美沙拉嗪灌肠液联合酪酸梭菌肠球菌三联活菌片治疗轻中度远端溃疡性结肠炎的疗效

Clinical efficacy of mesalazine enema combined with triple live bacterial agent of Clostridium butyricum, Streptococcus faecalis and Bacillus mesentericus in patients with mild to moderate distal ulcerative colitis

目的:观察美沙拉嗪灌肠液及其联合酪酸梭菌肠球菌三联活菌片治疗轻中度远端溃疡性结肠炎(ulcerative colitis,UC)的疗效.方法:将46例轻中度活动期远端UC患者随机分为美沙拉嗪组(对照组)及联合用药组(实验组),每组各23例,美沙拉嗪组予以美沙拉嗪灌肠液保留灌肠,联合用药组在上述用药的基础上加用酪酸梭菌肠球菌三联活菌片,疗程均为4 wk.比较两组患者疾病活动指数(disease activity index,DAI)、结肠镜评分、病理组织学评分、总有效率等指标的变化,并记录不良反应.结果:实验组DAI疾病活动指数评分由7.72±0.66降至2.84±2.35,对照组由7.17±0.94降至3.41±2.58,下降幅度差异有统计学意义(t=2.340,P=0.018).实验组肠镜积分由3.20±0.82降至1.80±0.90,对照组由3.10±0.72降至2.50±0.86,下降幅度差异有统计学意义(t=2.051,P=0.040).实验组总有效率(91.30%)高于对照组组(65.22%),差异有统计学意义(2=4.608,P=0.036).两组患者病理组织学变化无统计学意义(P>0.05).结论:美沙拉嗪灌肠液联合酪酸梭菌肠球菌三联活菌片治疗轻中度远端溃疡性结肠炎可更有效地改善患者临床症状及肠镜下黏膜表现,酪酸梭菌肠球菌三联活菌片可辅助治疗UC.

AIM： To evaluate the clinical efficacy of mesala- zine enema combined with triple live bacterial agent of Clostridium butyricum, Streptococcu faeca- lis and Bacillus mesentericus in patients with mild to moderate distal ulcerative colitis （UC）. METHODS： Forty-six patients with active mild to moderate distal UC were randomly divided into either a mesalazine group （control group, n = 23） or a combination group （trial group, n = 23）. Patients in the mesalazine group were treat- ed with mesalazine enema, and on the basis of this, the patients in the combination group were additionally given triple live bacterial agent ofClostridium butyricum, Streptococcu faecalis and Bacillus mesentericus. The course of treatment was four weeks. Disease activity index （DAI）, endoscopic score, response rate, histopathologi- cal changes, and adverse reactions were com- pared between the two groups. RESULTS： DAI decreased from 7.72 ± 0.66 to 2.84± 2.35 in the trial group and from 7.17± 0.94 to 3.41 ± 2.58 in the control group, and the decrease was statistically significant between the two groups （t = 2.340, P = 0.018）. The endoscopic score decreased from 3.20 ± 0.82 to 1.80 ±0.90 in the trial group and from 3.10± 0.72 to 2.50 ±0.86 in the control group, and the decrease was statistically significant between the two groups （t = 2.051, P = 0.040）. The response rate was sig- nificantly higher in the trial group than in the control group （91.30% vs 65.22%, 2 = 4.608, P = 0.036）. The histopathological changes showed no significant difference between the two groups （P 〉 0.05）. CONCLUSION： Combined therapy with mesala- zine and triple live bacterial agent can effectively alleviate clinical symptoms and colonoscopic manifestations in patients with mild to moderate distal UC.