红藤肠安汤治疗溃疡性结肠炎疗效观察

周赟等

摘要：目的 評价自拟方红藤肠安汤治疗轻中度溃疡性结肠炎（UC）的临床疗效及安全性。方法 选择120例轻中度UC患者，随机分为中药组和西药组各60例，中药组予自拟方红藤肠安汤，西药组予美沙拉嗪肠溶片，疗程均为6周，随访2周。观察并比较2组患者治疗前后红细胞沉降率（ESR）和血清C反应蛋白（CRP）水平变化、肠镜下结肠黏膜愈合情况（根据Baron评分）、临床疗效及安全性。结果 2组患者治疗后CRP水平均较治疗前降低，差异有统计学意义（P<0.05）；2组患者治疗后ESR降低，但差异无统计学意义（P>0.05）。肠镜下结肠黏膜愈合有效率中药组为61.37%（27/44），西药组为64.29%（27/42），组间比较差异无统计学意义（P>0.05）。临床总有效率中药组为86.7%（52/60），西药组为75.0%（45/60），中药组优于西药组（P<0.05）。中药组未出现不良反应。结论 红藤肠安汤能有效降低轻中度UC患者血清CRP水平，缓解炎症，促进结肠黏膜愈合，具有良好的临床疗效，且无不良反应。

关键词：溃疡性结肠炎；红藤肠安汤；红细胞沉降率；C反应蛋白；Baron评分

DOI：10.3969/j.issn.1005-5304.2015.09.007

中图分类号：R259.746.2 文献标识码：A 文章编号：1005-5304（2015）09-0022-04

Observation of Curative Effect of Hongteng Chang'an Decoction in Treating Ulcerative Colitis ZHOU Yun， SUN Ji， WU Ya-ying， WANG Hong-wei， KONG Jing， TANG Jin （Yueyang Hospital of Integrated Chinese and Western Medicine， Shanghai University of Traditional Chinese Medicine， Shanghai 200437， China）

Abstract：Objective To evaluate the clinical efficacy and safety of Hongteng Chang'an Decoction in treating mild and moderate ulcerative colitis （UC） cases. Methods Totally 120 patients of mild or moderate UC were randomly divided into two groups：TCM group of 60 patients， treated by self-made Hongteng Chang'an Decoction；Western medicine group of 60 patients， treated by mesalazine orally. The treatment course of both groups was 6 weeks， also with two-week follow-up. The ESR and CRP levels before and after treatment， the healing of colonic mucosa under endoscopy （according to the Baron score）， the clinical efficacy and safety were analyzed statistically. Results CRP of both groups decreased significantly， with obvious statistical significance （P<0.05）；ESR of both groups decreased， without statistical significance （P>0.05）. The effects of healing of colonic mucosa under endoscopy of TCM group and Western medicine group were 61.37% （27/44） and 64.29% （27/42）， respectively， without obvious statistical significance （P>0.05）. The total effective rates of TCM group and Western medicine group were 86.7% （52/60） and 75.0% （45/60）， respectively， and the TCM group was superior to the Western medicine group （P<0.05）. Conclusion Hongteng Chang'an Decoction can reduce the serum level of CRP of the mild and moderate UC patients effectively， relieve inflammation， and promote the healing of colonic mucosa. The treatment of mild and moderate ulcerative colitis by Hongteng Chang'an Decoction has good clinical efficacy， without toxic side effects.

Key words：ulcerative colitis；Hongteng Chang'an Decoction；ESR；CRP；Baron score

基金项目：上海申康医院发展中心资助项目（SHDC12012408）

通讯作者：汤瑾，E-mail：tangjin_yueyang@163.com

溃疡性结肠炎（ulcerative colitis，UC）是一种以慢性炎症和溃疡形成为主要病理特点的消化道疾病，病变多累及直肠和乙状结肠，也可遍及整个结肠，主要侵犯大肠黏膜与黏膜下层，是较为常见的消化系疾病[1]。本病在西方发达国家发病率较高，近年来随着饮食结构和生活方式的改变，我国的发病率显著上升。UC临床表现为腹泻、黏液脓血便、腹痛，病情轻重不等，多呈反复发作的慢性病程[2]，治疗棘手。西药美沙拉嗪肠溶片有相当疗效但存在一定不良反应。本院消化科多年来应用自拟方红藤肠安汤治疗轻中度UC，取得了较好的临床效果，现报道如下。

1 资料与方法