传统糖皮质激素联合布地奈德治疗远端溃疡性结直肠炎对照研究

A control study of traditional glucocorticosteroid combined with budesonide in the treatment of distal ulcerative colitis

目的 探讨传统糖皮质激素联合布地奈德治疗远端溃疡性结直肠炎的临床疗效及安全性. 方法 将88例远端溃疡性结直肠炎患者按随机数字表法分为两组,每组44例.两组均予以地塞米松治疗,实验组在此基础上联合布地奈德治疗,观察3周.比较两组患者的临床疗效、细胞间黏附分子-1表达水平、P-选择素表达水平以及不良反应发生状况.结果 治疗3周末,实验组总有效率为90.9%,对照组为68.2%,实验组显著高于对照组（P〈0.01）.治疗后两组细胞间黏附分子-1、P-选择素表达水平均较治疗前显著降低（P〈0.01）,实验组显著低于对照组（P〈0.01）.实验组不良反应发生率为9.1%,对照组为20.5%,实验组低于对照组,但差异无统计学意义（P〉0.05）.结论 传统糖皮质激素联合布地奈德治疗远端溃疡性结直肠炎疗效显著,能明显降低细胞间黏附分子-1、P-选择素的表达水平,安全性高.

Objective To explore the efficacy and safety of traditional glucocorticosteroid combined with budesonide in the treatment of distal ulcerative colitis （DUC）.Methods Eighty-eight DUC patients were randomly divided into two groups of 44 ones each according to random number table.Both groups received dexamethasone treatment and on this basis experimental group was plus budesonide for 3 weeks.Efficacies, intercellular adhesion molecule-1 （ICAM-1） and P-selectin （P-sel） expression levels, and adverse reactions were compared between the two groups.Results At the end of the 3rd week total effective rate was respectively 90.9% in experimental and 20.5% in control group and the former significantly higher than the latter （P〈0.01）.After treatment ICAM-1 and P-sel expression levels of both groups lowered more significantly compared with pretreatment （P〈0.01） and those were significantly lower in experimental than in control group （P〈0.01）.The incidence of adverse reactions was lower in experimental than in control group （9.1% vs.20.5%）, but group difference wasn＇t significant （P〉0.05）.Conclusion Traditional glucocorticosteroid combined with budesonide has an evident effect in the treatment of DUC, could notable lower ICAM-1 and P-sel expression levels, and has higher safety.