Interpretation of the experts consensus on traditional Chinese medicine diagnosis and treatment of ulcerative colitis(2023)
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摘要: 《溃疡性结肠炎中医诊疗专家共识(2023)》是2020年11月由中华中医药学会脾胃病分会在北京主导，联合全国26家三甲医院和高校科研院所共同修订的一部溃疡性结肠炎(UC)中医诊疗专家共识。它呈现了三大重要特点：①全面性，包括UC的诊断、病因病机、辨证分型、临床治疗、疗效评定、中医药循证医学进展、预防调摄、转归与随访等多方面，为中医诊疗UC提供全面指导；②前沿性，与UC国际诊疗前沿接轨，强调“诱导并维持病情深度缓解”的治疗目标，并介绍了“中医药循证医学进展”；③传承创新，新增“现代名家学术经验”专栏，传承中医名家经验。本文将解读该共识的主要更新和重点内容，以推动其在临床实践中的应用。Abstract: The experts consensus on traditional Chinese medicine diagnosis and treatment of ulcerative colitis(2023) is an experts consensus on traditional Chinese medicine diagnosis and treatment led by the Spleen and Stomach Diseases Branch of the China Association of Chinese Medicine in November 2020 in Beijing, in collaboration with 26 tertiary hospitals and universities and research institutes across the country. It presents three important features: ① Comprehensive, including the diagnosis of ulcerative colitis(UC), etiology and pathogenesis, identification and typing, clinical treatment, evaluation of efficacy, the progress of evidence-based medicine in traditional Chinese medicine(TCM), prevention and regimen, prognosis and follow-up, etc., which provides a comprehensive guide to TCM in the diagnosis and treatment of UC; ② Cutting-edge, in line with the international diagnostic and therapeutic front of UC, emphasizing the goal of "inducing and maintaining deep remission", and "advances in evidence-based medicine in TCM" is introduced; ③ Inheritance and innovation, a new column of "Modern academic experience of famous TCM practitioners" is added to inherit the experience of famous TCM practitioners. In this article, we will explain the main updates and key contents of the 2023 experts consensus to promote its application in clinical practice.
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Key words:
- ulcerative colitis /
- traditional Chinese medicine /
- experts consensus /
- interpretation
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[1] Kaplan GG, Windsor JW. The four epidemiological stages in the global evolution of inflammatory bowel disease[J]. Nat Rev Gastroenterol Hepatol, 2021, 18(1): 56-66. doi: 10.1038/s41575-020-00360-x
[2] Chen YL, Zhang YL, Dai YC, et al. Systems pharmacology approach reveals the antiinflammatory effects of Ampelopsis grossedentata on dextran sodium sulfate-induced colitis[J]. World J Gastroenterol, 2018, 24(13): 1398-1409. doi: 10.3748/wjg.v24.i13.1398
[3] Ng SC, Shi HY, Hamidi N, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies[J]. Lancet, 2017, 390(10114): 2769-2778. doi: 10.1016/S0140-6736(17)32448-0
[4] Kaplan GG. The global burden of IBD: from 2015 to 2025[J]. Nat Rev Gastroenterol Hepatol, 2015, 12(12): 720-727. doi: 10.1038/nrgastro.2015.150
[5] 史瑞, 李军祥, 沈洪, 等. 溃疡性结肠炎中医诊疗专家共识(2023)[J]. 中华中医药杂志, 2024, 39(01): 288-296. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202401099.htm
[6] 张声生. 溃疡性结肠炎中医诊疗共识意见[J]. 中华中医药杂志, 2010, 25(6): 891-895. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY201708071.htm
[7] 张声生, 沈洪, 郑凯, 等. 溃疡性结肠炎中医诊疗专家共识意见(2017)[J]. 中华中医药杂志, 2017, 32(8): 3585-3589. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY201708071.htm
[8] Satsangi J, Silverberg MS, Vermeire S, et al. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications[J]. Gut, 2006, 55(6): 749-753. doi: 10.1136/gut.2005.082909
[9] Ko CW, Singh S, Feuerstein JD, et al. AGA Clinical Practice Guidelines on the Management of Mild-to-Moderate Ulcerative Colitis[J]. Gastroenterology, 2019, 156(3): 748-764. doi: 10.1053/j.gastro.2018.12.009
[10] Cross R, Ko CW, Singh S. Mild-to-Moderate Ulcerative Colitis Guideline[J]. Gastroenterology, 2019, 156(3): 768. doi: 10.1053/j.gastro.2019.01.037
[11] Feuerstein JD, Isaacs KL, Schneider Y, et al. AGA Clinical Practice Guidelines on the Management of Moderate to Severe Ulcerative Colitis[J]. Gastroenterology, 2020, 158(5): 1450-1461. doi: 10.1053/j.gastro.2020.01.006
[12] 厉英超, 陈思玮, 邵佳媛, 等. 溃疡性结肠炎达标治疗的研究进展[J]. 西安交通大学学报(医学版), 2020, 41(4): 628-632. https://www.cnki.com.cn/Article/CJFDTOTAL-XAYX202004030.htm
[13] 中华医学会消化病学分会炎症性肠病学组. 炎症性肠病外科治疗专家共识[J]. 中华炎性肠病杂志, 2020, 4(3): 180-199. doi: 10.3760/cma.j.cn101480-20200617-00067
[14] 国家中医药管理局, 国家卫生健康委员会. 国家中医药管理局、国家卫生健康委员会关于印发《中医病证分类与代码》和《中医临床诊疗术语》的通知[J]. (2020-11-16)[2023-02-01].
