美沙拉嗪联合中药内镜下治疗轻、中度溃疡性结肠炎的临床研究

Clinical study of mesalazine combined with traditional Chinese medicine under endoscope in treatment of mild to moderate ulcerative colitis

目的研究美沙拉嗪联合中药内镜下治疗轻中度溃疡性结肠炎的临床疗效。方法本研选取治疗的轻中度溃疡性结肠炎患者200例,随机分为观察组和对照组,每组100例。对照组给予美沙拉嗪治疗,观察组在对照组的基础上联合内镜下给予中药的方法治疗。比较2组治疗前后的血清炎性因子白细胞介素(IL-1β、IL-8)、肿瘤坏死因子(TNF-α)、C-反应蛋白(CRP)含量及2组治疗前后的Mayo评分、结肠镜评分(Azzolini评分)等指标的变化,并观察临床疗效及不良反应。结果2组治疗后的血清IL-1β、IL-8、TNF-α、CRP含量均较治疗前降低,且观察组下降程度较对照组更明显(P<0.05);2组治疗后的Mayo评分、Azzolini评分均较治疗前降低,与对照组治疗后相比,观察组治疗后的评分明显降低(P<0.05);2组所有病例疗效比较,观察组治疗后总有效率明显高于对照组(P<0.05);2组不同病变部位疗效比较:2组E1型(直肠炎)病例的缓解率、总有效率差异无统计学意义(P>0.05);观察组E2型(左半结肠炎)、E3型(广泛结肠炎)的缓解率及总有效率均显著高于对照组(P<0.05);2组不良反应发生率差异无统计学意义(P>0.05)。结论美沙拉嗪联合中药内镜下治疗轻中度溃疡性结肠炎能减轻炎性反应、疗效确切,尤其对累及近端部位(E2、E3型)的溃疡性结肠炎临床疗效突出,且较少发生不良反应。

Objective To investigate the clinical efficacy of mesalazine combined with traditional Chinese medicine(TCM)under endoscope in treatment of mild to moderate ulcerative colitis(UC)under endoscope.Methods Two hundred patients with mild to moderate UC who were treated in our hospital were enrolled in the study,who were randomly divided into observation group(n=100)and control group(n=100).The patients in control group were treated by mesalazine,however,the patients in observation group,on the basis of the control group,were treated by TCM under endoscope.The serum inflammatory factors,including interleukin(IL-1β,IL-8),tumor necrosis factor(TNF-α),C-reactive protein(CRP)levels,and changes in the Mayo score and Azzolini score before and after treatment as well as the clinical efficacy and adverse reactions were observed and compared between the two groups.The clinical efficacy and adverse reactions were observed.Results After treatment,the serum levels of L-1β,IL-8,TNF-α,and CRP levels in both groups were significantly decreased,moreover,the decrease degree in observation group was more significant than that in control group(P<0.05).After treatment,Mayo scores and Azzolini scores in both groups were decreased,moreover,which in observation group were significantly lower than those in control group(P<0.05).In addition the total effective rate in observation group was significantly higher than that in control group(P<0.05).However there were no significant differences in remission rate and total effective rate with respect to E1(proctitis)between the two groups(P>0.05).The remission rate and total effective rate with respect to E2(colitis of the left hemicolon)and E3(extensive colitis)in observation group were significantly higher than those in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Mesalazine combined with TCM under endoscope in treatment of mild to moderate UC can relieve the inflammatory reaction and has definite therapeutic effects,especially on UC involving the proximal part(E2 and E3),with fewer adverse reactions.