A Retrospective Study Of Disease Differentiation And Treatment Of Crohn’s Disease

ObjectiveAmong the patients with Crohn’ s disease treated in the outpatient clinic of inflammatory bowel disease chronic disease in Fangcun Hospital of Guangdong Province Hospital of Traditional Chinese Medicine,the cases treated with traditional Chinese medicine for a long time were selected and retrospectively studied to analyze the effects of disease discrimination treatment group and syndrome differentiation treatment group on the disease activity and nutritional status of patients with Crohn’s disease.To provide exploration and guidance for clinical TCM treatment of Crohn’s disease,and hope to provide direction for finding more effective TCM treatment methods.MethodsA retrospective investigation was conducted to select Crohn’s disease patients who adhered to traditional Chinese medicine treatment from January 2015 to March 2019 in the IBD chronic disease outpatient clinic of Guangdong Provincial Hospital of Traditional Chinese Medicine.They were divided into disease discrimination treatment group and syndrome differentiation treatment group.General data,TCM syndromes,simplified CDAI score,and human component analysis data of these cases were collected.SPSS 25.0 was used to establish the database for the above collected data and to make statistical analysis.The curative effect was evaluated by self-control before and after the two groups and mutual control between the two groups.Results1.Basic condition:a total of 35 cases were included,including 23 cases in the disease differentiation group,12 cases in the syndrome differentiation group,25 cases in the male group and 16 cases in the female group.The patients were aged between 18 and 70 years old,mainly young and middle-aged patients.The course of disease is between 0.5 and 21 years.TCM syndromes include spleen and stomach deficiency and cold,liver depression and spleen deficiency,dampness and heat accumulating knot and dampness and dampness trapping spleen.There was no significant statistical difference between the two groups.2.Simplified CDAI score:the two groups of patients were analyzed before and after treatment,and the simplified CDAI score was decreased after treatment,with statistical differences(p=0.001<0.05 in the disease differentiation group,p=0.011<0.05 in the syndrome differentiation group),suggesting that traditional Chinese medicine may have the effect of decreasing the simplified CDAI score.The comparison between the two groups showed no statistically significant difference in the simplified CDAI score(p>0.05),suggesting that the clinical benefits of disease differentiation treatment and syndrome differentiation treatment may be similar in decreasing the simplified CDAI score.3.Human body composition analysis results:before-and-after disease group itself according to the weight,total body water,intracellular water,extracellular water,protein,minerals,soft lean mass,fat free mass,skeletal muscle mass,body mass index,percent body fat,waist-to-hip ratio,visceral fat area,body cell mass,measured circumference of neck,measured circumference of chest,measured circumference of abdomen,measured circumference of hip,bone mineral content were obviously improved,statistically significant difference(p<0.05).There were significant differences in waist-hip ratio and whole body phase angle between the two groups(p<0.05).In comparison between the two groups,the disease differentiation group had an advantage over the syndrome differentiation group in improving human body composition,especially in improving skeletal muscle content,increasing basal metabolic rate,reducing body fat percentage and reducing visceral fat area,the effect of disease differentiation was more obvious,but the difference could not be shown in the statistical category(p>0.05).ConclusionThis study showed that the treatment regimens of disease differentiation group and syndrome differentiation group improved the disease activity and nutritional status of crohn’s disease to a certain extent,among which the effect of disease differentiation treatment group was more obvious.On the one hand,both disease differentiation and syndrome differentiation can effectively improve the simplified CDAI score of CD patients,and the clinical effect of both is similar.On the other hand,compared with the syndrome differentiation group,the improvement of human body composition in the disease differentiation group was more obvious in improving skeletal muscle content,increasing basal metabolic rate,reducing body fat percentage and reducing visceral fat area.However,in terms of the sample data in this study,the differences between the two groups could not be shown in the statistical category.However,from the perspective of the implementation of treatment methods,syndrome differentiation treatment is related to the clinical experience of doctors,which has high requirements on the level of traditional Chinese medicine of clinicians,which is not conducive to the promotion.However,disease differentiation treatment belongs to systematic treatment,and general TCM doctors and even western doctors can make diagnosis and treatment according to the disease differentiation system,facilitating the promotion of traditional Chinese medicine programs.