https://www.gov.cn/zhengce/zhengceku/2020-11/24/content_5563703.html .[15] 李军祥, 谭祥, 张阳. 董建华"心身同调"理论在功能性胃肠病治疗中的继承与发展[J]. 中医杂志, 2020, 61(22): 1953-1956. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ202022008.htm
[16] 朱良春. 国医大师卷: 朱良春[M]. 北京: 中国中医药出版社, 2011: 102-105.
[17] 崔松香, 卢海霞, 陆为民. 国医大师徐景藩从脾论治溃疡性结肠炎经验浅析[J]. 中华中医药杂志, 2022, 37(10): 5763-5766. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202210045.htm
[18] 庄昆海, 刘凤斌. 劳绍贤教授对溃疡性结肠炎的辨证论治思想[J]. 广州中医药大学学报, 2013, 30(6): 914-916. https://www.cnki.com.cn/Article/CJFDTOTAL-REST201306041.htm
[19] Liu Y, Li BG, Su YH, et al. Potential activity of Traditional Chinese Medicine against Ulcerative colitis: A review[J]. J Ethnopharmacol, 2022, 289: 115084. doi: 10.1016/j.jep.2022.115084
[20] Naganuma M, Sugimoto S, Mitsuyama K, et al. Efficacy of Indigo Naturalis in a Multicenter Randomized Controlled Trial of Patients With Ulcerative Colitis[J]. Gastroenterology, 2018, 154(4): 935-947. doi: 10.1053/j.gastro.2017.11.024
[21] Saba E, Lee YY, Kim M, et al. A novel herbal formulation consisting of red ginseng extract and Epimedium koreanum Nakai-attenuated dextran sulfate sodium-induced colitis in mice[J]. J Ginseng Res, 2020, 44(6): 833-842. doi: 10.1016/j.jgr.2020.02.003
[22] Pituch-Zdanowska A, Dembiński Ł, Banaszkiewicz A. Old but Fancy: Curcumin in Ulcerative Colitis-Current Overview[J]. Nutrients, 2022, 14(24): 5249. doi: 10.3390/nu14245249
[23] Coelho MR, Romi MD, Ferreira D, et al. The Use of Curcumin as a Complementary Therapy in Ulcerative Colitis: A Systematic Review of Randomized Controlled Clinical Trials[J]. Nutrients, 2020, 12(8): 2296. doi: 10.3390/nu12082296
[24] Xiong X, Cheng Z, Wu F, et al. Berberine in the treatment of ulcerative colitis: A possible pathway through Tuft cells[J]. Biomed Pharmacother, 2021, 134: 111129. doi: 10.1016/j.biopha.2020.111129
[25] Xu L, Zhang Y, Xue X, et al. A Phase Ⅰ Trial of Berberine in Chinese with Ulcerative Colitis[J]. Cancer Prev Res(Phila), 2020, 13(1): 117-126. doi: 10.1158/1940-6207.CAPR-19-0258
[26] Tang T, Targan SR, Li ZS, et al. Randomised clinical trial: herbal extract HMPL-004 in active ulcerative colitis-a double-blind comparison with sustained release mesalazine[J]. Aliment Pharmacol Ther, 2011, 33(2): 194-202. doi: 10.1111/j.1365-2036.2010.04515.x
[27] Langmead L, Feakins RM, Goldthorpe S, et al. Randomized, double-blind, placebo-controlled trial of oral aloe vera gel for active ulcerative colitis[J]. Aliment Pharmacol Ther, 2004, 19(7): 739-747. doi: 10.1111/j.1365-2036.2004.01902.x
[28] 高凤洋, 张大方, 李超英. 中药青黛炮制及药理作用的研究进展[J]. 长春中医药大学学报, 2020, 36(1): 180-183, 188. https://www.cnki.com.cn/Article/CJFDTOTAL-CZXX202001050.htm
[29] Nishio M, Hirooka K, DoiY. Pulmonary Arterial Hypertension Associated With the Chinese Herb Indigo Naturalis for Ulcerative Colitis: It May Be Reversible[J]. Gastroenterology, 2018, 155(2): 577-578. doi: 10.1053/j.gastro.2018.04.038
