甲硝唑联合康复新液保留灌肠治疗溃疡性结肠炎的临床研究

Therapeutic effects of metronidazole combined with Kangfuxin liquid retention enema on active ulcerative colitis

目的观察甲硝唑联合康复新液保留灌肠治疗活动期溃疡性结肠炎(UC)的疗效。方法选取86例活动期溃疡性结肠炎患者随机分为治疗组和对照组,每组43例。2组均口服美沙拉嗪肠溶片4.0g/d,分4次口服,对照组采用温0.9%氯化钠溶液100ml、庆大霉素16万U,利多卡因100mg保留灌肠;治疗组采用0.5%甲硝唑注射液100ml,康复新液50ml保留灌肠。比较2组大便次数、性状、便血量及不良反应,比较2组肝肾功能、血清CRP和疗效。结果对照组大便次数情况的缓解有效率为53.5%,治疗组为81.4%,2组比较差异有统计学意义(χ^2=7.35,P<0.05)。对照组大便性状改善率为65.1%,治疗组为81.4%,2组比较差异无统计学意义(χ^2=2.008,P>0.05)。对照组便血量情况好转率为81.4%,治疗组为95.3%,2组比较差异有统计学意义(χ^2=6.418,P<0.05)。对照组治疗疗效的总有效率为74.4%,治疗组为93.0%,2组比较差异有统计学意义(P<0.05)。对照组总不良反应发生率为20.9%,治疗组为16.3%,2组比较差异无统计学意义(P>0.05)。对照组肝肾功能异常情况发生率为4.6%,治疗组为7.0%,2组比较差异无统计学意义(P>0.05)。2组治疗前CRP差异无统计学意义(P>0.05);2组治疗后CRP明显低于治疗前,且治疗组明显低于对照组,差异有统计学意义(P<0.05)。结论甲硝唑联合康复新液保留灌肠治疗活动期溃疡性结肠炎的疗效优于庆大霉素和利多卡因。

Objective To observe the therapeutic effects of metronidazole combined with Kangfuxin liquid retention enema on active ulcerative colitis(UC).Methods A total of 86 patients with active ulcerative colitis were randomly divided into treatment group and control group,with 43 cases in each group.The patients in both groups were treated by oral mesalazine enteric-coated tablet 4.0g/d,taking orally in four times.The patients in control group were treated by retention enema with 0.9%sodium chloride solution 100ml,gentamicin 160,000 units and lidocaine 100mg,however,thepatients in treatment group were treated by retention enema with 0.5%metronidazole injection 100ml and Kangfuxin liquid 50ml after 4-week treatment,the frequency of stools,characteristics,fecal blood volume,adverse reactions,liver and kidney function,serum CRP and therapeutic effects were observed and compared between the two groups.Results There was significant difference in remission rate of stool frequency between control group and treatment group(53.5%vs 81.4%,P<0.05),and the improvement rate of stool characters in control group was 65.1%,which in treatment group was 79.1%,there was no significant difference between the two grousp(P>0.05).There was significant difference in the improvement rate of hematochezia volume between control group and treatment group(81.4%vs 95.3%53.P<0.05).Moreover the total effective rate in control group was 74.4%,which in treatment group was 93.0%,there was significant difference between the two grousp(P<0.05).The incidence rate of total adverse reactions in control group was 20.9%,which in treatment group was 16.3%,there was no significant difference between the two grousp(P>0.05).The incidence rate of liver and renal function abnormality in control group was 4.6%,which in treatment group was 7.0%,there was no significant difference between the two grousp(P>0.05).Befeore treatment there was no significant difference in CRP between the two grousp(P>0.05).After treatment the CRP in both groups was significantly decreased,moreover,which in treatment group was significantly lower than that in control group(P<0.05).Conclusion The therapeutic effects of metronidazole combined with Kangfuxin liquid on active ulcerative colitis are superior to those by gentamicin and lidocaine.