1.江苏省中医院/南京中医药大学附属医院,江苏省南京市秦淮区汉中路155号,210029
2.昆山市中医医院
3.常州市中医医院
4.南通市中医院
5.江阴市中医院
6.南京市中医院
zhulei5100@njucm.edu.cn
收稿:2025-09-30,
修回:2026-02-05,
录用:2026-01-13,
纸质出版:2026-04-17
移动端阅览
黄乐娟,陆喜荣,李晴晴等.中医药治疗活动期溃疡性结肠炎的多中心双向队列研究[J].中医杂志,2026,67(08):875-880.
HUANG Lejuan,LU Xirong,LI Qingqing,et al.Traditional Chinese Medicine Therapy for Active Ulcerative Colitis:A Multicenter Bidirectional Cohort Study[J].Journal of Traditional Chinese Medicine,2026,67(08):875-880.
黄乐娟,陆喜荣,李晴晴等.中医药治疗活动期溃疡性结肠炎的多中心双向队列研究[J].中医杂志,2026,67(08):875-880. DOI: 10.13288/j.11-2166/r.2026.08.012.
HUANG Lejuan,LU Xirong,LI Qingqing,et al.Traditional Chinese Medicine Therapy for Active Ulcerative Colitis:A Multicenter Bidirectional Cohort Study[J].Journal of Traditional Chinese Medicine,2026,67(08):875-880. DOI: 10.13288/j.11-2166/r.2026.08.012.
目的
2
评价真实世界中中医药治疗活动期溃疡性结肠炎(UC)的临床疗效。
方法
2
开展多中心、回顾性+前瞻性双向队列研究,纳入江苏省5家医院的UC活动期患者,口服中药≥8周的患者为暴露组,口服中药时间<8周或不服用中药的患者为非暴露组。中药治疗方案:回顾性研究参照《溃疡性结肠炎中医诊疗专家共识意见(2017)》,前瞻性研究参照《溃疡性结肠炎中医诊疗专家共识(2023)》。基于倾向性评分均衡混杂因素,分析干预8周后中医药治疗UC活动期的临床疗效。主要疗效指标为治疗8周末临床有效率、临床缓解率;次要疗效指标包括炎症指标[红细胞沉降率(ESR)、C反应蛋白(CRP)、粪便钙卫蛋白(FC)]、营养指标[血红蛋白(Hb)、血清白蛋白(ALB)]和中医证候积分、各单项症状得分。
结果
2
共纳入174例患者,其中暴露组78例、非暴露组96例,倾向性评分匹配后各70例。治疗8周后,暴露组和非暴露组临床缓解率分别为78.57%(55/70)和60.00%(42/70),暴露组高于非暴露组(
χ
2
=5.673,
P
=0.017)。暴露组和非暴露组临床有效率分别为85.71%(60/70)和45.71%(32/70),暴露组亦高于非暴露组(
χ
2
=24.855,
P
<0.001)。治疗后暴露组ESR、FC显著低于非暴露组(
P
<0.05),中医证候总积分及肛门灼热、腹
胀单项症状得分亦低于非暴露组(
P
<0.05)。
结论
2
中医药治疗能有效提高UC活动期临床有效率,改善UC临床症状、降低炎症水平。
Objective
2
To evaluate the clinical efficacy of traditional Chinese medicine (TCM) therapy in the treatment of active ulcerative colitis (UC) in a real-world setting.
Methods
2
A multicenter, retrospective and prospective bidirectional cohort study was conducted, enrolling patients with active UC from five hospitals in Jiangsu Province. The exposure group comprised patients who received oral Chinese herbal medicine (CHM) for≥8 weeks, while the control group included those with oral CHM administration for < 8 weeks or having no CHM treatment. In the retrospective study, the CHM regimen was formulated in accordance with the
Expert Consensus on TCM Diagnosis and Treatment of Ulcerative Colitis (2017 Edition),
while in the prospective study, the regimen follows the
Expert Consensus on TCM Diagnosis and Treatment of Ulce
-
rative Colitis (2023 Edition)
. Confounding factors were balanced using propensity score matching, and the clinical efficacy of TCM in active UC was evaluated after 8 weeks of intervention. The primary outcomes were the clinical effectiveness rate and clinical remission rate at the end of 8 weeks of treatment; the secondary outcomes were inflammatory markers including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and fecal calprotectin (FC), nutritional indicators including hemoglobin (Hb) and serum albumin (ALB), and TCM syndrome score.
Results
2
A total of 174 patients were enrolled, including 78 in the exposure group and 96 in the control group. After propensity score matching, there were 70 patients in each group. After 8 weeks of treatment, the clinical remission rate was 78.57% (55/70) in the exposure group and 60.00% (42/70) in the control group, with a significan
tly higher rate in the exposure group (
χ
2
= 5.673,
P
= 0.017). The clinical effective rate was 85.71% (60/70) in the exposure group, significantly higher than 45.71% (32/70) in the control group (χ
2
= 24.855,
P
<0.001). The levels of ESR and FC in the exposure group were significantly lower than those in the control group (
P
<0.05), as well as the total TCM syndrome score and individual symptom scores of anal burning and abdominal distension (
P
<0.05).
Conclusion
2
TCM therapy can effectively improve the clinical effective rate of active UC, alleviate clinical symptoms and reduce inflammatory levels.
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