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目的观察化毒愈肠方与益生菌联合治疗轻中度溃疡性结肠炎(UC)的疗效和安全性。方法选择柳州市中医院2013年6月至2015年6月门诊和住院的轻中度UC患者62例,根据患者意愿分为两组,研究组33例患者于活动期给予化毒愈肠方内服灌肠治疗,症状缓解后化毒愈肠方与益生菌维持治疗;对照组29例患者于活动期给予柳氮磺吡啶肠溶片内服灌肠治疗,症状缓解后柳氮磺吡啶肠溶片维持治疗,疗程结束后评价近期疗效,比较菌群变化;所有患者均随访12个月,比较两组复发率。结果疗程结束后两组症状积分、脾虚湿蕴证积分、活动度评分均较治疗前显著降低(P<0.05)。研究组症状积分、脾虚湿蕴证、活动度积分降低幅度明显大于对照组(P<0.05)。研究组治疗后乳酸杆菌、双歧杆菌数量较治疗前增加,大肠杆菌、肠球菌较治疗前减少(P<0.05)。对照组治疗前后菌群无明显变化。研究组完全缓解率为45.45%,总有效率为100%,随访12个月复发率为42.42%;完全缓解率和总有效率明显高于对照组,复发率显著低于对照组(P<0.05)。研究组无明显不良反应病例,两组不良反应发生情况比较差异有统计学意义(P<0.05)。结论化毒愈肠方与益生菌联合治疗UC安全性好,可改善患者临床症状,维持肠道菌群平衡,从而提高疗效,减少复发。
Objective To observe the curative effect and safety of combination of Huatu Yuchang and probiotics in the treatment of mild to moderate ulcerative colitis (UC). Methods Sixty-two patients with mild-to-moderate UC in outpatients and inpatients from June 2013 to June 2015 in Liuzhou Traditional Chinese Medicine Hospital were divided into two groups according to the wishes of the patients. The study group consisted of 33 patients who were given active drugs during the active phase Enema treatment, relieve symptoms after chemotherapy and probiotics maintenance of intestinal side; control group of 29 patients given active period of sulfasalazine enteric-coated enema treatment, relief of symptoms after the maintenance of sulfasalazine enteric-coated tablets, The curative effect was evaluated after the course of treatment, and the change of flora was compared. All patients were followed up for 12 months, and the recurrence rate was compared between the two groups. Results After treatment, symptom scores, scores of spleen wetness syndrome and activity were significantly lower than those before treatment (P <0.05). Symptom points in the study group, Spleen deficiency syndrome, activity points decreased significantly more than the control group (P <0.05). After treatment, the number of Lactobacillus and Bifidobacterium in the study group increased compared with that before treatment, and the number of Escherichia coli and enterococci in the study group decreased compared with that before treatment (P <0.05). There was no significant change in the control group before and after treatment. The complete remission rate and total effective rate were significantly higher in the study group than in the control group (45.45%, 100%, 100%). The recurrence rate was 42.42% at 12 months of follow-up. The recurrence rate was significantly lower than that of the control group ). There were no obvious adverse reactions in the study group, and there was significant difference in adverse reactions between the two groups (P <0.05). Conclusions The combination of Huayu Yuchang and probiotics in the treatment of UC has good safety and can improve the clinical symptoms of patients and maintain the balance of intestinal flora, so as to improve curative effect and reduce recurrence.