基于“肝脾同治”理论治疗肝郁脾虚型溃疡性结肠炎临床观察  

Clinical observation on ulcerative colitis of liver stagnation and spleen deficiency type based on the theory of"simultaneous treatment of liver and spleen"

作　　者：赵恩春[1] 王斌[1] 郑勇[1] 付荣华[1] ZHAO Enchun;WANG Bin;ZHENG Yong(Department of Anorectal,Huai'an Hospital of Traditional Chinese Medicine,Huai'an,Jiangsu 223001)

机构地区：[1]江苏省淮安市中医院肛肠科,江苏淮安223001

出　　处：《河北中医》2020年第6期826-831,836,共7页Hebei Journal of Traditional Chinese Medicine

基　　金：江苏省中医药局科技项目(编号:YB2017069)。

摘　　要：目的观察基于“肝脾同治”理论治疗肝郁脾虚型溃疡性结肠炎(UC)的临床疗效。方法将60例肝郁脾虚型UC患者按照随机数字表法分为2组。治疗组30例予怡情止泻汤口服治疗,对照组30例予美沙拉嗪肠溶片治疗。2组均治疗4周。比较2组治疗前和治疗2、4周中医症状评分、疾病活动性指数(DAI)、结肠内镜评分、汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分、炎症性肠病患者生活质量量表(IBDQ)评分,肠道大肠杆菌、乳酸杆菌及双歧杆菌数量,并统计疗效。结果治疗2、4周2组各中医症状评分均较本组治疗前降低(P<0.05),治疗4周2组均较本组治疗2周降低(P<0.05),且治疗2、4周治疗组均低于对照组同期(P<0.05)。治疗2、4周2组疾病活动度均较本组治疗前降低(P<0.05),治疗4周2组均较本组治疗2周降低(P<0.05),且治疗2、4周治疗组疾病活动度低于对照组同期(P<0.05)。治疗2、4周2组结肠内镜评分均较本组治疗前降低(P<0.05),治疗4周2组均较本组治疗2周降低(P<0.05),且治疗2、4周治疗组均低于对照组同期(P<0.05)。治疗2、4周2组HAMA、HAMD评分均较本组治疗前降低(P<0.05),治疗4周2组均较本组治疗2周降低(P<0.05),且治疗2、4周治疗组均低于对照组同期(P<0.05)。治疗2、4周2组IBDQ评分均较本组治疗前升高(P<0.05),治疗4周2组均较本组治疗2周升高(P<0.05),且治疗2、4周治疗组均高于对照组同期(P<0.05)。治疗2、4周2组肠道大肠杆菌数量均较本组治疗前降低(P<0.05),乳酸杆菌、双歧杆菌数量均升高(P<0.05);治疗4周2组肠道大肠杆菌数量均较本组治疗2周降低(P<0.05),乳酸杆菌、双歧杆菌数量均升高(P<0.05);治疗2、4周治疗组肠道大肠杆菌数量低于对照组同期(P<0.05),乳酸杆菌、双歧杆菌数量均高于对照组同期(P<0.05)。结论以“肝脾同治”为理论基础,采用怡情止泻汤治疗肝郁脾虚型UC,能明显改善患者临床症�Objective To observe the effect of ulcerative colitis(UC)of liver stagnation and spleen deficiency type based on the theory of"simultaneous treatment of liver and spleen".Methods 60 UC patients with liver stagnation and spleen deficiency type were randomly divided into two groups according to the random number table method.30 cases in the treatment group were treated by Yiqing Zhixie decoction.30 cases in the control group were treated by mesalazine enteric coated tablets.Both groups were treated for 4 weeks.The TCM symptom score,disease activity index(DAI),colonoscopy score,Hamilton Anxiety Scale(HAMA)score,Hamilton Depression Scale(HAMD)score,quality of life scale score of patients with inflammatory bowel disease(IBDQ),the number of intestinal escherichia coli,lactobacillus and bifidobacteria were compared between the two groups before treatment and 2 and 4 weeks of treatment,and the curative effect was counted.Results After 2 and 4 weeks of treatment,the TCM symptom scores of the two groups were lower than those in the group before treatment(P<0.05),after 4 weeks of treatment,the two groups were lower than this group at 2 weeks of treatment(P<0.05),and the treatment group was lower than that of the control group at 2 and 4 weeks of treatment(P<0.05).After 2 and 4 weeks of treatment,the disease activity of the treatment group was lower than that of the control group at the same period(P<0.05).After 2 and 4 weeks of treatment,the scores of colonoscopy in both groups were lower than those in the group before treatment(P<0.05),after 4 weeks of treatment,the two groups were lower than this group at 2 weeks of treatment(P<0.05),and the treatment group was lower than that of the control group at 2 and 4 weeks of treatment(P<0.05).After 2 and 4 weeks of treatment,the scores of HAMA and HAMD in both groups were lower than those in the group before treatment(P<0.05),after 4 weeks of treatment,the two groups were lower than this group at 2 weeks of treatment(P<0.05),and the treatment group was lower than that of the cont

关 键 词：结肠炎 溃疡性 调和肝脾 中药疗法 

分 类 号：R574.621[医药卫生—消化系统]