锡类散灌肠联合激素治疗溃疡性结肠炎临床疗效及对病理分级的影响

Efficiency and effect on histology grading of Xi Lei Powder and glucocorticosteroid therapy in patients with ulcerative colitis

目的观察锡类散灌肠联合激素治疗溃疡性结肠炎（UC）的疗效，探讨疗效与UC病情严重程度、病理分级间的关系。方法选择53例病变局限于远段的中、重度活动期UC患者，给予锡类散灌肠联合糖皮质激素治疗1个月，观察临床疗效。采用分级方法描述UC病情严重程度，分级和积分法描述病理特征。结果32．08％患者（17例）完全缓解，43．39％（23例）部分缓解，24．53％（13例）无效。中度组和重度组总有效率比较差异无统计学意义（81．09％V8．62．5％，χ2=2．114，P〉0．05）。治疗前、后重度组病理积分均高于中度组[治疗前（3．50±0．44）（2．68±0．57），t=3．935；治疗后（1．88±0．49）（1．41±0．35），t=2．734，P〈0．05]；且两组治疗后积分均降低（t=10．094、7．228，P〈0．05）。按疗效比较，治疗前后，完全缓解组、部分缓解组和无效组病理积分差异有统计学意义[治疗前（2．12±0．74）、（3．17±0．80）和（3．23±0．76），F=5．043；治疗后（0．65±0．63）、（1．96±0．57）和（2．31±0．61），F=7．382，P〈0．05]，且完全缓解组和无效组治疗前后差异均无统计学意义（q=0．233、2．003。P〉0．05），但均高于完全缓解组（q=4．462-7．734，P〉0．05）。结论锡类散灌肠联合激素治疗对大部分UC患者有效，但其疗效与患者病情严重程度无关，也不完全反映患者病理分级变化。

Objective To observe the effect of Xi Lei Powder combined with glucocorticosteroid therapy on ulcerative colitis （UC）, and to explore the relationship among efficacy, the severity of UC and pathological grading. Methods 53 pa- tients with lesions confined to the distal, moderate to severe and active UC were selected. ALL were giving Xi Lei Powder com- bined with glucocorticoid treatment for a month, and clinical effect was observed. The severity of UC was described by classifica- tion, and pathological feature was described by classification and integration. Results In 53 cases, 32. 08% （ 17 cases） was complete remission, 43.39% （23 cases） was partial remission, and 24. 53% （13 cases） was invalid. The total effective rate between moderate group and severe group had no significant difference （81.09% vs 62. 5% , t =2. 114, P 〉0. 05）o The pa- thology integral in the severe group were higher than that in moderate group before [ （3.50±0. 44） vs （2. 68 ± 0. 57 ）, t = 3. 935 ] and after the treatment [ （ 1.88 ± 0. 49） vs （ 1.41 ± 0. 35）, t = 2. 734, P 〈 0. 05 ], and all were significantly lower after treatment （t = 10. 094, 7. 228, P 〈 0. 05） . According to curative effect, the pathology integral among complete remission group, partial remission group and invalid group had significant difference before [ （2. 12± 0. 74 ）, （3. 17±0. 80 ） and （3.23 ± 0.76）, F=5.0431 and after treatment [ （0.65 ±0.63）, （1.96± 0.57） and （2.31 ± 0.61）, F=7.382, P 〈 0. 05 ] . There was no significant difference between complete remission group and partial remission group （q = 0. 233, 2. 003, P 〉 0.05 ） , and each was higher than that in complete remission group （ q = 4. 462 - 7. 734, P 〉 0.05 ） . Conclu- sion It＇ s effective of Xi Lei Powder combined with glucocorticosteroid therapy for the majority of patients with UC, but the effi- cacy may not be correlated with severity of the disease, and not reflect the pathological changes completely.