美沙拉嗪口服联合灌肠治疗轻中度远段溃疡性结肠炎的近期临床疗效分析

Analysis on clinical efficacy in the near future of mesalazine oral combined with enema for mildly to moderately distal ulcerative colitis

目的:观察美沙拉嗪口服联合灌肠治疗轻中度远段溃疡性结肠炎的近期临床疗效及作用机制。方法:40例轻、中度活动期远段溃疡性结肠炎患者,随机分成两组:治疗组20例,口服美沙拉嗪联合美沙拉嗪灌肠液保留灌肠;对照组20例,单用美沙拉嗪口服治疗,疗程均为4周。评价治疗前后两组患者的临床疗效、疾病活动指数(Sutherland DAI),采用Realtime-PCR法检测两组治疗前后肠黏膜MiR-155的表达。结果:治疗4周后,治疗组总有效率明显高于对照组(P<0.05);治疗组DAI下降程度明显大于对照组(P<0.05);治疗组肠黏膜MiR-155下降程度明显大于对照组(P<0.01)。结论:美沙拉嗪口服联合灌肠治疗活动期轻中度远段溃疡性结肠炎的近期临床疗效优于单用美沙拉嗪,能迅速促进肠道溃疡黏膜愈合,降低DAI,其机制可能通过抑制肠黏膜MiR-155的表达而发挥作用。

AIM： To observe clinical efficacy and mechanism of mesalamine oral combined with enema for mildly to moderately distal ulcer- ative colitis. METHODS： 40 patients with mildly to moderately distal active ulcerative colitis were randomly divided into two groups： trial group （20 cases, mesalamine oral combined with ene- ma）and control group （20 cases, mesalamine o- ral only）, were both treated for 4 weeks. The changes of clinical efficacy and disease activity index （Sutherland DAI）were evaluated before and after the treatment. The expression of MiR- 155 in intestinal mucosa was detected by Real- time-PCR. RESULTS： After the treatment for 4 weeks ,the trial group total efficiency was better than the control group （P〈0. 05）, the descentrange of DAI significantly was higher in trial group than that in control group（P〈0.05）, the descent range of the expression of MiR-155 in in- testinal mucosa significantly was higher in trial group than that in control group （P 〈 0.01）. CONCLUSION.. The clinical efficacy in the near future of mesalamine oral combined with enema for distal mildly to moderately active ulcerative colitis was superior to that of mesalamine oral only, the intestinal mucosa ulcer heal rapidly and the DAI cut down, by decreasing expression of MiR-155.