康复新液联合美沙拉嗪治疗老年溃疡性结肠炎的效果及对炎症因子和凝血功能的影响

Effect of Kangfuxin solution combined with mesalazine in treating ulcerative colitis and its influence on inflammatory factors and coagulation function in elderly patients

目的探讨康复新液联合美沙拉嗪治疗老年溃疡性结肠炎（UC）的效果及对患者炎症因子和凝血功能的影响。方法纳入浙江省诸暨市人民医院2013年10月至2015年1月收治的60例老年UC患者，按照随机数字表法分为观察组和对照组，每组30例。对照组于常规治疗基础上口服美沙拉嗪1g/次，3次／d；观察组在对照组基础上加用康复新液30ml＋150ml 0．9％氯化钠注射液灌肠，每次20min，1次／d。治疗4周后比较2组疗效，血清炎症因子[肿瘤坏死因子α（TNF-α）、白细胞介素1β（IL-1β）、IL-6、IL-8]水平和凝血功能[凝血酶原时间（PT）、纤维蛋白原（FBG）、血小板计数（PLT）、平均血小板体积（MPV）]。结果观察组总有效率明显高于对照组f93．3％（28／30）比73．3％（22／30）1，差异有统计学意义（P〈0．05）。治疗4周后，观察组血清TNF-α、IL-1β、IL-6、IL-8水平均低于对照组[（134±20）ng／L比（175±23）ng／L、（2．3±1．0）μg／L比（2．8±1．1）μg／L、（8±4）μg／L比（15±6）μg/L、（88±43）μg／L比（123±67）μg/L]，差异均有统计学意义（均P〈0．05）；观察组PT、MPV高于而FBG、PLT低于对照组[（13．8±1．2）s比（11．2±1．2）s、（9．9±0．8）n比（8．2±0．6）n、（2．5±0．5）g／L比（3．1±0．7）g／L、（188±68）×109／L比（211±73）×109／L]，差异均有统计学意义（均P〈0．05）。随访6个月，观察组复发率明显低于对照组[10．0％（3／30）比33．3％（10／30）]，差异有统计学意义（P〈0．05）。结论与单独口服美沙拉嗪比较，康复新液灌肠联合口服美沙拉嗪治疗老年UC疗效确切，可明显减轻炎性反应、改善凝血功能，并可降低复发率。

Objective To investigate the effect of Kangfuxin solution combined with mesalazine in treating ulcerative colitis （UC） and its infuence on inflammatory factors and coagulation function in elderly patients. Methods Totally 60 elderly patients with UC from October 2013 to January 2015were randomly divided into observation group and control group （30 cases in each group）. Both group was orally given mesalazine （ 1 g/time, 3 times/d） ; observation group were additionally given enema treatment with Kangfuxin solution （30 ml ＋ 150 ml 0. 9% sodium chloride, 20 rain/time, once a day）. After 4 weeks of treatment, the clinical curative effect, levels of inflammatory factors [tumor necrosis factor α （TNF-α）, interleukin （IL）-1β, IL-6, IL-8] and coagulation function [ prothrombin time （ PT）, fibrinogen （ FBG）, Platelet count （ PLT）, mean platelet volume （MPV） were compared between groups. Results The total effective rate in observation group was significantly higher than that in control group [93.3% （28/30） vs 73.3% （22/30）] （P 〈0. 05）. After 4 weeks of treatment, the levels of TNF-α, IL-1β, IL-6, IL-8 in observation group were all significantly lower than those in control group [ （ 134 ± 20） ng/L vs （175±23） ng/L, （2.3±1.0） μg/L vs （2.8±1.1） μg/L, （8＋4） μg/L vs （15±6） μg/L, （88 ±43） μg/L vs （123± 67） μg/L] （P 〈0.05）; in observation group, the levels of PT and MPV were significantly higher, the levels of FBG and PLT were significantly lower than those in control group [ （ 13.8 ± 1.2） s vs （11.2±1.2） s, （9.9 ±0. 8） fl vs （8.2 ±0.6） fl, （2.5 ±0.5） g/L vs （3.1 ±0.7） g/L, （188 ± 68） × 109/L vs （211±73） x 109/L] （P 〈0.02）. After 6 months of followed-up, the recurrence rate of observation group was significantly lower than that of control group [ 10. 0% （3/30） vs 33.3% （10/30） ] （P 〈 0. 05）. Conclusion Compared with single mesalazine, enema treatment with Kangfuxin solution combined with oral mesalazine can significantly improve the clinical therapeutic effect, reduce the inflammation degree, improve the coagulation function and reduce the recurrence rate in elderly patients with UC.