美沙拉嗪不同给药方式对溃疡性结肠炎患者疗效与安全性的影响

Impact of efficacy and safety of mesalazine on ulcerative colitis patients by different ways of administration

目的:分析美沙拉嗪对溃疡性结肠炎患者的治疗效果及安全性,并探讨最佳给药方式。方法:选取107例溃疡性结肠炎患者,随机分为A、B、C 3组,A组36例口服美沙拉嗪,B组36例应用美沙拉嗪口服加灌肠,C组35例作为对照餐后口服柳氮磺吡啶。连续治疗2个月后比较临床疗效、凝血指标与细胞因子水平及不良反应发生情况。结果:3组治疗前后DAI评分差值差异具有统计学意义(F=7.439,P=0.008),B组临床疗效显著优于A、C两组(P=0.045、P=0.004)。B组治疗后的IFN-γ、IL^(-1)、IL-8及Fib水平显著低于A组(t=2.981、2.342、2.318、3.059,P<0.05)。A、B两组的不良反应发生率显著低于C组(Z=3.582、3.168,P<0.01),而A组与B组不良反应情况比较差异无统计学意义(Z=0.512,P>0.05)。结论:美沙拉嗪口服联合灌肠治疗溃疡性结肠炎疗效显著,能明显改善患者炎症情况,且安全性较高。

Objective： To analyze the efficacy and safety of mesalazine on ulcerative colitis patients and to explore the optimal administration. Methods： One hundred and seven ulcerative colitis patients were divided into group A,B and C group randomly. Group A（ 36 cases）,group B（ 36 cases） and group C（ 35 cases） were given oral mesalazine,oral mesalazine combined with retention enema and oral sulfasalazine respectively. Clinical efficacy,cytokine levels,coagulation indexes and adverse reactions were compared after 2 months of treatment among the three groups. Results： The differences of DAI score before and after treatment in the three groups were statistically significant（ F = 7. 439,P = 0. 008）. Further analysis showed that clinical efficacy of group B was much better than that of group A and C（ P = 0. 045,P = 0. 004）. The levels of IFN-γ,IL^（-1）,IL-8 and Fib in group B were significantly lower than those in group A（ t = 3. 581,2. 342,2. 318,3. 159; P 〈0. 05）. The incidence of adverse events in group A and B was significantly lower than that in group C（ Z = 3. 582,3. 168,P 〈0. 01）. No significant difference of incidence of adverse reactions between group A and group B was found（ Z = 0. 512,P 〉0. 05）.Conclusion： Oral administration of mesalazine combined with enema has good clinical efficacy in the treatment of ulcerative colitis,which can improve inflammatory state in patients with higher safety.