美沙拉嗪灌肠液治疗轻中度远段溃疡性结肠炎的疗效观察

目的评价美沙拉嗪灌肠液治疗远段溃疡性结肠炎(UC)的疗效及作用机制。方法将38例轻、中度活动期远段UC患者随机分成2组,每组各19例,治疗组给予美沙拉嗪灌肠液(莎尔福灌肠液4g,QN)保留灌肠治疗,对照组给予美沙拉嗪缓释颗粒(艾迪莎1.0g/次,Qid)口服治疗,疗程均为4周。比较两组患者结肠镜评分、疾病活动指数(DAI)及症状消失时间,记录不良反应,并用免疫组织化学法测定其治疗前后结肠黏膜诱导型一氧化氮合酶(iNOS)的表达水平。结果两组患者比较,结肠镜下评分、DAI指数及患者临床症状消失时间差异均有统计学意义(P<0.05),且肠黏膜iNOS平均灰度值比较差异亦有显著性(P<0.05)。结论美沙拉嗪灌肠液治疗轻中度远段溃疡性结肠炎疗效显著,且具有安全性高、症状缓解快的优势。

Objective To evaluate the efficiency of mesalazine enemas in patients with distal ulcerative colitis（UC）,and to explore its mechanism.Methods Thirty-eight patients with active mild to moderate distal ulcerative colitis in accordance with inclusion criteria were randomly divided into trial group（n=19） and control group（n=19）.The patients were treated by mesalazine enemas（4.0g,every night） and mesalazine sr granules（1.0g,four times a day） for 4 weeks.Compared their endoscopic score,disease active index（DAI）,dates of clinical disappearence and adverse reaction.The expression of Induction of nitric oxide synthase type（iNOS） in colonic mucosa was also detected by immunohistochemical staining.Results Their endoscopic manifestation,DAI,dates of clinical disappearence was statistically significant between two groups（P0.05）,The iNOS expression was significantly higher in trial group than in control group（P0.05）.Conclusion The mesalazine enemas have the advantage of more effective,higher safety,less time of symptoms than oral mesalazine sr granules in treatment of mild-to-moderately active distal UC.