[30] Uchiyama K, Takami S, Suzuki H, et al. Efficacy and safety of short-term therapy with indigo naturalis for ulcerative colitis: An investigator-initiated multicenter double-blind clinical trial[J]. PLoS One, 2020, 15(11): e0241337. doi: 10.1371/journal.pone.0241337
[31] 李军祥, 王化虹. 中成药治疗溃疡性结肠炎临床应用指南(精简版, 2022年)[J]. 胃肠病学, 2023, 28(1): 17-26. https://www.cnki.com.cn/Article/CJFDTOTAL-WIEC202301001.htm
[32] Fukunaga K, Ohda Y, Hida N, et al. Placebo controlled evaluation of Xilei San, a herbal preparation in patients with intractable ulcerative proctitis[J]. J Gastroenterol Hepatol, 2012, 27(12): 1808-1815. doi: 10.1111/j.1440-1746.2012.07215.x
[33] Zhang F, Li Y, Xu F, et al. Comparison of Xilei-san, a Chinese herbal medicine, and dexamethasone in mild/moderate ulcerative proctitis: a double-blind randomized clinical trial[J]. J Altern Complement Med, 2013, 19(10): 838-842. doi: 10.1089/acm.2012.0296
[34] Gong Y, Zha Q, Li L, et al. Efficacy and safety of Fufangkushen colon-coated capsule in the treatment of ulcerative colitis compared with mesalazine: a double-blinded and randomized study[J]. J Ethnopharmacol, 2012, 141(2): 592-598. doi: 10.1016/j.jep.2011.08.057
[35] 沈洪, 朱磊, 胡乃中, 等. 虎地肠溶胶囊联合美沙拉秦肠溶片治疗活动期溃疡性结肠炎多中心、随机对照、双盲双模拟的临床研究[J]. 中国中西医结合杂志, 2019, 39(11): 1326-1331. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXJ201911012.htm
[36] Shen H, Zhang S, Zhao W, et al. Randomised clinical trial: Efficacy and safety of Qing-Chang-Hua-Shi granules in a multicenter, randomized, and double-blind clinical trial of patients with moderately active ulcerative colitis[J]. Biomed Pharmacother, 2021, 139: 111580. doi: 10.1016/j.biopha.2021.111580
[37] Joos S, Wildau N, Kohnen R, et al. Acupuncture and moxibustion in the treatment of ulcerative colitis: a randomized controlled study[J]. Scand J Gastroenterol, 2006, 41(9): 1056-1063. doi: 10.1080/00365520600580688
[38] Bernstein CN. Treatment of IBD: where we are and where we are going[J]. Am J Gastroenterol, 2015, 110(1): 114-126. doi: 10.1038/ajg.2014.357
[39] Bischoff SC, Bager P, Escher J, et al. ESPEN guideline on Clinical Nutrition in inflammatory bowel disease[J]. Clin Nutr, 2023, 42(3): 352-379. doi: 10.1016/j.clnu.2022.12.004
[40] Bopanna S, Ananthakrishnan AN, Kedia S, et al. Risk of colorectal cancer in Asian patients with ulcerative colitis: a systematic review and meta-analysis[J]. Lancet Gastroenterol Hepatol, 2017, 2(4): 269-276. doi: 10.1016/S2468-1253(17)30004-3
[41] Rubin DT, Ananthakrishnan AN, Siegel CA, et al. ACG Clinical Guideline: Ulcerative Colitis in Adults[J]. Am J Gastroenterol, 2019, 114(3): 384-413. doi: 10.14309/ajg.0000000000000152
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