Treatment of ulcerative colitis with mild to moderate distal damp heat syndrome of large intestine with Boyu enema retrospective cohort analysis
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摘要: 目的 回顾性分析柏榆灌肠方治疗轻中度远端大肠湿热证溃疡性结肠炎(UC)的临床疗效。方法 采用回顾性研究的方法，将2016年1月—2020年12月就诊的213例轻中度远端大肠湿热证UC患者根据治疗方式分为观察组(清肠化湿加减口服+柏榆灌肠方灌肠，100例)、对照组(清肠化湿加减口服+美沙拉秦栓组，113例)，比较两组患者的临床缓解率、中医证候疗效、单项症状积分和炎症指标水平。结果 观察组患者的临床缓解率高于对照组(85.00% vs 78.76%)，两组间比较差异有统计学意义(P < 0.05)；观察组患者的中医证候临床总有效率高于对照组(88.00% vs 76.99%)，两组间比较差异有统计学意义(P < 0.05)；黏液脓血便和腹痛评分两组比较差异有统计学意义(P < 0.05)；部分Mayo评分较治疗前降低，观察组患者低于对照组，两组间比较差异有统计学意义(P < 0.05)；两组患者的粪便钙卫蛋白、C-反应蛋白、血沉水平均较治疗前降低，两组间比较差异无统计学意义(P>0.05)。治疗过程中未发现明显治疗相关的肝肾损害等不良反应。结论 柏榆灌肠方灌肠可提高轻中度远端大肠湿热证UC患者的临床疗效，改善患者的临床症状及降低炎症指标水平。Abstract: Objective To retrospectively analyze the clinical efficacy of Boyu enema in the treatment of ulcerative colitis(UC) with mild to moderate distal damp heat syndrome of large intestine.Methods A retrospective study was conducted and 213 cases of mild to moderate large intestine damp heat UC were divided into the observation group(100 cases were treated with Qingchang Huashi Jiajian oral+Boyu enema) and the control group(113 cases were treated with Qingchang Huashi Jiajian oral+mesalazine suppository) according to the treatment method. The clinical remission rate, Traditional Chinese Medicine syndrome score, single symptom and inflammatory index level were analyzed and compared.Results The clinical remission rate in the observation group was higher than that in the control group(85.00% vs 78.76%, P < 0.05), and the total clinical effective rate of Traditional Chinese Medicine symptoms in the observation group was higher than that in the control group(88.00% vs 76.99%, P < 0.05); there was a significant difference between the two groups in the scores of mucopurulent stool and abdominal pain; some Mayo scores in the observation group were lower than those in the control group(P < 0.05); the levels of fecal calprotectin, C-reactive protein and erythrocyte sedimentation rate in the two groups were lower than those before treatment, and there was no statistical difference between the two groups(P>0.05). No significant treatment related adverse reactions such as liver and kidney damage were found.Conclusion Boyu enema recipe can improve the clinical efficacy of UC with mild to moderate damp heat syndrome of large intestine, improve the clinical symptoms of patients, and reduce the level of inflammatory indicators.
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Key words:
- ulcerative colitis /
- Boyu enema formula /
- enema /
- damp heat syndrome of large intestine
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表 1 两组患者的中医证候疗效比较
例(%) 组别 例数 临床缓解 显效 有效 无效 总有效(%) 观察组 100 27(27.00) 9(9.00) 52(52.00) 12(12.00) 88(88.00)1) 对照组 113 23(20.35) 3(2.65) 61(53.98) 26(23.01) 87(76.99) 与对照组比较，1)P＜0.05。 
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表 2 两组患者治疗前后的单项症状积分比较
分，X±S 组别 时间 例数 腹泻 黏液脓血便 腹痛 里急后重 肛门灼热 观察组 治疗前 100 3.52±1.72 2.85±1.38 1.61±1.50 0.05±0.22 0.05±0.22 治疗后 100 1.42±1.511) 0.48±1.111)2) 0.64±1.231)2) 0.02±0.041) 0.01±0.102) 对照组 治疗前 113 3.08±1.52 2.47±1.34 1.65±1.50 0.07±0.261) 0.04±0.19 治疗后 113 1.43±1.511) 1.12±1.461) 0.98±1.411) 0.01±0.09 0.04±0.19 与本组治疗前比较，1)P < 0.05；与对照组治疗后比较，2)P < 0.05。
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表 3 两组患者治疗前后的炎症指标比较
X±S 组别 时间 FC/(μg·g-1) CRP/(mg·L-1) ESR/(mm·1 h-1) 观察组 治疗前 121.31±338.57 5.01±13.76 7.13±18.05 治疗后 37.66±120.121) 1.59±4.441) 1.82±6.951) 对照组 治疗前 55.72±204.55 4.22±11.59 5.71±15.75 治疗后 20.91±96.571) 1.69±4.481) 2.80±9.221) 与本组治疗前比较，1)P < 0.05。
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