联合美沙拉嗪治疗溃疡性结肠炎内镜下的疗效观察

Observe the endoscopic effect of combined oral and mesalazine enema in treating of ulcer colitis

目的:观察美沙拉嗪口服与灌肠的联合应用治疗溃疡性结肠炎短期内黏膜愈合的疗效。方法:将84例溃疡性结肠炎患者随机分成实验组和对照组,实验组患者予以口服与灌肠的联合应用,对照组患者予以单一口服疗法,观察治疗2周后的内镜下黏膜愈合率及MAYO评分、不良反应的情况。结果:治疗2周后,整体分析发现:实验组黏膜愈合率(76.2%)高于对照组(50%),差异有统计学意义(P<0.05)。局部分析发现:实验组全结肠的黏膜愈合率优于对照组(P<0.05),且实验组对直乙状结肠的黏膜愈合率明显高于对照组(P<0.05)。治疗2周后实验组的MAYO评分(3.40±1.499)低于对照组(4.33±1.408),差异有统计学意义(P<0.05),且实验组不良反应发生率未见增加(P>0.05)。结论:美沙拉嗪的联合应用起效快,可在2周内快速愈合黏膜,建议对于中重度活动期溃疡性结肠炎,尤其是对直肠、左半结肠局部病变者提倡联合灌肠治疗2周。

Objective：Observe the endoscopic effect of combined oral and mesalazine enema in treating of moderate-to-severe ulcer colitis curative in short time. Methods：84 cases of patients with ulcerative colitis were randomly divided into the experimental group and control group. The experimental group received combined oral and enema treatment and the control group received oral-only treatment. We observed the endoscopic remission and MAYO score, adverse reactions after 2 weeks of treatment. Results：The healing mucosal rate was obtained in 76.2% of the mesalazine enema group and in 50% of the control group at two weeks （P〈 0.05）. Locality stratified analysis found that： the healing mucosal rate of the whole colon in the experimental group was obviously higher than that of control group （P〈 0.05） and the healing mucosal of straight sigmoid colon in the experimental was obviously higher than that of control group. The MAYO score of the experimental Group score was 3.40 lower than the control group4.33 ±1.408 after 2 weeks （P〈 0.05）. 3 people in the experimental group （6%） appeared adverse reactions, While 2 people in the control group （4%） ,P〉 0.05. Conclusion： Combined oral and mesalazine enemas can take effect and heal mucosal quickly in 2 weeks. So, for moderate-to-severe active ulcerative colitis, especially for the lesion in the left half colon, we suggest giving combined oral and mesalazine enemas therapy for 2 weeks.