發(fā)布時間：2018-05-29 21:34

  本文選題：克羅恩病 + 中西醫(yī)結(jié)合��； 參考：《南京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的采用對照方法,通過與西醫(yī)治療組進(jìn)行對照,觀察和評價清熱化濕、活血解毒法聯(lián)合西藥誘導(dǎo)克羅恩病緩解是否比單用西藥具有更好的臨床療效和安全性,從而為中西藥聯(lián)合治療克羅恩病提供依據(jù)。方法選取40例江蘇省中醫(yī)院收治的克羅恩病輕、中度活動期患者,并且中醫(yī)證型符合濕熱內(nèi)蘊、瘀毒搏結(jié)證,分為試驗組和對照組各20例。試驗組采用西醫(yī)標(biāo)準(zhǔn)治療+清化濕熱、活血解毒法方,對照組采用西藥標(biāo)準(zhǔn)治療。12周為總療程,觀察臨床緩解率;臨床有效率;內(nèi)鏡應(yīng)答率等。結(jié)果在臨床緩解率方面,治療組17例緩解,緩解率為85.00%,對照組11例緩解,緩解率為55.00%。兩組經(jīng)χ 2檢驗比較(P0.01),治療組療效優(yōu)于對照組。在臨床有效率方面,治療組臨床有效率為90.00%,對照組臨床有效率為60.00%。兩組經(jīng)χ2檢驗比較(P0.01),治療組療效優(yōu)于對照組。在中醫(yī)證候療效方面,治療組總有效率80.00%;對照組總有效率65.00%,兩組經(jīng)χ 2檢驗有統(tǒng)計學(xué)意義(P0.05),治療組療效優(yōu)于對照組。在內(nèi)鏡應(yīng)答方面,治療組療效優(yōu)于對照組(P0.01)。中醫(yī)癥狀療效方面,治療結(jié)束時兩組均能改善腹痛、腹瀉、血便癥狀,組間比較,兩組在腹痛、血便、腹脹、腹部包塊方面均無明顯差異(P0.05),但在腹瀉、納差方面有差異性(P0.05),表明治療組在改善腹瀉、增進(jìn)食欲的療效優(yōu)于對照組。生存質(zhì)量治療組療效優(yōu)于對照組(P0.01)。兩組安全性指標(biāo)在治療前后無差異(P0.05)。結(jié)論經(jīng)過系統(tǒng)評價,本研究中葉柏教授經(jīng)多年臨床實踐及研究的清化濕熱、活血解毒方聯(lián)合西藥治療輕中度克羅恩病的治療方案臨床療效證實優(yōu)于單用西藥治療,有臨床進(jìn)一步研究及推廣應(yīng)用的必要性。
[Abstract]:Objective to observe and evaluate the clinical efficacy and safety of western medicine combined with western medicine in inducing Crohn's disease relief by contrast with western medicine and western medicine in order to observe and evaluate the clinical efficacy and safety of clearing heat and removing dampness and activating blood circulation and detoxification combined with western medicine. So as to provide the basis for the combined treatment of Crohn's disease with Chinese and western medicine. Methods A total of 40 patients with Crohn's disease at mild and moderate active stage were selected from Jiangsu traditional Chinese Medicine Hospital. The TCM syndromes were consistent with dampness and heat accumulation and blood stasis toxin syndrome. The patients were divided into two groups: experimental group (n = 20) and control group (n = 20). The experimental group was treated with western medicine standard for clearing dampness-heat and activating blood circulation and detoxifying method, while the control group was treated with western medicine standard for .12 weeks as the total course of treatment to observe the clinical remission rate, clinical effective rate, endoscopic response rate and so on. Results in the clinical remission rate, 17 cases in the treatment group were relieved, the remission rate was 85.00, and 11 cases in the control group were relieved, the remission rate was 55.00. The curative effect of the treatment group was better than that of the control group by 蠂 2 test. The clinical effective rate was 90.00g in the treatment group and 60.00g in the control group. The curative effect of the treatment group was better than that of the control group by 蠂 2 test. The total effective rate of the treatment group was 80.000.The total effective rate of the control group was 65.00 and the two groups had statistical significance by 蠂 2 test (P 0.05). The curative effect of the treatment group was better than that of the control group. In terms of endoscopic response, the therapeutic effect in the treatment group was better than that in the control group (P 0.01). At the end of treatment, there was no significant difference in abdominal pain, blood stool, abdominal distension, abdominal mass and abdominal pain between the two groups, but in diarrhea, there was no significant difference between the two groups in abdominal pain, blood stool, abdominal distension and abdominal mass. The difference in anorexia showed that the therapeutic effect of the treatment group was better than that of the control group in improving diarrhea and improving appetite. The quality of life in the treatment group was better than that in the control group (P 0.01). There was no difference in safety index between the two groups before and after treatment (P 0.05). Conclusion after a systematic evaluation, the clinical effect of the treatment scheme of Huoxue jiedu prescription combined with western medicine in the treatment of mild and moderate Crohn's disease has been proved to be superior to that of western medicine alone after many years of clinical practice and research on clearing dampness and heat, activating blood circulation and detoxification of Chinese medicine in the treatment of mild and moderate Crohn disease. It is necessary for further clinical research and application.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R574.62

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本文編號：1952470