臭氧直肠灌注辅助治疗溃疡性结肠炎(活动期)48例临床观察

Clinical observation on ozone rectal perfusion for assisted treatment in 48 cases of ulcerative colitis (active stage)

目的观察臭氧直肠灌注对溃疡性结肠炎(活动期)的临床疗效及安全性。方法将2015年7月至2017年2月重庆市垫江县人民医院收治的96例溃疡性结肠炎(活动期)患者采用随机数字表法分为治疗组和对照组,每组48例。两组患者肠道准备均给予等渗生理盐水500 mL清洁灌肠,同时给予柳氮磺胺吡啶肠溶片温水送服,每次1 g,每天4次。对照组给予氮气直肠灌注,治疗组给予臭氧直肠灌注,30 d为1个疗程,1个疗程后评价两组患者临床疗效、Suntherland疾病活动指数评分(DAI)、肠镜Baron评分及不良反应发生情况等。结果治疗组患者总有效率[89.58%(43/48)]、DAI[(2.78±1.43)分]、肠镜Baron评分[(0.86±0.19)分]均明显优于对照组[分别为75.00%(36/48),(3.85±1.88)、(1.27±0.24)分],差异均有统计学意义(P<0.05);治疗组患者中出现皮肤瘙痒1例(2.08%),对照组患者中出现恶心、食欲减退2例(4.17%),两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论臭氧直肠灌注辅助疗法可明显改善溃疡性结肠炎(活动期)患者的临床症状,降低DAI,改善结肠镜下黏膜病变程度,且安全性好,可进一步在临床推广应用。

Objective To observe the clinical efficacy and safety of ozone rectal perfusion in ulcerative colitis（active stage）. Methods Ninety-six cases of ulcerative colitis（active stage） treated in the Dianjiang County People′s Hospital from July 2015 to February 2017 were divided into the treatment group and control group according to the random number table method,48 cases in each group. The two groups were given 0.9% isotonic normal saline 500 mL by cleaning enema in bowel preparation,meanwhile sulfasalazine enteric coated tablets were administrated by warm water,1 g per time,4 times daily. The control group was given the nitrogen rectal perfusion,while the treatment group used the ozone rectal perfusion,30 d as 1 course of treatment.After one course of treatment,the clinical efficacy,Suntherland disease activity index（DAI） score,endoscopic Baron score and adverse reactions occurrence were evaluated in the two groups. Results The total effective rate in the treatment group was 89.58%（43/48）,DAI score was（2.78±1.43） points,colonoscopic Baron score was（0.86±0.19） points,which were significantly superior to 75.00%（36/48）,（3.85±1.88） points and（1.27±0.24） points in the control group,the differences were statistically significant（P〈0.05）. The treatment group appeared 1 case（2.08%） of skin pruritus,while the control group appeared 2 cases（4.17%） of nausea and anorexia, the occurrence rate of adverse reactions had no statistical difference between the two groups（P〈0.05）. Conclusion The ozone rectal perfusion adjuvant therapy can obviously improve the clinical symptoms in the patients with ulcerative colitis（active stage）,reduces DAI,improves the severity of mucosa lesion under colonoscope,has good safety and can be further promoted and applied in clinic.