美沙拉嗪口服联合灌肠治疗高龄活动期溃疡性左半结肠炎的疗效

Comparison of efficacy of oral mesalazine and mesalazine enema in the treatment of active ulcerative left hemicolonitis

目的探讨美沙拉嗪口服与灌肠联合应用治疗高龄活动期溃疡性左半结肠炎的临床疗效及安全性。方法选择2014年1月至2018年6月我院诊治120例高龄活动期溃疡性左半结肠炎患者,随机分为对照组和观察组,每组60例,两组患者均衡可比。对照组单纯口服美沙拉嗪肠溶片,观察组采用口服美沙拉嗪肠溶片联合美沙拉嗪灌肠液治疗,两组患者均连续治疗4周;观察两组治疗有效率及不良反应,并比较两组患者治疗前后Baron肠镜积分、结肠组织病理评分、血清炎症因子、丙二醛(Malondialolehyde,MDA)、超氧化物歧化酶(SOD)水平变化情况。结果观察组治疗有效率为95.00%明显高于对照组(73.33%),差异有统计学意义(P<0.05);治疗后,观察组Baron内镜评分和DAI指数均明显低于对照组(P<0.05),血清TNF⁃α、IL⁃8、hs⁃CRP、MDA水平均明显低于对照组(P<0.05),SOD水平明显高于对照组(P<0.05)。观察组不良反应发生率(3.33%)与对照组(1.67%)无差异(P>0.05)。结论美沙拉嗪口服与灌肠联合应用能够有效改善高龄活动期溃疡性左半结肠炎的临床症状,减轻患者炎症反应,具有显著抗氧化、清除自由基的作用,促进肠道黏膜愈合,且不良反应少,安全性高。

Objective To investigate the clinical efficacy and safety of mesalazine combined with enema in the treatment of active ulcerative left hemicolonitis in the elderly.Methods 120 elderly patients with active ulcerative left hemicolonitis from January 2014 to June 2018 were randomly divided into control group and observa⁃tion group,60 cases in each group.Patients in the two groups were comparable.The control group was treated with mesalazine enteric⁃coated tablets only,while the observation group was treated with oral mesalazine enteric⁃coated tablets combined with mesalazine enema.Two groups of patients were treated for 4 weeks continuously.The efficacy and adverse reactions of the two groups were observed,and Baron′s enteroscopy score,colon histopathological score,serum inflammatory factors,MDA and SOD levels were compared before and after treatment.Results The effective rate of treatment in the observation group was 95.00%higher than 73.33%in the control group(P<0.05).After treatment,Baron endoscopy score and DAI index in the observation group were significantly lower than those in the control group(P<0.05),the levels of serum TNF⁃a,IL⁃8,hs⁃CRP and MDA in the observation group were significantly lower than those in the control group(P<0.05),and the level of SOD in the observation group was significantly higher than that in the control group(P<0.05).The incidence of adverse reactions in the obser⁃vation group was 3.33%and there was no significant difference between the two groups(P>0.05).Conclusion Mesalazine combined with enema can effectively improve the clinical symptoms of ulcerative left hemicolonitis in the active stage of elderly patients,alleviate the inflammatory reaction with significant antioxidant and free radical scavenging effects,and promote the healing of intestinal mucosa,with fewer adverse reactions and high safety.