美沙拉嗪联合维生素D3和益生菌治疗轻中度活动期溃疡性结肠炎疗效观察

Efficacy of mesalazine combined with vitamin D3and probiotics on ulcerative colitis

目的观察轻中度活动期溃疡性结肠炎患者应用维生素D3、益生菌及美沙拉嗪治疗后血清C反应蛋白(C-reactive protein,CRP)、红细胞沉降率(erythrocyte sedimentation rate,ESR)、血小板计数及1,25-羟维生素D3[1,25-hydroxyvitamin D3,1,25(OH)2D3]水平变化,探讨其治疗效果及安全性。方法轻中度活动期溃疡性结肠炎患者116例,随机分为观察组57例,对照组59例。对照组给予美沙拉嗪治疗;观察组在对照组基础上联合维生素D3、益生菌治疗;2组疗程均为6个月。分别于治疗前及治疗6个月检测2组ESR、血小板计数及血清CRP、1,25(OH)2D3水平;治疗6个月时评定治疗效果;记录治疗期间不良反应发生率。结果观察组、对照组治疗前血小板计数[(365.85±50.36)×10^9/L、(369.21±48.65)×10^9/L]、ESR[(25.96±7.65)、(26.54±8.69)mm/h]、CRP[(14.25±6.50)、(14.35±6.30)mg/L]、1,25(OH)2D3[(13.26±7.63)、(13.36±8.63)μg/L]比较差异均无统计学意义(P>0.05);治疗6个月观察组、对照组血小板计数[(250.65±29.86)×10^9/L、(330.98±35.87)×10^9/L]、ESR[(12.69±4.58)、(14.69±3.65)mm/h]、CRP[(4.63±2.35)、(7.56±6.63)mg/L]均低于治疗前,1,25(OH)2D3[(23.68±5.69)、(16.35±7.63)μg/L]均高于治疗前(P<0.05);观察组治疗6个月时血小板计数、ESR、CRP均低于对照组,1,25(OH)2D3高于对照组(P<0.05)。治疗6个月,观察组有效率(89.5%)高于对照组(69.5%)(P<0.05)。观察组发生不良反应发生率(12.3%)与对照组(11.9%)比较差异无统计学意义(P>0.05)。结论轻中度活动期溃疡性结肠炎患者应用美沙拉嗪联合维生素D3、益生菌治疗可提高临床疗效,具有较高的安全性。

Objective To observe the changes of serum C-reactive protein(CRP)level,erythrocyte sedimentation rate(ESR),platelet(PLT)and 1,25-hydroxyvitamin D3(1,25(OH)2D3)after treating with mesalazine combined with vitamin D3and probiotics,and to investigate the efficacy and safety in the treatment of mild and moderate active ulcerative colitis.Methods Totally 116mild and moderate ulcerative colitis patients were randomly divided into 57patients treated with mesalazine combined with vitamin D3and probiotics(observation group)and 59patients treated with mesalazine for 6months(control group).The serum CRP level,ESR,PLT and(1,25(OH)2D3)were detected before and after 6-month treatment.The clinical efficacy after 6-month treatment and adverse reactions during treatment were assessed and observed in two groups.Results There were no significant differences in PLT((365.85±50.36)×10^9/L vs.(369.21±48.65)×10^9/L),ESR((25.96±7.65)mm/h vs.(26.54±8.69)mm/h),CRP((14.25±6.50)mg/L vs.(14.35±6.30)mg/L)and 1,25(OH)2D3((13.26±7.63)μg/L vs.(13.36±8.63)μg/L)between observation group and control group before treatment(P>0.05);PLT((250.65±29.86)×109/L,(330.98±35.87)×10^9/L),ESR((12.69±4.58),(14.69±3.65)mm/h)and CRP((4.63±2.35),(7.56±6.63)mg/L)after 6-month treatment were lower than those before treatment(P<0.05),and 1,25(OH)2D3levels were higher after 6-month treatment((23.68±5.69),(16.35±7.63)μg/L)than those before treatment in observation group and control group(P<0.05).PLT,ESR and CRP were lower in observation group than those in control group after 6-month treatment,and 1,25(OH)2D3 was higher than that in control group(P<0.05).The effective rate after 6-month treatment was higher in observation group(89.5%)than that in control group(69.5%)(P<0.05),while the incidence of adverse reactions showed no significant difference between two groups(12.3%vs.11.9%)(P>0.05).Conclusion Mesalazine combined with vitamin D3and probiotics can significantly improve the clinical efficacy on mild and moderate ulcerative colitis,and it has high safety.