美沙拉嗪联合金双歧对溃疡性结肠炎患者炎症反应及直肠肛门动力学的影响

Mesalazine combined with Golden Bifid for treatment of patients with ulcerative colitis:Effect on inflammatory response and anorectal motility

目的探讨美沙拉嗪联合金双歧治疗溃疡性结肠炎对患者炎症反应及直肠肛门动力学的影响.方法按随机数字表法将2016-02/2017-09淳安县第一人民医院和台州医院接诊的84例溃疡性结肠炎患者分为两组,给予对照组42例患者美沙拉嗪治疗,给予研究组42例患者美沙拉嗪联合金双歧治疗.连续治疗2 mo后,比较两组血清细胞因子水平[白介素-10(interleukin-10,IL-10)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-18(interleukin-18,IL-18)、可溶性白细胞介素-2受体(soluble interleukin 2receptor,s IL-2R)]、病变活动性积分、临床疗效、直肠肛门动力学.结果研究组和对照组IL-10水平分别为68.87 pg/m L±5.12 pg/m L、59.26 pg/m L±10.28 pg/m L,IL-18分别为86.25 pg/m L±42.86 pg/m L、212.26 pg/m L±56.42 pg/m L,TNF-α分别为21.08 ng/m L±3.71ng/m L、23.62 ng/m L±3.84 ng/m L,s IL-2R水平分别为215.75 U/m L±80.71 U/m L、544.72 U/m L±210.56 U/m L,差异具有统计学意义(P<0.05);研究组病变活动性积分为(2.07分±1.52分)低于对照组(3.14分±2.14分),差异具有统计学意义(P<0.05);研究组治疗总有效率为95.24%(40/42)优于对照组的76.19%(32/42),差异具有统计学意义(P<0.05);研究组直肠疼痛阀值、直肠顺应性、直肠排便阀值均高于对照组,差异具有统计学意义(P<0.05).结论对溃疡性结肠炎患者采用美沙拉嗪联合金双歧治疗效果显著,能有效改善血清炎症因子水平,降低病变活动性,促进直肠肛门动力学恢复.

AIM To investigate the effect of mesalazine combined with Golden Bifid on inflammatory response and anorectal motility in patients with ulcerative colitis （UC）. METHODS Eighty-four UC patients treated at the First People＇s Hospital of Chun＇an County and Taizhou Hospital from February 2016 to September 2017 were randomly divided into either a control group or a study group, with 42 cases in each group. The control group was given mesalazine alone, while the study group was treated with mesalazine combined with Golden Bifid. After two months of treatment, serum levels of cytokines [interleukin-10 （IL-10）, tumor necrosis factor-α （TNF-α）, interleukin-18 （IL-18）, and soluble interleukin 2 receptor （SIL-2R）], disease activity index （DAI）, clinical efficacy, and anorectal motility were compared between the two groups. RESULTS Serum level of IL-10, IL-18, TNF-α, and sIL-2R differed significantly between the study group and the control group （68.87 pg/mL ± 5.12 pg/mL, 86.25 pg/mL ±42.86 pg/mL, 21.08 ng/mL ± 3.71 ng/mL, and 215.75 U/mL ± 80.71 U/mL, respectively） and control group （59.26 pg/ mL ± 10.28 pg/mL, 212.26 pg/mL ± 56.42 pg/mL, 23.62 ng/mL ± 3.84 ng/mL, and 544.72 U/mL ± 210.56 U/mL, respectively） （P 〈 0.05）. DAI in the study group （2.07 ± 1.52） was significantly lower than that of the control group （3.14 ± 2.14; P 〈 0.05）. The total effective rate was significantly higher in the study group than in the control group [95.24% （40/42） vs 76.19% （32/42）, P 〈 0.05]. Rectal pain threshold value, rectal compliance, and rectal defecation threshold value were significantly higher in the study group than in the control group （P 〈 0.05） CONCLUSION Mesalazine combined with Golden Bifid is effective in the treatment of UC and can improve the levels of inflammatory cytokines, decrease DAI, and promote the recovery of anorectal motility.