艾迪莎联合美沙拉嗪栓治疗溃疡性直肠炎的疗效观察

Efficacy of Etiasa combined with mesalazine suppository on ulcerative colitis

目的：分析艾迪莎（美沙拉嗪缓释颗粒）联合美沙拉嗪栓治疗溃疡性直肠炎临床效果及用药安全性。方法：选取2013年6月～2015年1月我院收治的溃疡性直肠炎患者82例,随机分为观察组（42例）和对照组（40例）,两组患者均给予口服艾迪莎治疗,观察组同时配合以予美沙拉嗪栓剂纳肛治疗,用药4～6周为1疗程,比较两组患者治疗1个疗程后症状缓解情况,结肠镜下粘膜病变总缓解率及治疗后3、6个月后溃疡性结肠炎活动指数（DAI）变化,治疗前后血清IL-8、IL-10水平变化。结果：两组治疗前临床疗效量化评分及DAI比较差异无统计学意义（P〉0.05）,观察组治疗后两项指标显著下降（P〈0.05）,且下降幅度均大于同期对照组（P〈0.05）;观察组治疗后总有效率显著高于对照组（P〈0.05）;观察组治疗后血清IL-8水平较同期对照组明显下降（P〈0.05）,IL-10明显升高（P〈0.05）;两组患者不良反应发生数比较无明显差异（P〉0.05）。结论：艾迪莎口服联合美沙拉嗪栓剂治疗溃疡性直肠炎可使肠道局部药物浓度增加,纠正抗炎细胞因子与促炎细胞因子失衡,疗效显著。

Objective：To analyze the clinical effect of Etiasa（mesalazine slow-release granules）combined with mesalazine suppository in the treatment of ulcerative colitis and the medication safety.Methods：A total of 82 patients with ulcerative colitis who were admitted in our hospital from June,2013 to January,2015 were included in the study and randomized into the observation group（n=42）and the control group（n=40）.The patients in the two groups were orally given Etiasa.The patients in the observation group were given additional mesalazine suppository.Medication for 4-6 weeks was regarded as one course.The symptom relieving,the total remission rate of mucosal lesions after one course,the change of DAI 3and 6months after treatment,and the serum IL-8and IL-10 levels before and after treatment in the two groups were compared.Results：The difference of quantitative scoring of clinical efficacy and DAI before treatment between the two groups was not statistically significant（P〈0.05）.The above indicators after treatment in the observation group were significantly reduced（P〈0.05）and the reduced degree was significantly greater than that in the control group（P〈0.05）.The total effective rate in the observation group was significantly higher than that in the control group（P〈0.05）.IL-8level after treatment in the observation group was significantly lower than that in the control group（P〈0.05）,while IL-10 level was significantly higher than that in the control group（P〈0.05）.The difference of the occurrence rate of adverse reactions during the treatment process between the two groups was not statistically significant（P〈0.05）.Conclusions：Etiasa combined with mesalazine suppository in the treatment of ulcerative colitis can increase the local drug concentration,and correct the imbalance of anti-inflammatory cytokines and proinflammatory cytokines,with a significant efficacy.