀、全身癥狀、情感能力均較對(duì)照組明顯改善,具有統(tǒng)計(jì)學(xué)意義(P0.05),但社會(huì)能力未見(jiàn)明顯差異(P0.05)。結(jié)論:加味柴胡疏肝散顆粒治療UC氣滯濕阻證療效確切,優(yōu)于美沙拉嗪腸溶片對(duì)照組,能夠有效地改善UC患者臨床癥狀及舌脈象,提高生活質(zhì)量,降低疾病活動(dòng)度,促進(jìn)腸道粘膜修復(fù),減少疾病復(fù)發(fā)率,該方療效顯著,安全可靠,具有推廣價(jià)值。
[Abstract]:Objective: to observe the clinical efficacy of Jiawei Chaihu Shugan Powder in treating UC with Qi stagnation and dampness obstruction, and to provide objective basis for the treatment of UC with Jiawei Bupleurum Shugan Powder. Methods: UC patients with Qi stagnation and dampness obstruction syndrome were selected from the first affiliated Hospital of Guangxi University of traditional Chinese Medicine from November 2014 to August 2016. According to the inclusion criteria, 60 patients were randomly divided into two groups. The treatment group was treated with modified Chaihu Shugan Powder combined with mesalazine enteric-coated tablets, and the control group was given only mezalazine enteric-coated tablets. The course of treatment in both groups was 2 months. After the treatment, the changes of related indexes before and after treatment were observed. The general curative effect, clinical symptom score, tongue pulse change, colonoscopy results, disease activity and the improvement of patients' quality of life were analyzed statistically. Results: one case was eliminated in the treatment group, 29 cases were eliminated in the treatment group, and 29 cases in the control group. (1) the total effective rate of the treatment group was 86.2, and the total effective rate of the control group was 68.9. The comprehensive curative effect of the treatment group was obviously better than that of the control group. The difference between the two groups was statistically significant (P0.05); (2). The treatment group was superior to the control group in improving the symptoms such as diarrhea, mucous purulent stool, abdominal pain, severe abdominal distension and non-thinking about diet, etc. There was significant difference between the two groups. There was statistical significance (P0.05); (3) before and after the treatment of TCM syndromes comparison, the treatment group total effective rate of 89.7, including 10 cases of clinical recovery, 9 cases of remarkable effect, 7 cases of effective, suggesting that Jiawei Chaihu Shugan Powder granule can improve the clinical symptoms of UC Chinese medicine, There was significant difference (P0.05); (4) before and after treatment of tongue pulse changes, the treatment group compared with the control group can improve the tongue pulse status, with significant differences (P0.05); (5) before and after treatment of colonoscopy comparison, The effective rate of the treatment group was 86.2 and that of the control group was 68.9. By statistical analysis, the difference was statistically significant. (6) the histopathological comparison of intestinal mucosa. The difference before and after treatment was statistically significant (P0.05), the treatment group can significantly reduce the intestinal mucosal histological grading; (7) before and after treatment of the two groups of drugs to routine stool red, white blood cell number improvement, the treatment group is better than the control group, There was significant difference between the two groups (P0.05); (8). After 2 months of treatment, 58 patients underwent enteroscopy to evaluate their disease activity. Before treatment, 17 patients had mild activity, 12 patients had moderate activity, and 15 patients had clinical remission after treatment. There were 10 cases of mild activity and 4 cases of moderate activity. The difference before and after treatment was statistically significant (P0.05); (9) the recurrence rate in the treatment group was 4, which was significantly lower than that in the mesalazine enteric-coated tablet group within half a year after the treatment of UC. (10) the quality of life score was compared before and after treatment. The quality of life of patients in the treatment group including intestinal symptoms, systemic symptoms, emotional ability were significantly improved compared with the control group (P0.05), but there was no significant difference in social ability (P0.05). Conclusion: the modified Chaihu Shugan Powder granule is more effective than mesalazine enteric-coated tablet in treating UC syndrome of qi stagnation and dampness obstruction. It can effectively improve the clinical symptoms and tongue pulse, improve the quality of life and reduce the disease activity in patients with UC. It is effective, safe and reliable to promote intestinal mucosal repair and reduce the recurrence rate of the disease.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 肖琳;王孟春;;快速糞便鈣衛(wèi)蛋白檢測(cè)卡在潰瘍性結(jié)腸炎患者病情評(píng)估中的作用[J];胃腸病學(xué)和肝病學(xué)雜志;2017年01期

2 劉書(shū)紅;尹亞?wèn)|;;理氣健脾法治療潰瘍性結(jié)腸炎30例[J];光明中醫(yī);2016年15期

3 肖福香;萬(wàn)莉華;陳舞燕;;加味附子理中湯應(yīng)用于脾腎陽(yáng)虛型潰瘍性結(jié)腸炎治療的有效性分析[J];數(shù)理醫(yī)藥學(xué)雜志;2016年06期

4 王增;;中醫(yī)針灸治療潰瘍性結(jié)腸炎療效分析[J];淮海醫(yī)藥;2016年03期

5 李帥軍;林仁敬;莫彬艷;;腸舒顆粒治療肝郁脾虛型潰瘍性結(jié)腸炎60例[J];中國(guó)醫(yī)藥指南;2016年13期

6 陳鋒;嚴(yán)常開(kāi);;治療潰瘍性結(jié)腸炎藥物的最新進(jìn)展[J];世界華人消化雜志;2016年12期

7 田玲玲;劉麗娜;;潰瘍性結(jié)腸炎治療的現(xiàn)代觀點(diǎn)[J];世界華人消化雜志;2016年07期

8 陸山紅;趙榮華;幺晨;陳曉順;韓明暖;俞捷;;砂仁的化學(xué)及藥理研究進(jìn)展[J];中藥藥理與臨床;2016年01期

9 曾曉梅;;參苓白術(shù)散加減配合中藥灌腸治療潰瘍性結(jié)腸炎46例[J];北方藥學(xué);2016年02期

10 毛從俊;;中藥灌腸治療潰瘍性結(jié)腸炎的療效分析[J];國(guó)際醫(yī)藥衛(wèi)生導(dǎo)報(bào);2016年01期

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