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[目的]观察辨证分型与解毒消痈方灌肠联合西药治疗溃疡性结肠炎疗效。[方法]使用随机平行对照方法,将58例住院及门诊患者按抽签法简单随机分为两组。对照组28例硫氮磺吡啶,2.0g/次,3次/d,口服;蒙脱石散,3g/次,3次/d,口服;解毒消痈方(红藤20g,败酱草30g,鱼腥草20g,马齿苋30g,白芷、丹参各15g,地丁草20g,益母草15g;脾胃虚弱加党参20g,白术、茯苓各15g;湿热蕴脾加黄芩、苦参各20g,黄柏15g;肾阳虚衰加附子、肉桂、巴戟天各15g),1剂/d,加水1000mL浓煎成250mL,每晚临睡前保留灌肠。治疗组30例1脾胃虚弱,参苓白术散(党参20g,白术15g,茯苓12g,山药、白扁豆各15g,砂仁、陈皮各10g,桔梗9g,薏米仁15g,大枣5枚;腹痛明显加白芍15g,小茴香10g);2湿热蕴脾,葛根芩连汤(葛根20g,黄芩12g,黄连、甘草各10g,金银花15g,茯苓、泽泻、枳壳各10g,桔梗6g;湿邪偏重加厚朴12g,陈皮、白术各10g;热邪偏重加苦参、黄柏、车前子各10g);3肾阳虚衰,四神丸(补骨脂15g,吴茱萸10g,肉豆蔻20g,五味子、附子、干姜各15g;气虚加党参20g,白术15g,黄芪20g;血瘀加当归10g,川芎12g,赤芍15g);上方均1剂/d,水煎200mL,早晚口服;西药及解毒消痈方灌肠治疗同对照组。连续治疗56d为1疗程。观测临床症状、结肠镜检查、不良反应。连续治疗2疗程,判定疗效。随访6个月,观测复发率。[结果]治疗组痊愈16例,有效11例,无效3例,总有效率90.00%。对照组痊愈13例,有效8例,无效7例,总有效率75.00%。治疗组疗效优于对照组(P<0.05)。[结论]辨证分型与解毒消痈方灌肠联合西药治疗溃疡性结肠炎疗效显著,值得推广。
[Objective] To observe the curative effect of syndrome differentiation and detoxification Xiaoya Recipe enema combined with Western medicine in treating ulcerative colitis. [Methods] Using randomized parallel control method, 58 inpatients and outpatients were randomly divided into two groups according to the random selection method. Control group, 28 cases of sulfasalazine, 2.0g / times, 3 times / d, oral; montmorillonite powder, 3g / times, 3 times / d, oral; detoxification Xiaoya side (red vine 20g, Patrinia 30g , Herba Houttuyniae 20g, purslane 30g, Angelica, Salvia 15g, toad grass 20g, Motherwort 15g; spleen and stomach plus Codonopsis 20g, Atractylodes, Poria 15g; damp heat spleen plus skullcap, sophora flavescens 20g, Treats 15g ; Kidney Yang deficiency plus aconite, cinnamon, Morinda 15g each), 1 / d, add water 1000mL thick decoction into 250mL, night before going to sleep retention enema. The treatment group 30 cases 1 spleen and stomach, Shenling Baizhu San (Codonopsis 20g, Atractylodes 15g, Poria 12g, yam, white lentils each 15g, Amomum, dried tangerine peel 10g, Campanulaceae 9g, barley kernel 15g, jujube 5; Add white peony root 15g, cumin 10g); 2 damp heat Yun spleen, Gegen Qinlian soup (Pueraria 20g, Scutellaria 12g, berberine, licorice 10g, honeysuckle 15g, Poria, Alisma, Citrus aurantium 10g, Campanulaceae 6g; Emphasis on thickening Park 12g, dried tangerine peel, Atractylodes each 10g; hot evil emphasis on plus Sophora, Phellodendron, Plantago 10g); 3 kidney yang failure, Sishen pill (psoralen 15g, Evodia 10g, nutmeg 20g, Schisandra, aconite, ginger 15g; qi plus Codonopsis 20g, Atractylodes 15g, Astragalus 20g; blood stasis plus angelica 10g, Chuanxiong 12g, red peony 15g); above are 1 / d, decoction 200mL, morning and evening oral; Detoxification Xiaoyan enema treatment with the control group. Continuous treatment of 56d for a course of treatment. Observation of clinical symptoms, colonoscopy, adverse reactions. Continuous treatment of 2 courses to determine the efficacy. Followed up for 6 months, observed the recurrence rate. [Result] In the treatment group, 16 cases were cured, 11 cases were effective, 3 cases were ineffective, and the total effective rate was 90.00%. The control group recovered in 13 cases, effective in 8 cases, 7 cases, the total effective rate was 75.00%. The treatment group was better than the control group (P <0.05). [Conclusion] Syndrome differentiation and detoxification Xiaoya enema combined with western medicine have significant curative effect on ulcerative colitis, which is worth to be popularized.