清肠方灌肠治疗溃疡性结肠炎的疗效研究  

The effect of Qingchang Decoction enema in patients with ulcerative colitis

作　　者：温红珠[1] 李培菡 林江[1] WEN Hongzhu;LI Peihan;LIN Jiang(Department of 1st Gastroenterology,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai,200032,China)

机构地区：[1]上海中医药大学附属龙华医院脾胃病一科,上海200032

出　　处：《中国中西医结合消化杂志》2025年第2期112-116,共5页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：浦东新区中医药传承创新发展示范试点项目建设—高水平研究型中医医院建设(No:YC-2023-0901)。

摘　　要：目的:评价清肠方保留灌肠治疗左半结肠型溃疡性结肠炎(ulcerative colitis,UC)的疗效和安全性。方法:选择2018年5月—2021年3月住院接受每晚1次,每次1袋180 mL清肠方保留灌肠8周,治疗后完成内镜检查,并继续接受维持治疗的10例左半结肠型UC患者。计算黏膜愈合率,比较治疗前后改良的Mayo评分、内镜Mayo评分和便血评分,并研究维持治疗期间的疾病复发情况。结果:治疗8周后,9/10例(90%)患者达到黏膜愈合。治疗4周时,患者的便血评分即出现显著下降(0分vs 1分,P<0.05);治疗8周后,患者改良的Mayo评分(2.0分vs 6.9分,P<0.01)和内镜Mayo评分(1.0分vs 3.0分,P<0.01)均较治疗前显著下降。诱导缓解后,5例采用清肠方灌肠维持治疗,3例采用清肠栓纳肛维持治疗,此8例患者均无复发。1例患者以清肠方诱导缓解后,继续给予清肠方保留灌肠维持治疗19个月,期间无复发,停用灌肠仅以美沙拉嗪口服治疗3个月后出现症状复发。本研究最长随访时间为31个月。研究中无不良事件发生。结论:清肠方保留灌肠可诱导左半结肠型UC患者获得黏膜愈合,并可有效维持缓解。Objective To assess the efficacy and safety of Qingchang Decoction(QcD)enema in patients with left-sided ulcerative colitis(UC).Methods Clinical data were obtained from 10 patients diagnosed with left-sided UC who had received QcD enema(180 mL per night)for 8 weeks and received endoscopy after treatment between May 2018 and March 2021.Patients also received treatment to maintain remission.The mucosal healing rate was calculated.The baseline modified Mayo scores,Mayo endoscopy subscores,and rectal bleeding subscores were compared with those after treatment.The recurrence rate was also assessed.Results After 8 weeks of treatment,9 out of 10 patients(90%)achieved mucosal healing.At the 4-week mark,patients'rectal bleeding subscore showed a significant decrease(0 point vs 1 point,P<0.05).By the end of the 8-week treatment period,patients'modified Mayo score(2.0 points vs 6.9 points,P<0.01)and Mayo endoscopic subscore(1.0 point vs 3.0 points,P<0.01)both significantly decreased compared to before treatment.After induction relief,5 cases were treated with QcD enema for maintenance,and 3 cases were treated with Qingchang suppository for maintenance.All these 8 patients had no recurrence.After inducing remission with QcD enema,one patient continued to receive QcD retention enema for 19 months without recurrence,however,after stopping the enema and only taking oral mesalazine for 3 months,the symptoms recurred.The longest follow-up period for this study was 31 months.None of the patients experienced any adverse event.Conclusion QcD retention enema may induce mucosal healing in left-sided UC and maintain remission.

关 键 词：左半结肠型 溃疡性结肠炎 清肠方 灌肠 

分 类 号：R574.62[医药卫生—消化系统]