Clinical Study Of Treating Both Manifestation And Root Cause Of Ulcerative Colitis In The Elderly And Evaluating Curative Effect By Integral Method

Objective The purpose of this study is to explore the curative effect of the traditional Chinese medicine combined with western medicine treatment developed for elderly patients suffering from mild to moderate activity ulcerative colitis under the guidance of the concept traditional Chinese medicine,and to improve the clinical efficacy assessment of these patients by integral method for the target of reflecting the characteristics of the elderly,the characteristics of traditional Chinese medicine syndrome,and the quality of life,then to discuss on its effectiveness preliminarily,so we can providing a certain clinical research reference for the combined treatment of traditional Chinese and Western medicine and the evaluation of curative effect for elderly patients suffering from mild to moderate activity ulcerative colitis.Methods According to the relevant criteria of ulcerative colitis diagnosis and case inclusion,54 elderly patients(more than 60 years old)suffering from mild to moderate activity ulcerative colitis in Wuhan General Hospital of the Chinese people’s Liberation Army in recent years were selected,and divided into observation group and control group according to the random parallel control design principle,27 cases of elderly patients suffering from mild to moderate activity ulcerative colitis in each group.The observation group and control group were equally treated with conventional western medicine mesalazine sr granules(take medicine for 1 grams each time,4 times a day)and other necessary symptomatic treatment.After inducing the remission of clinical symptoms,the use of mesalazine sustained-release granules should be changed to 1 grams each time,2times a day.The observation group of elderly patients suffering from mild to moderate activity ulcerative colitis was also treated with compound glutamin entersoluble capsule orally after three meals(take medicine for 3 grain each time,3 times a day),and retention enema with 100 m L diluted kangfuxin liquid(diluted with normal saline)before sleeping.The method of doing retention enema therapy is 6 days a course of treatment,and 1 days as a course interval.After improving the relevant inspection and detailed record in 12 weeks of treatment and close observation of safety during the treatment,we evaluated the efficacy and the safety of the elderly ulcerative colitis patients in two groups with a self-made integral table for evaluating the curative effect of elderly patients with ulcerative colitis.To verify the effectiveness(also called validity)of the integral table by comparing with Sutherland disease activity index(also called modified Mayo score)commonly used in clinical scientific research.Results In the course of this study,the elderly patients suffering from mild to moderate activity ulcerative colitis in two groups had no loss of visits or shedding,and they were not removed because of meeting the standard of termination.The statistical analysis told us that there exist a comparability in gender,the age of patients,course of disease,Severity of the disease,and the range involved in the lesion of disease between 27 elderly ulcerative colitis patients in the observation group and 27 elderly ulcerative colitis patients in the control group.Before and after the 12 course,the comprehensive curative effect was evaluated on the basis of the index of disease activity index : In the observation group of elderly UC patients,there were 7 cases of complete remission(25.9%),12 marked effective cases(44.4%),6 effective cases(22.3%),2ineffective cases(7.4%),and the total effective rate was 92.6%(for 25 elderly ulcerative colitis patients),while in the control group there were5 cases of complete remission(18.5%),8 marked effective cases(29.6%),6 effective cases(22.3%),8 ineffective cases(29.6%)in the elderly UC patients,and the total effective rate was 70.4%(for 19 elderly ulcerative colitis patients).The total effective rate of the patients in observation group was higher than that of the control group,and the difference had its statistically significant(P<0.05).The evaluation of the comprehensive curative effect by the self-made integral table for evaluating the curative effect of elderly patients with ulcerative colitis was in accordance with the Sutherland disease activity index method.In terms of security,there was no severe liver and renal impairment,allergy and other reactions in both the observation group and the control group of elderly patients suffering from mild to moderate activity ulcerative colitis,and the specific adverse reactions associated with the drug program had not been found.Conclusion For those elderly patients suffering from mild to moderate activity ulcerative colitis,through the combination of traditional chinese and western medicine therapy of mesalazine sr granules,compound glutamin entersoluble capsule and retention enema with kangfuxin liquid,their clinical manifestation such as diarrhea and hematochezia could be relieved rapidly,safely and effectively.The therapy could also significantly reduce the scale scores of the integral table for the evaluation of the curative effect of ulcerative colitis in the elderly,and the curative effect was better than pure mesalazine sr granules treatment.The improved integral table for evaluation of curative effect could reflect the characteristics of the elderly,traditional Chinese medicine syndrome characteristics and changes in quality of life score,and the test results were as similar as the Sutherland index,so it is worthy of further improvement after the promotion.