布地奈德远端结肠局部用药治疗溃疡性结肠炎临床观察

CLINICAL OBSERVATION OF DISTAL COLON TOPICAL ADMINISTRATION OF BUDESONIDE ON ULCERATIVE COLITIS

目的探讨采用布地奈德远端结肠局部用药治疗溃疡性结肠炎的疗效及安全性。方法对确诊患者随机分为对照组和治疗组,对照组常规给予半流质饮食,纠正水电解质紊乱,口服柳氮磺吡啶1gqid、复方谷氨酰胺颗粒1小包tid连用4 w;布地奈德治疗组在一般治疗基础上,给予布地奈德混悬液2 mg加入100 ml 0.9%生理盐水溶液保留灌肠,上下午各一次,连续2 w,2 w后改为晚间睡前30 min,每日一次。根据用药前后症状改善情况、纤维结肠镜的变化来评定疗效。观察治疗前后的血常规、肝肾功能以评价其安全性。结果治疗组及对照组的总有效率分别为92.6%、64.3%,两组比较有显著性差异(p<0.05)。结论在常规治疗基础上加用布地奈德远端结肠局部用药治疗可以较快控制病情,无明显不良反应,是治疗溃疡性结肠炎一种较好的方案。

Objective To study the efficacy and safety of budesonide distal colon topical administration in treating ulcerative colitis. Methods The patients that were final diagnosed were randomly divided into therapy group and control group. The patients in the control group were regularly given semi liquid diet and correct the water - elec- trolyte disturbances, associated with taking orally Sulfasalazine 1.0 g qid and complex glutamine grains 1 packet tid for 4 weeks. The therapy group, on the basis of conventional treatment, the budesonide were given in enema by budesonide supplement （budesonide 2 mg was added into 100 ml normal saline solution） twice everyday（ morning and afternoon） for 2 weeks ,and were only given an enema 30 minutes before evening sleep 2 weeks later. The efficacy was evaluated according to improving after medication and the change of colonofiberscope. To evaluate safety through observing the blood routine test and liver - renal function before and after therapy. Results The total effective rate of therapy group and control group were 92. 6% and 64. 3%. There was significant difference between two groups （p 〈 0. 05）. Conclusion To supply budesonide distal colon topical administration on the basis of conventional treatment can quickly control pathogenetic condition, without evidence of adverse effect. It is a better project in treating ulcerative colitis.