结肠水疗仪中药灌肠联合美沙拉嗪治疗活动期溃疡性结肠炎的疗效与预后观察  

Efficacy and prognosis observation of Chinese medicine enema via colon hydrotherapy device combined with mesalazine in treatment of active ulcerative colitis

作　　者：张娇 顾树江 邢凯 陶源 王立颖 刘秀华 ZHANG Jiao;GU Shujiang;XING Kai;TAO Yuan;WANG Liying;LIU Xiuhua(Department of Spleen-stomach Diseases,Changping District Hospital of Traditional Chinese Medicine,Beijing 102200,China)

机构地区：[1]北京市昌平区中医医院脾胃病科,北京102200

出　　处：《北京中医药》2025年第4期430-434,共5页Beijing Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(82074420);北京市昌平区中医医院学科发展项目(CZ202213)。

摘　　要：目的观察结肠水疗仪中药灌肠联合美沙拉嗪治疗活动期溃疡性结肠炎的疗效与预后情况。方法选取2021年1月—2023年10月在本院收治的活动期溃疡性结肠炎患者90例进行前瞻性研究,根据随机数字表法将其分为对照组和观察组,各45例。2组均给予常规治疗,另外对照组给予美沙拉嗪肠溶片口服,1 g/次,4次/d;观察组在对照组基础上给予结肠水疗仪中药灌肠治疗,1次/d,14 d后休息2 d。2组均连续治疗3个月。对比2组证候疗效、复发率、不良反应,治疗前后中医证候积分、血清炎症因子[白细胞介素-8(IL-8)、肿瘤坏死因子α(TNF-α)、超敏C反应蛋白(hs-CRP)]、Baron分级、Sutherland疾病活动指数(DAI)评分、改良Mayo评分。结果观察组总有效率高于对照组(P<0.05),复发率低于对照组(P<0.01)。与治疗前比较,2组治疗后各项中医证候积分均降低(P<0.05);治疗后观察组各项中医证候积分均低于对照组(P<0.05)。与治疗前比较,2组治疗后血清IL-8、TNF-α、hs-CRP水平均降低(P<0.05);治疗后观察组血清IL-8、TNF-α、hs-CRP水平均低于对照组(P<0.05)。与治疗前比较,治疗后2组Baron评分、DAI评分、Mayo评分均降低(P<0.05);观察组Baron评分、DAI评分、Mayo评分均低于对照组(P<0.05)。2组不良反应发生情况比较,差异无统计学意义(P>0.05)。结论结肠水疗仪中药灌肠联合美沙拉嗪治疗活动期溃疡性结肠炎患者疗效显著、复发率低,可有效改善临床症状,减轻炎症反应。Objective To observe the efficacy and prognosis of Chinese medicine enema via colon hydrotherapy device combined with mesalazine in the treatment of active ulcerative colitis.Methods A total of 90 patients with active ulcerative colitis,who were treated at our hospital from January 2021 to October 2023,were selected for a prospective study.They were randomly divided into the control group and the observation group according to a random number table,with 45 cases in each group.Both groups received routine treatment,and the control group was additionally given mesalazine enteric-coated tablets orally(1 g per dose,4 times per day).The observation group,on the basis of the control group's treatment,was given Chinese medicine enema via colon hydrotherapy device(once per day,for 14 days,followed by a 2-day rest period).Both groups were treated continuously for 3 months.The efficacy of treatment,recurrence rate,adverse reactions,changes in traditional Chinese medicine(TCM)syndrome scores,serum inflammatory factors[interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),hypersensitive C-reactive protein(hs-CRP)],Baron classification,Sutherland Disease Activity Index(DAI),and Modified Mayo score were compared before and after treatment.Results The total effective rate in the observation group was significantly higher than that in the control group(P<0.05),and the recurrence rate was significantly lower in the observation group(P<0.01).Compared with baseline,the TCM syndrome scores in both groups decreased after treatment(P<0.05),and the scores in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the serum levels of IL-8,TNF-α,and hs-CRP were significantly reduced in both groups(P<0.05),with the observation group showing significantly lower levels than the control group(P<0.05).The Baron score,DAI,and Mayo scores all decreased significantly after treatment in both groups(P<0.05),and the observation group had significantly lower scores than the control group(P<0.05).There w

关 键 词：活动期溃疡性结肠炎 美沙拉嗪 中药灌肠 预后 疗效 

分 类 号：R574.62[医药卫生—消化系统]