Li Pei-Han, Tang Yu, Wen Hong-Zhu
Department of Gastroenterology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.
Department of Basic Medicine, Fudan University, Shanghai 200032, China.
World J Clin Cases. 2022 Apr 16;10(11):3573-3578. doi: 10.12998/wjcc.v10.i11.3573.
Ulcerative colitis (UC) is a chronic autoimmune disease characterized by relapsing-remitting abdominal pain, diarrhea, mucopurulent discharge and rectal bleeding. To date, the etiology of the disease remains unknown; therefore, medical therapy is not yet available. Left-sided UC is mainly treated with oral and topical mesalazine. However, due to its modest clinical effect, endoscopic mucosal remission is not achieved in all patients.
A 44-year-old man presented to Longhua Hospital with a history of left-sided UC for more than 6 years and slight bloody diarrhea over time. Endoscopy suggested hyperemia, edema, and erosive mucosa involving the rectum and sigmoid colon. The Traditional Chinese medicine Qingchang decoction (QCD) enema treatment was initiated once a day combined with a previous standard dose of mesalazine for 8 wk, and rectal bleeding ceased after 4 wk of treatment. Another QCD enema treatment was provided after symptom relapse due to drug withdrawal for nearly 6 mo. At the 2-mo follow-up, the colonoscopy results indicated mucosal healing with no erosion or ulcers.
The Chinese formula QCD retention enema represents a potential treatment for left-sided UC with predominant rectal bleeding to achieve clinical and mucosal remission.
溃疡性结肠炎（UC）是一种慢性自身免疫性疾病，其特征为反复发作的腹痛、腹泻、黏液脓性分泌物及直肠出血。迄今为止，该病的病因仍不明；因此，尚无特效药物治疗。左侧溃疡性结肠炎主要采用口服和局部应用美沙拉嗪治疗。然而，由于其临床效果一般，并非所有患者都能实现内镜下黏膜缓解。
一名44岁男性因左侧溃疡性结肠炎病史6年余，且长期有轻度便血，就诊于龙华医院。内镜检查提示直肠和乙状结肠黏膜充血、水肿及糜烂。采用中药清肠汤（QCD）灌肠治疗，每日1次，联合之前标准剂量的美沙拉嗪，持续8周，治疗4周后直肠出血停止。因停药近6个月症状复发后，再次给予QCD灌肠治疗。在2个月的随访中，结肠镜检查结果显示黏膜愈合，无糜烂或溃疡。
中药方剂QCD保留灌肠是治疗以直肠出血为主的左侧溃疡性结肠炎、实现临床和黏膜缓解的一种潜在治疗方法。
