不同治疗方案对活动期溃疡性结肠炎患者生存质量的影响

Effects of different therapeutic schedules on the quality of life in patients with active ulcerative colitis

目的探讨由益生菌口服、溃结灌肠液气药灌肠及5-ASA制剂与结肠炎丸口服组合成的3种阶梯式递减治疗方案对活动期溃疡性结肠炎患者生存质量的影响。方法将72例活动期溃疡性结肠炎患者随机等分为3组。试验组采用3种阶梯递减治疗方案,对照Ⅰ组较试验组减少益生菌口服,对照Ⅱ组再减少溃结灌肠液气药灌肠。每例患者治疗前后分别填写《炎症性肠病生存质量问卷》,并对结果进行统计学分析。结果试验组有效观察16例,对照Ⅰ组15例,对照Ⅱ组21例。与治疗前相比,各组生存质量均有提高(P均<0.05),且试验组优于对照组。结论 3种治疗方案均可改善患者生存质量,试验组最优;但对照组病例脱落少,依从性较好;尤以对照Ⅱ组最为显著。试验组治疗获取不易及气液灌肠时的不适可能是患者依从性差的原因。

Objective It is to explore the therapy by three stepwise decreasing different therapeutic schedules including probiotic agentia by oral use,gas-pressured TCM ulcerative colitis（ UC） enema and 5- ASA agentia with colitis pill by oral use on the quality of life（ QOL） in patients with active ulcerative colitis. Methods 72 cases of active UC patients were random divided into 3 groups,and 24 cases in each group. The test group was treated by the three stepwise decreasing different therapeutic schedules,control group Ⅰwas treated by the more brevity schedule which deleted probiotic agentia,and control groupⅡ was treated with orally 5- ASA agentia with colitis pill only. Inflammatory bowel diseases questionnaire（ IBDQ） should be filled by each patient before and after treatment,then the results were put into the database for statistical analysis. Results 16 cases in treatment group,15 cases in control group Ⅰand 21 cases in control group Ⅱ had been observed effectively. The scores were improved in all groups after treatment（ P〈 0. 05）,and the improvements of the test group were better than that of the other two groups. Conclusion These three kinds of therapeutic schedules all could improve the QOL of active UC patients,and the effect in test group is better than others,but the obedience of patients in control group is better than that in test group because of lower case drain rate,especially in control group II,the effect is more significant. The difficulty about to get the clysis with gas-pressured TCM UC enema by an instrument,and the discomfort caused by clysis maybe the reason why patients dislike the therapeutic schedules.