【作者】 孙阳；

【导师】 马建；

【作者基本信息】 黑龙江中医药大学 ， 中医学， 2010， 硕士

【摘要】 目的：观察中药灌肠联合美沙拉嗪治疗湿热内蕴型轻、中度远端溃疡性结肠炎的临床疗效及对血清肿瘤坏死因子α(TNF-α)的影响。方法：本研究采用随机、阳性药对照的试验方法,将64例湿热内蕴型轻、中度远端溃疡性结肠炎的患者随机分为治疗组32例,对照组32例。两组一般治疗相同(充分休息,调畅情志,合理饮食,均衡营养),对照组在一般治疗基础上给予美拉沙嗪口服治疗,治疗组在对照组基础上加用清热燥湿、凉血止痢中药灌肠治疗。总疗程为四周。四周后评价两组患者治疗前后中医症候、肠镜表现及TNF-α改善情况以观察本方法的治疗效果。结果：治疗组和对照组中医症候、肠镜表现、TNF-α于治疗后均有不同程度改善,其中TNF-α于治疗前后两组内比较有显著性差异(P<0.01)。治疗组与对照组组间比较,中医症候疗效显效率和总有效率分别为62.5%和18.8%(P<0.05),87.5%和81.2%(P>0.05),显效率差异有统计学意义,治疗组优于对照组；肠镜疗效显效率和总有效率分别为65.6%和34.4%(P<0.05),87.5%和81.3%(P>0.05),显效率差异有统计学意义,治疗组优于对照组；TNF-α改善程度治疗组优于对照组(P<0.05)。试验期间无不良事件与不良反应发生。结论：中药灌肠联合美沙拉嗪治疗湿热内蕴型轻、中度远端溃疡性结肠炎疗效较好,可有效改善患者中医症候及肠镜表现,且可以降低患者血清TNF-α水平。更多还原

【Abstract】 Purpose:To observe the effect of herbal enema combined mesalazine treatment of dampness-heat stagnanting ulcerative colitis,located in the rectum and the degree is mild or middle;and the impact on tumor necrosis factor-a(TNF-α).Method:64 cases of mild or middle rectual ulcerative colitis of dampness-heat stagnanting were randomly divided into two groups.The basic treatment of two groups is same(adequate rest,regulating emotion,proper diet,balanced nutrition).32 cases of the control group take the mesalazine,while 32 cases of the treatment group use herbal enema on the basic treatment of control group.The period of two groups is four weeks.Evaluating the improvement of TCM syndrome,the performance of colonoscopy,and TNF-αbetween the two groups to observe the effect of this method.Result:After treatment the TCM syndrome,the performance of colonoscopy,TNF-αof the two groups are improved,among them the TNF-αin each group before and after the group has significant difference(P<0.01). Between the treatment group and control group after treatment,the marked and total effective rate of TCM syndrome are 62.5% and 18.8%(P<0.05),87.5% and 81.2%(P>0.05),the difference of marked effective rate between the two groups is statistically significant,the effect of the treatment group is better than the control group;the marked and total colonoscopy effective rate are 65.6% and 34.4%(P<0.05),87.5% and 81.3%(P>0.05),the difference of marked colonoscopy effective rate between the two groups is statistically significant,the effect of the treatment group is better than the control group;the improvement of TNF-αin treatment group is better than the control group(P<0.05).During the trial there are no adverse events and adverse reactions.Conclusion:The method of herbal enema combined mesalazine can treat the dampness-heat stagnanting of mild or middle rectual ulcerative colitis better,improve the TCM syndrome and the performance of colonoscopy and reduce the level of TNF-α.更多还原