美沙拉嗪联合酪酸梭菌婴儿双歧杆菌双联活菌制剂治疗活动期轻中度溃疡性结肠炎的疗效观察

Clinical efficacy of mesalazine combined with live bacterial agent of clostridium butvricum and bifidobacterium infantis in the treatment of patients with active mildmoderate ulcerative colitis

目的观察美沙拉嗪联合酪酸梭菌婴儿双歧杆菌双联活菌制剂治疗活动期轻中度溃疡性结肠炎的疗效。方法将34例诊断为初发型、慢性复发型的轻中度活动期溃疡性结肠炎患者随机分为美沙拉嗪组(对照组)和联合用药组(观察组)。美沙拉嗪组给予美沙拉嗪口服,联合用药组给予美沙拉嗪加酪酸梭菌婴儿双歧杆菌双联活菌制剂,疗程均为12周。比较两组患者用药前后Mayo评分、结肠镜评分、总有效率和肠道菌群等指标的变化,并记录不良反应。结果观察组Mayo评分由(7.12±2.54)分降至(2.32±1.68)分,对照组由(7.23±1.98)分降至(4.57±2.36)分,两组下降幅度差异均有统计学意义(P<0.05);观察组治疗后的Mayo评分明显低于对照组(P<0.05)。观察组和对照组治疗后的Azzolini内镜积分均较治疗前下降,差异有统计学意义(P<0.05);与对照组治疗后相比,观察组治疗后的Azzolini积分明显降低(P<0.05)。观察组总有效率为88.2%,对照组为64.7%,两组比较差异有统计学意义(P<0.05)。两组治疗后双歧杆菌和乳酸杆菌的数量均增加,肠球菌数量下降,与治疗前比较差异有统计学意义(P<0.05);与对照组治疗后相比,观察组治疗后双歧杆菌和乳酸杆菌的菌落数明显增加,肠球菌菌落数明显减少(P<0.01)。结论美沙拉嗪联合酪酸梭菌婴儿双歧杆菌双联活菌制剂治疗活动期轻中度溃疡性结肠炎,可改善患者的临床症状并促进肠黏膜愈合,其机制可能与益生菌对肠道茼群的调节作用有关。

Objective To evaluate the clinical efficacy of mesalazine combined with probiotics of Clostridium butyricum and bifidobacterium infantis in the treatment of patients with active mild-moderate ulcerative colitis.Methods Thirty-four patients with active mild-moderate ulcerative colitis were randomly divided into mesalazine group（control group,n = 17） and combination group（observation group,n = 17）.Patients in control group were treated with mesalazine,while patients in observation group were given mesalazine combined with live bacterial agent of Clostridium butyricum and bifidobacterium infantis.The treatment course was twelve weeks.The Mayo score,Azzolini score,response rate,analysis of fecal microflora and adverse reactions were compared between the two groups.Results The Mayo score decreased from 7.12 ±2.54 to 2.32 ± 1.68 in observation group and from 7.23 ± 1.98 to 4.57 ±2.36 in control group.The decrease showed statistical difference（P〈0.05）.Besides,comparison between the two groups after treatment showed that obvious decrease was observed in observation group（P〈0.05）.The Azzolini score decreased in the two groups after treatment compared to that before treatment（P〈0.05）,and lower score was observed in observation group as compared to control group（P〈0.05）.The response rate was significantly higher in observation group than control group（88.2%vs.64.7%,P〈0.05）.Analysis of fecal microflora showed increase in the abundance of bacillus bifidus and lactobacillus,and decrease in the number of enterococcus in the two groups after treatment（P〈0.05）.Moreover,an obvious difference was identified in observation group after treatment as compared to that of control group（P〈0.01）.Conclusion Combined therapy with mesalazine and live bacterial agent of Clostridium butyricum and bifidobacterium infantis can effectively alleviate clinical symptoms and colonoscopic manifestations in patients with active mild-moderate ulcerative colitis.The mechanism may be related to the regulation of fecal microflora.