陆文洪 罗雯鹏 肖戈

摘要 目的：探究芩柏加減方治疗溃疡性结肠炎的疗效及安全性。方法：选取2018年1月至2020年7月湖南中医药大学第二附属医院肛肠科收治的溃疡性结肠炎患者104例作为研究对象，按随机数字表法分为对照组和观察组，每组52例。对照组采用西药美沙拉嗪治疗，观察组采用美沙拉嗪结合芩柏加减方治疗，比较2组患者治疗效果。结果：与对照组（84.62%）比较，观察组有效率（96.15%），差异有统计学意义（P<0.05）;治疗前，2组患者中医证候（腹泻腹痛、腹胀血便、里急后重、纳呆乏力等）积分、肠镜黏膜Baron积分变化、组织病理学Geboes评分、白细胞介素-10（IL-10）及肿瘤坏死因子-α（TNF-α）水平比较，差异无统计学意义（P>0.05），治疗后2组指标均改善，观察组优于对照组，差异有统计学意义（P<0.05）。对照组不良反应率（1.92%）与观察组（0.00%）均较低，差异无统计学意义P>0.05;观察组患者6个月复发率（0.00%）低于对照组（7.69%），差异有统计学意义（P<0.05）。结论：芩柏加减方治疗溃疡性结肠炎效果佳，安全性较高。

关键词 溃疡性结肠炎;芩柏加减方;疗效;中医证候积分;炎性因子;肠镜黏膜Baron积分;不良反应;复发率

Efficacy and Safety of Modified Qinbai Decoction in the Treatment of Ulcerative Colitis

LU Wenhong，LUO Wenpeng，XIAO Ge

（Department of Anorectal Medicine，Second Affiliated Hospital of Hunan University of Chinese Medicine，Changsha 410005，China）

Abstract Objective：This study investigated the efficacy and safety of modified Qinbai Decoction in the treatment of ulcerative colitis.Methods：A total of 104 patients with ulcerative colitis who were admitted to the Second Affiliated Hospital of Hunan University of Chinese Medicine the from January 2018 to July 2020，were selected and randomized into the control group and observation group with the random number table method，52 in either group.The control group was treated with mesalazine and the observation group with mesalazine and modified Qinbai Decoction.The efficacy in the two groups was compared.Results：The effective rate in the observation group（96.15%） was higher than in the control group（84.62%）（P<0.05）.Before treatment，the TCM syndrome score（diarrhea and abdominal pain，abdominal distension and bleeding stools，tenesmus，and poor appetite and fatigue），Baron score for intestinal mucosal changes，Geboes score for histological severity，and the levels of interleukin-10（IL-10） and tumor necrosis factor α（TNF-α） in two groups were insignificantly different（P>0.05）.After treatment，the indexes in either group were improved and the improvement in the observation group was better than that in the control group（P<0.05）.The occurrence of adverse reactions was low in control group（1.92%） and observation group（0.00%） with insignificant difference（P>0.05）.The recurrence rate in 6 months in observation group（0.00%） was lower than that in control group（7.69%）（P<0.05）.Conclusion：Modified Qinbai Decoction is effective and safe in the treatment of ulcerative colitis.

Keywords Ulcerative colitis; Modified Qinbai Decoction; Curative effect; TCM syndrome score; Inflammatory factors; Baron score for intestinal mucosal changes; Adverse reactions; Recurrence rate412CECCE-A96B-4904-87B8-97B27D9D24E6

中图分类号：R256.3文献标识码：Adoi：10.3969/j.issn.1673-7202.2022.08.013

溃疡性结肠炎（Ulcerative Colitis，UC）为临床常见疾病，该病病因不明，属于慢性非特异性肠病，病变位置在结肠黏膜层，溃疡常累及结直肠，多伴有肠外并发症，表现为腹痛、腹泻、脓血便等症状，影响患者健康及生命质量[1]。近年来，UC发病率不断上升，且疾病迁延难愈，复发率高，存在癌变风险，无法彻底治愈，属于终身性疾病，是现代临床关注的疑難疾病，需要寻求新的、疗效确切、安全可靠的治疗方法[2]。美沙拉嗪治疗UC具有一定疗效，临床应用较多[3]。中医治疗UC具有一定疗效[4]。芩柏加减方具有较好的益气、健脾、除湿、祛瘀等功效，对UC患者疗效较好，尤其是UC脾虚湿阻证，值得深入探讨。本研究纳入104例UC脾虚湿阻证患者进行分组研究，以探究芩柏加减方应用效果，现报道如下。……