中药疏肝健脾止痢方治疗溃疡性结肠炎患者的临床作用  

Effects of traditional Chinese medicine combined with 5-aminosalicylic acid in treatment of ulcerative colitis

作　　者：黄英姿 张丽 

机构地区：[1]贵州省六盘水市水矿集团总医院中医科,贵州省六盘水市553000 [2]贵州省六盘水市水矿集团公司康宁大众医药有限责任公司,贵州省六盘水市553000

出　　处：《世界华人消化杂志》2013年第31期3445-3449,共5页World Chinese Journal of Digestology

摘　　要：目的:探讨中药疏肝健脾止痢方与5-氨基水杨酸制剂治疗溃疡性结肠炎患者的临床疗效.方法:随机将140例溃疡性结肠炎患者均分为实验组和对照组,两组患者均给予常规营养支持、局部灌肠用药和饮食治疗,实验组采取中药疏肝健脾止痢方联合5-氨基水杨酸治疗,对照组采取5-氨基水杨酸治疗,比较两组患者临床疗效、治疗前后临床症状及肿瘤坏死因子-(tumor necrosis factor-,TNF-)水平变化情况.结果:实验组治疗显效率(52.86%vs 32.86%)及总有效率(94.29%vs 71.43%)均明显高于对照组,差异具有显著性(P<0.05);两组患者治疗后便次(0.75±0.31 vs 3.78±1.89,1.96±0.88 vs 3.79±1.76)、便质稀薄(1.31±0.19vs 3.97±0.71,2.32±1.09 vs 3.87±1.79)、黏液血便(1.49±0.60 vs 3.16±1.42,2.36±0.22vs 3.18±1.66)以及腹痛(1.33±0.69 vs 3.21±0.85,2.19±0.78 vs 3.12±1.30)临床症状较治疗前均明显改善,差异具有显著性(P<0.05或P<0.01);治疗后实验组各临床症状改善情况均明显优于对照组(0.75±0.31 vs 1.96±0.88,1.31±0.19 vs 2.32±1.09;1.49±0.60 vs 2.36±0.22,1.33±0.69vs 2.19±0.78),差异具有显著性(P<0.05);两组患者治疗后TNF-水平均明显降低(15.37 ng/L±4.56 ng/Lvs 30.86 ng/L±4.27 ng/L、23.35 ng/L±3.37 ng/L vs 31.08ng/L±3.57 ng/L,差异具有显著性(P<0.05或P<0.01);治疗后实验组TNF-水平明显低于对照组(15.37 ng/L±4.56 ng/Lvs 23.35 ng/L±3.37 ng/L),差异具有显著性(P<0.05);所有患者均获得3 mo电话随访,仅对照组9例患者出现不同程度腹泻,实验组并未发生不良反应,两组患者治疗后均未复发.结论:中药疏肝健脾止痢方联合5-氨基水杨酸治疗溃疡性结肠炎临床疗效显著,安全性高,有助于降低患者血清TNF-水平,临床应用和推广价值较高.AIM： To evaluate the effects of traditional Chi- nese medicine combined with 5-aminosalicylic acid in the treatment of ulcerative colitis. METHODS： One hundred and forty patients with ulcerative colitis were randomly divided into either an experimental group or a control group. Both groups were given routine nutri- tional support, local enema and diet therapy. The treatment group was additionally treated by traditional Chinese medicine combined with 5-aminosalicylic acid, and the control group was treated with 5-aminosalicylic acid alone. Clini- cal efficacy, clinical symptoms, and the changes in levels of cytokine tumor necrosis factor-m, （TNF-γ） were compared between the two groups. RESULTS： The effective rate （52.86% vs 32.86%） and overall response rate （94.29% vs 71.43%） were significantly higher in the treatment group than in the control group （both P 〈 0.05）. The stool times （0.75 ± 0.31 vs 3.78 ± 1.89, 1.96 ± 0.88 vs 3.79 ± 1.76）, thin stools （1.31 ± 0.19 vs 3.97 ± 0.71, 2.32 ± 1.09 vs 3.87 ± 1.79）, mucous bloody stools （1.49 ± 0.60 vs 3.16 ± 1.42, 2.36 ± 0.22 vs 3.18 ± 1.66）, and abdominal pain （1.33 ± 0.69 vs 3.21 ± 0.85, 2.19 ± 0.78 vs 3.12 ± 1.30） were significantly improved after treatment （all P 〈 0.05 or 〈 0.01）. The curative effect was significantly better in the treatment group than in the control group （0.75 ± 0.31 vs 1.96 ± 0.88, 1.31 ± 0.19 vs 2.32 ± 1.09; 1.49 ± 0.60 vs 2.36 ± 0.22, 1.33 ± 0.69 vs 2.19 ± 0.78; all P 〈 0.05）. The level of TNF-γ was significantly lower in the treatment group than in the control group （15.37 ng/L ± 4.56 ng/L vs 23.35 ng/L ± 3.37 ng/L, P 〈 0.05）. During a 3-month follow- up period, nine patients in the control group de- veloped diarrhea, while no any adverse reaction occurred in the treatment group. There were no recurrences for the two groups. CONCLUSION： Traditional Chinese medicine combined with 5-aminosalicylic acid is effective and safe in the treatment of ulcerative col

关 键 词：中药 5-氨基水杨酸 溃疡性结肠炎 

分 类 号：R259[医药卫生—中西医结合]