美沙拉嗪口服联合保留灌肠治疗轻中度溃疡性结肠炎的疗效分析

Oral Mesalazine plus Retention Enema in the Treatment of Mild and Mid-Ulcerative Colitis:An Analysis of Effect

为探讨美沙拉嗪口服联合保留灌肠治疗轻中度溃疡性结肠炎(UC)的临床疗效,将132例轻中度UC患者随机分为A、B、C组,各44例。A组口服美沙拉嗪肠溶片,每次1.0g,每天4次;B组口服美沙拉嗪肠溶片(每次1.0g,每天2次)的同时,给予美沙拉嗪(2.0g)溶液灌肠;C组常规口服柳氮磺吡啶肠溶片。3组均治疗2个月。比较3组临床疗效,治疗前后疾病活动指数(DAI)、肠黏膜Baron内镜评分、血清炎症因子水平,以及不良反应发生情况。结果显示,1)临床疗效:3组总有效率比较差异显著(P<0.05),B组最高,A组次之,C组最低。2)DAI和Baron内镜评分:治疗前,3组DAI和Baron内镜评分比较差异均无统计学意义(P>0.05);治疗后,3组DAI和Baron内镜评分均明显降低(P<0.05),其中B组最低,A组次之,C组最高。3)血清炎症因子水平:治疗前,3组患者血清白细胞介素-1(IL-1)、C反应蛋白(CRP)及肿瘤坏死因子-α(TNF-α)水平比较差异均无统计学意义(P>0.05);治疗后,3组患者IL-1、CRP、TNF-α均明显降低(P<0.05),其中B组最低,A组次之,C组最高。4)不良反应:3组并发症发生率比较,B组最低(11.36%),A组次之(20.45%),C组最高(36.36%),差异有统计学意义,P<0.05。结果表明,美沙拉嗪口服联合保留灌肠治疗轻中度UC患者,可有效控制炎症反应,提高治疗有效率,而且安全性高。

This study was to invetigate clinical effect of ulcerative colitis(UC)treated with oral mesalazine plus retention enema,randomly divided 132 mild and mid-UC patients into group A,B and C,44 cases for each;group A orally administered mesalazine enteric-coated tablets,1.0 g/time,4 times/d;group B 2 times/d,other same;group B,added with mesalazine(2.0 g)solution for enema;group C routinely orally administered salazosulfapyridine enteric-coated tablets.Treatment course of all groups was 2 months;then clinical effect,DAI,Baron endoscopic score,serum inflammatory factor level,and untoward reaction incidence were compared between the three groups.As results,1)clinical effect:there was significant difference between the three groups in total effective rate(group B>group A>group C);2)DAI and Baron endoscopic score:before treatment there was no statistical difference(P>0.05),after treatment the three groups had all significantly lower(P<0.05),in order of group C>group A>group B;3)the level of serum inflammatory factor:before treatment in the levels of IL-1,CRP and TNF-αthere was no statistical difference between the three groups(P>0.05),but after treatment the levels of IL-1,CRP and TNFαwere significantly declined in all groups(P<0.05)in order of group C>group A>group B;4)untoward reaction incidence:group C(36.36%)>group A(20.45%)>group B(11.36%),P<0.05.Resutls show that mesalazine plus enema for treating mild and mid-UC can effectively control inflammatory response,enhance effective rate,and with high safety.