复方灌肠液治疗溃疡性结肠炎的临床观察(1)
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【摘要】 目的 观察西医内科基础治疗辅以复方灌肠液保留灌肠治疗溃疡性结肠炎的临床疗效。方法 将80例患者随机分为治疗组及对照组各40例,对照组口服柳氮磺胺吡啶(SASP)1.0 g,4次/d;治疗组在此基础上加用复方灌肠液保留灌肠,14 d为1疗程,连用3个疗程。比较两组患者治疗前后的临床症状、疾病活动指数(DAI)、肠镜表现、复发情况及不良反应。结果 治疗组患者的临床症状、DAI、肠镜表现明显改善,复发率低,对照组改善不明显,差异有统计学意义(P<0.05),两组不良反应发生率差异无统计学意义(P>0.05)。结论 SASP口服联合复方灌肠液保留灌肠治疗溃疡性结肠炎,疗效显著,简便实用,值得临床推广。
【关键词】结肠炎;溃疡性;三黄汤;灌肠
The clinical observation of compound recipe enema in the Treatment of ulcerative colitis
LIN Zuo guang.Department of digestive system,Gaozhou Municipal People’s Hospital,Guangdong Gaozhou,525200,China
【Abstract】 Objective To observed the clinical effect of compound recipe enema in the treatment of ulcerative colitis based on western medical treatment.Methods 80patients were randomly divided into control group(n=40)and therapy group(n=40).The group was treated with sulfasalazine(SASP),1.0 g,qid;the treatment group were added based on compound recipe enema retention enema,14 d for a course of treatment,three courses used in conjunction.Compared with clinical symptoms,disease activity index(DAI),colonoscopy performance,relapse,and adverse reactions before and after treatment in two groups.Results The clinical symptoms,DAI,colonoscopy performance and relapse were significant difference(P<0.05),the incidence of adverse reactions was no significant difference(P>0.05).Conclusion SASP combine with compound enema recipe retention enema to treat ulcerative colitis,a significant curative effect、simple and practical,It deserves to be popularized.
【Key words】Colitis;Ulcerative;Tree yellow liquor;Enema
溃疡性结肠炎(ulcerative colitis,UC)又称慢性非特异性结肠炎,是一种病因尚不十分清楚的直肠和结肠慢性非特异性炎性疾病,病变主要限于大肠黏膜与黏膜下层,呈连续性弥漫性分布,多数在直肠乙状结肠,也可累及全结肠,范围多自肛端直肠开始,逆行向近段发展[1]。由于病程较长,易反复发作,西药治疗效果欠佳,近年来中药保留灌肠治疗UC受到关注。本文采用复方灌肠液保留灌肠治疗UC,取得良好疗效,现报道如下。
1 材料与方法
1.临床资料
按照2007年《对我国炎症性肠病诊断治疗规范的共识意见》中的诊断标准[2],选择从2008年1月至2009年2月在我科收治UC患者80例,所有患者均经结肠电子肠镜检查及病理检查证实。80例患者随机分为治疗组及对照组各40例,两组患者年龄、病程、临床表现和肠镜下炎症表现差异均无统计学意义(P>0.05),具有可比性,见表1。
1.2 治疗方法 两组患者予相同的常规内科治疗,治疗组在此基础上加用中药灌肠。复方灌肠液由三黄汤(用黄芩15 g、黄柏15 g、黄连15 g煎成水)100 ml+1%普鲁卡因20 ml+地塞米松5~10 mg+灭滴灵0.4 g组成。灌肠时患者采取侧卧屈膝位,左、右侧位根据病变部位而定,并抬高臀部,以保留药液在肠道内的停留时间,药液灌注完后注入空气50 ml,排出肛管内残留的药液,并借助气流冲击加速药液弥散,转动体位使药液与病变肠黏膜充分接触,每晚睡前保留灌肠一次,14 d为一个疗程,连用3个疗程 ......
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