美沙拉嗪联合地衣芽孢杆菌活菌治疗溃疡性结肠炎的效果观察

Clinical effect of mesalazine combined with live bacillus licheniformis on ulcerative colitis

目的 观察美沙拉嗪联合地衣芽孢杆菌活菌治疗溃疡性结肠炎的效果。方法 选取2014年5月至2015年5月于中国核工业北京四〇一医院消化科门诊就诊的190例UC患者，信封法随机分为观察组（96例）和对照组（94例）。观察组口服美沙拉嗪肠溶片1.0 g/次、4次/d及地衣芽孢杆菌活菌胶囊0.5 g/次、3次/d；对照组口服柳氮磺胺嘧啶片1.0 g/次、4次/d。药物治疗均持续12周。分析2组治疗前后的症状变化［采用炎症性肠病生存质量问卷（IBDQ）］、结肠黏膜炎症变化（采用改良Baron内镜下UC活动度分级结合组织病理学分级标准）及临床疗效。记录2组患者治疗中的不良反应。结果 治疗后，观察组、对照组症状IBDQ积分均明显低于治疗前［（33±7）分比（189±6）分，P＝0.040；（59±6）分比（191±7）分，P＝0.049］，且观察组IBDQ积分明显低于对照组（P＝0.048）。观察组、对照组经治疗后结肠黏膜炎症均明显改善（P＝0.010，0.023），且观察组改善情况明显优于对照组（P＝0.038）。观察组总有效率高于对照组［87.5%（84/96）比77.7%（73/94）］，差异有统计学意义（P＝0.047）。观察组不良反应发生率低于对照组［1.0%（1/96）比8.5%（8/94）］，差异有统计学意义（P＝0.041）。结论 美沙拉嗪联合地衣芽孢杆菌活菌治疗溃疡性结肠炎安全有效。

Objective To observe the clinical effect of mesalazine combined with live bacillus licheniformis on ulcerative colitis. Methods Totally 190 patients with ulcerative colitis from May 2014 to May 2015 in China Nuclear Industry Beijing 401 Hospital were randomly divided into observation group（96 cases） and control group（94 cases）. The observation group was treated with mesalamine enteric-coated tablets and live bacillus licheniformis capsules for 12 weeks. The control group was treated with sulfasalazine tablets for 12 weeks. Symptom changes were recorded by inflammatory bowel disease life quality questionnaire（IBDQ）. Colonic mucosal inflammation changes were recorded by modified Baron UC activity classification and histopathological classification. Clinical efficacy and adverse reactions were analyzed. Results After treatment, IBDQ scores in observation group and control group were significantly lower than those before treatment[（33±7）scores vs （189±6）scores, P=0.040; （59±6）scores vs （191±7）scores, P=0.049]; the IBDQ score in observation group was significantly lower than that in control group（P=0.048）. Colonic mucosal inflammation in observation group and control group were significantly improved（P=0.010, 0.023）; the inflammation condition in observation group was significantly better than that in control group after treatment（P=0.038）. The observation group had a higher effective rate and a lower adverse reaction rate compared to control group; the differences were significant[87.5%（84/96） vs 77.7%（73/94）, P=0.047; 1.0%（1/96） vs 8.5%（8/94）, P=0.041]. Conclusions Mesalazine combined with live bacillus licheniformis treating ulcerative colitis is safe and effective.