溃疡性结肠炎大肠湿热证研究现状与思考

朱磊; 程成; 刘小娟; 张洪海; 许聪; 葛畅畅; 卢一; 沈洪

doi:10.14148/j.issn.1672-0482.2023.0188

溃疡性结肠炎大肠湿热证研究现状与思考

doi: 10.14148/j.issn.1672-0482.2023.0188

南京中医药大学附属医院, 江苏南京 210029

基金项目:

国家自然科学基金面上项目 81873260

江苏省研究生实践创新计划 SJCX22-0730

江苏省中医药科技发展计划项目 ZT202103

详细信息

作者简介:
朱磊, 女, 副主任中医师, E-mail: zhulei5100@163.com

通讯作者:
沈洪, 男, 教授, 主任中医师, 主要从事中医药治疗消化系疾病临床与基础研究, E-mail: shenhong999@163.com

中图分类号: R259
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- 文章访问数: 308
- HTML全文浏览量: 70
- PDF下载量: 50
- 被引次数: 0
出版历程
- 收稿日期: 2022-05-25
- 网络出版日期: 2023-02-17
- 发布日期: 2023-02-10

Research Status and Thinking of Ulcerative Colitis with Large Intestine Damp-Heat Syndrome

Department of Gastroenterology, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing 210029, China

摘要

摘要: 大肠湿热证是溃疡性结肠炎(UC)的核心证候。梳理总结了近年来有关溃疡性结肠炎中医证候特点、大肠湿热证症状特点以及相关生物学基础的研究现状, 证实了大肠湿热证是溃疡性结肠炎最常见的中医证候, 但现有证候诊断标准条目仍以主观为主, 客观理化指标、证候生物学基础研究缺乏有效整合, 尚未发现特异性证候标志物。今后需进一步加强多学科联合, 注重病-证-症相结合, 寻找溃疡性结肠炎大肠湿热证特异性诊断性标志物, 建立涵盖主观、客观的病证结合诊断标准, 完善中医证候科学理论体系。
- 溃疡性结肠炎 /
- 大肠湿热证 /
- 中医证候 /
- 生物学基础
Abstract: Damp-heat syndrome of large intestine is the core syndrome of ulcerative colitis disease (UC).In this paper, we summarized the research status of TCM syndrome characteristics, large intestine damp heat syndrome characteristics and the related biological basis of ulcerative colitis in recent years, it was confirmed that the syndrome of damp-heat in large intestine was the most common TCM syndrome in the ulcerative colitis, but the existing syndrome diagnostic criteria were still subjective, the objective physical and chemical indicators, the biological basis of syndrome research is lack of effective integration, and no specific syndrome markers have been found. In the future, it is necessary to strengthen the combination of multi-subjects, pay attention to the combination of disease-syndrome-symptom, look for specific diagnostic markers of damp-heat syndrome of large intestine in ulcerative colitis, and establish the subjective and objective diagnostic standards of the combination of disease and syndrome, to perfect the scientific theoretical system of TCM syndrome.
- ulcerative colitis /
- damp-heat syndrome of large intestine /
- TCM syndrome /
- biological basis

HTML全文

表 1 溃疡性结肠炎大肠湿热证的症状特点

Table 1. Large intestine damp heat syndrome characteristics of ulcerative colitis

指南/专家共识	时间	证型名称	主症	次症
中华全国中医学会肛肠学会《慢性非特异性溃疡性结肠炎诊断分型及治疗标准(讨论稿)》^[9]	1987	湿热内蕴型	便中夹脓带血, 里急后重, 身热, 舌苔黄腻, 脉滑数。	肛门灼热, 胃痞纳呆, 大便秽臭, 小便短赤。
中华中西医结合学会消化专业委员会《慢性非特异性溃疡性结肠炎中西医结合诊断、辨证和疗效标准(试行方案)》^[10]	1994	湿热内蕴型	腹泻黏液脓血便, 里急后重, 舌苔黄腻, 脉滑数或濡数。	肛门灼热, 身热, 下腹坠痛或灼痛, 口苦, 口臭, 小便短赤。
(中国中西医结合学会消化系统疾病专业委员会《溃疡性结肠炎中西医结合诊治方案(草案)》^[11]	2003	大肠湿热证	腹泻黏液脓血便, 里急后重, 舌苔黄腻, 脉滑数或濡数。	肛门灼热, 身热, 下腹坠痛或灼痛, 口苦, 口臭, 小便短赤。
中华中医药学会脾胃病分会《溃疡性结肠炎中医诊疗共识》^[12]	2009	大肠湿热证	腹痛, 腹泻, 便下黏液脓血, 舌质红, 苔黄腻。	肛门灼热, 里急后重, 身热, 小便短赤, 口干口苦, 口臭, 脉滑数。
中国中西医结合学会消化系统疾病专业委员会《溃疡性结肠炎中西医结合诊疗共识》^[13]	2010	大肠湿热证	腹泻黏液脓血便, 腹痛或里急后重, 肛门灼痛, 舌苔黄厚或腻。	身热, 口干口苦, 小便短赤, 脉滑数或濡数。
中西医结合学会消化系统疾病专业委员会《溃疡性结肠炎中西医结合诊疗指南(草案)》^[14]	2010	大肠湿热证	腹泻黏液脓血便, 腹痛或里急后重, 肛门灼痛, 舌苔黄厚或腻。	身热, 口干口苦, 小便短赤, 脉滑数或濡数。
中华中医药学会脾胃病分会《溃疡性结肠炎中医诊疗专家共识意见》^[15]	2017	大肠湿热证	腹泻, 便下黏液脓血, 腹痛, 里急后重。	肛门灼热, 腹胀, 小便短赤, 口干, 口苦, 舌质红, 苔黄腻, 脉滑。
中西医结合学会消化系统疾病专业委员会《溃疡性结肠炎中西医结合诊疗共识意见》^[16]	2017	大肠湿热证	腹泻黏液脓血便; 腹痛; 里急后重。	肛门灼热, 身热不扬, 口干口苦, 小便短赤。舌质红苔黄腻; 脉滑数。

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