微生态制剂对溃疡性结肠炎患者治疗前后临床疗效观察

Clinical effect of microecologic pharmaceutical in ulcerative colitis

目的观察微生态制剂如枯草杆菌和屎肠球菌（美常安），双歧杆菌活菌抵制剂（丽珠肠乐）联合柳氮磺胺吡啶（SASP）片治疗轻、中度活动期溃疡性结肠炎（UC）的临床疗效和安全性。方法采用随机、对照设计，将30例轻、中度活动期UC患者分为：美常安联合SASP组（A组）10例、丽珠肠乐联合SASP组（B组）10例、SASP组（C组）10例，疗程均为4周。对3组患者治疗前后的大便菌群、临床症状总积分降低百分比、Suthedand疾病活动性指数、肠镜分级、组织学分级变化进行比较。结果大便菌群变化、临床症状总积分降低百分比，A、B组治疗前后为显效，C组治疗前后为有效。治疗前后3组（组内）Suthedand指数、肠镜分级积分、病理组织学分级积分变化均具有统计学意义。3组（组间）比较：Sutherland指数变化差值均数分别为5．400±1．848、5．500±2．273、2．500±0．527，A、B组间差异无统计学意义，与C组比较差异均有统计学意义；肠镜分级积分变化差值均数分别为1．800±0．422、2．100±0．316、0．800±0．432，A、B组间差异无统计学意义，与C组比较差异均有统计学意义；病理组织学分级积分变化差值均数分别为1．900±0．544、1．800±0．484、0．600±0．516。结论SASP加用微生态制剂治疗轻、中度活动期UC的临床疗效优于单用SASP，而SASP联合美常安，SASP联合丽珠肠乐两组间无明显差异，皆具有较好的安全性，具有临床推广价值。

Objective To evaluate the therapeutic effect of such microecologic pharmaceuticals as Medilac-S and bifidobacterium capsule combined with sabcylasosulphapyridine （SASP） in the treatment of mild and moderate active ulcerative colitis （ UC ）. Methods 30 patients with mild or moderate UC （ active phase） were randomly divided into group A（n = 10）, treated with Medilac-S and SASP, group B （n = 10）, given bifidobacterium capsule and SASP and group C（ n = 10）, as the control, treated with SASP only. The period of treatment of the 3 groups is 4 weeks. Fecal microbial population, the decrease in percentage of the clinical symptoms score, Sutherland disease active index, colonoscopic findings, and histological results were compared before and after the treatment. Results Fecal microbial population and the decrease in percentage of the clinical symptoms score showed marked difference in both group A and group B, while those variables in groups C showed no significant difference. There was significant difference in Sutherland disease active index, colonoscopic findings and histological results within the 3 groups respectively before and after the treatment. The changes of Sutherland index before and after the treatment in 3 groups were 5. 400 ± 1. 848,5. 500 ± 2. 273 and 2. 500 ± 0. 527 respectively. There was no significant difference between groups A and B, however, there was significant difference between C and 2 other groups. Changes in colonoscopic findings were 1. 800±0. 422, 2. 100±0. 316 and 0. 800±0. 432 respectively, which meant significant difference between groups A and B, no difference between C and the other 2 groups. Changes of histological findings were 1. 900± 0. 544,1. 800 ±0. 484 and 0. 600 ±0. 516 respectively. Conclusion Combination of microecologic pharmaceuticals and SASP, safe and effective, is superior to SASP only in the treatment of UC.