ABSTRACT
Objective To explore the clinical effect of Chinese medicine enema combined with massage of Hui medicine for treatment of patients with ulcerative colitis (UC).Methods A prospective randomized controlled trial (RCT) was conducted, 390 patients with UC admitted to Department of Traditional Chinese Medicine (TCM) of Ningxia Hui Autonomous Region People's Hospital from January 2013 to December 2014 were enrolled, and they were divided by using random envelope method into the western medicine control group (88 cases), simple TCM enema group (102 cases), simple massage of Hui medicine group (94 cases) and enema combined with massage group (106 cases). The patients in western medicine control group took sulfasalazine orally, once 0.75 g, thrice a day. The simple TCM enema group adopted the self prepared Shexue Fuyang decoction (ingredients: carbonized sanguisorba root 15-20 g, bletilla striata 15 g, patrinia 15-30 g, sculellaria barbata 15-30 g, Chinese goldthread 15 g, radix glycyrrhizae preparata 15 g, Fry terminaliachebuia 10 g, yam 15-30 g, india madder root 15 g) retention enema once a day. The following principles should be followed: firstly, the dose of drug should be large enough (250 mL), secondly the speed of enema should be relatively slow and it finished in 15-20 minutes, thirdly the temperature of decoction should be kept at moderate degree about 39-41 ℃ (a warm bag being around the enema tube), and lastly, the patient's posture should be changed (lying left-side for 20 minutes, lying at chest-abdomen position for 20 minutes, lying right-side for 20 minutes). In massage of Hui medicine group, based on the location and size, depth and seriousness of the lesion, the doctor would selectively use palm or index finger to carry out massage manipulations of pressing, fractioning, rubbing or grasping for different disease situations of patients, once 30 minutes pre day. The patients in enema combined massage group were treated with the same methods as above, and the therapeutic course of the four groups was 15 days; at the end of experiment,the therapeutic effects and the improvement of main symptoms in four groups were observed.Results The clinical total effective rates of Chinese medicine enema group, massage of Hui medicine group, enema combined massage group were obviously higher than the rate of western medicine control group [78.4% (80/102), 85.1% (80/94), 93.4% (99/106) vs. 62.5% (55/88), allP < 0.05]; the symptom integrals, such as abdominal pain, diarrhea, tenesmus, purulent blood stool, fever, etc. were significantly decreased after treatment in the TCM enema, massage and combined treatment groups, and the integrals of the three treatment groups were obviously lower than those in the western medicine control group (abdominal pain: 0.45±0.75, 0.56±0.57, 0.35±0.96 vs. 1.13±0.86, diarrhea: 0.76±0.91, 0.78±0.69, 0.55±0.81 vs. 1.43±0.34, tenesmus: 0.52±0.37, 0.44±0.23, 0.21±0.13 vs. 0.72±0.98, purulent blood stool: 0.43±0.34, 0.50±0.24, 0.52±0.76 vs. 0.68±0.44, fever: 0.32±0.56, 0.35±0.65, 0.26±0.45 vs. 0.49±0.77, allP < 0.05).Conclusion The therapeutic effects of Shexue Fuyang decoction enema combined with massage of Hui medicine for treatment of patients with UC are better than those of each of the following treatment alone: western medicine, Chinese medicine enema or medical massage treatment.