中西医结合分期治疗溃疡性结肠炎的临床研究王传思1,谢贻祥,郑学海,姚磊,黄鸿武,王永森,吴永军(安徽医科大学附属六安医院肛肠外科,安徽六安237005)摘要目的:观察中西医结合分期法治疗溃疡性结肠炎的临床疗效和优势。方法:40例轻、中度初发或复发型溃疡性结肠炎活动期湿热内蕴证患者随机分为中西医结合组20例及西药组20例。中西医结合组活动期予美沙拉嗪肠溶片口服,每次0.5g,每日3次;配合参黄合剂保留灌肠,每日2次。缓解期单用参黄合剂灌肠,每日1次。如遇病情复发,恢复活动期治疗方案。西药组活动期给予美沙拉嗪肠溶片1.0g,每日4次口服;缓解期给予0.5g,每日3次。两组均治疗观察90天,并分别于30、60、90天观察患者病情变化,及维持缓解时间。结果:治疗90天后,中西医结合组腹泻、脓血便、腹痛均较治疗前明显好转(P<0.05),且对腹泻、脓血便的缓解优于西药组(P<0.05)。中西医结合组治疗30、60、90天后,中医证候疗效分别为85.00%、90.00%、95.00%,诱导缓解率分别为50.00%、70.00%、85.00%,均优于同期西药组(P<0.05)。治疗90天后,两组患者生活质量各维度胃肠症状、全身症状、情感能力、社会能力等方面较治疗前均显著改善(P<0.05),且中西医结合组患者生活质量各维度改善程度均优于西药组(P<0.05)。结论:中西医结合分期治疗能有效改善溃疡性结肠炎患者的主要临床症状,改善患者中医证候,提高溃疡性结肠炎缓解率和患者整体生活质量,具有良好的临床疗效。关键词:中西医结合;分期;UC;生活质量;临床研究ClinicalStudyofComprehensiveTreatmentofCombinedTherapyofChineseandWesternMedicineintreatingUlcerativeColitisaccordingtotheStageofDiseaseWANGChuan-si,XIEYi-xiang,ZHENGXue-hai,etal(DepartmentofAnorectalsurgery,TheAffiliatedLu'anHospitalofAnhuiMedical1基金项目:安徽省高校自然科学基金项目(KJ2013Z144)作者简介:王传思(1974-),男,副主任医师University,AnhuiLu’an237005China)[Abstract]ObjectiveToobservetheclinicalefficacyofcomprehensivetreatmentofcombinedtherapyofChineseandWesternmedicineintreatingulcerativecolitis(UC)accordingtosyndromedifferentiationtherapyandthestageofdisease.MethodsFortypatientswithmildormoderate,initialonsetorrelapsedactiveUCoflargeintestinaldampness-heatsyndromewererandomlyassignedtotwogroups,thetreatmentgroup(20cases)andthecontrolgroup(20cases).ThetreatmentgroupwastreatedwithoralMesalazineentericcoatedtablet(MSRT,0.5g,threedaily)andexternalapplicationofShenhuangMixture(SM)retentionenemaintheactivestage,twodaily;applicationofShenhuangMixture(SM)retentionenemaintheremissionstage,onedaily.Symptomaticmodificationwasperformedaccordingtothefeaturesofthesymptoms.PatientsinthecontrolgroupweretreatedwithoralMesalazineentericcoatedtablet(MSRT,1.0g,fourdaily)intheactivestage,oraladministrationofMSRT(0.5g,threedaily)intheremissionstage.Themainclinicalsymptoms,Chinesemedicinesyndrome,inducedremissionrate,andchangesofqualityoflifewereobservedonthe30th,60th,and90thdayaftertreatment.ResultsAfter90daysoftreatment,thescoresofthesymptomssuchasdiarrhea,passingstoolwithpusandblood,andtheabdominalpaininthetreatmentgroupwereobviouslyimprovedwhencomparedwithbeforetreatment(P<0.05).Thescoresofthesymptomssuchasdiarrhea,andpassingstoolwithpusandbloodinthetreatmentgroupwerebetterthanthoseinthecontrolgroup(P<0.05).After30,60,and90daysoftreatment,theclinicalefficacyofChinesesyndromeswere85.00%,90.00%,and95.00%,respectively,andtheinducedremissionrateswere50.0%,70.0%,and85.0%,respectivelyinthetreatmentgroup,betterthanthoseinthecontrolgroupofthesamephase(P<0.05).After90daysoftreatment,thescoresofthequalityoflife,thegeneralsymptoms,theemotionalcapacity,andthesocialcapac...