柳氮磺胺吡啶联合复方谷氨酰胺治疗溃疡性结肠炎患者的临床研究

Clinical trial of sulfasalazine combined with compound glutamine in the treatment of patients with ulcerative colitis

目的观察柳氮磺胺吡啶联合复方谷氨酰胺治疗溃疡性结肠炎患者的临床疗效及对患者血清炎性因子抵抗素(resistin)、人甲壳质酶蛋白40(YKL-40)、过氧化物酶体增殖物激活受体(PPARγ)的影响。方法将溃疡性结肠炎患者120例,随机分为试验组和对照组,每组60例。对照组单纯口服柳氮磺胺吡啶,每次1 g,每天3次;试验组在对照组的基础上给予复方谷氨酰胺,每次1 g,每天3次,半月后减量为每次0.5 g,每天3次,口服。2组均持续治疗2个月。观察2组的临床疗效、Mayo评分变化和患者的Resistin、YKL-40、PPARγ及炎症因子水平。结果治疗后,试验组和对照组总有效率为93.33%(56例/60例)和60.00%(36例/60例),第8周Mayo评分分别为(5.07±2.08),(7.40±2.14)分,Resistin分别为(14.30±4.22),(16.73±3.54)ng·mL^(-1),YKL-40分别为(21.17±5.44),(25.92±5.25)ng·mL^(-1),PPARγ分别为(47.19±3.63)%,(39.03±2.63)%,差异均有统计学意义(均P<0.05)。治疗后,试验组炎症因子白细胞介素-6(IL-6)、C反应蛋白(CRP)和肿瘤坏死因子-α(TNF-α)水平均低于对照组,差异均有统计学意义(均P<0.05)。试验组和对照组的药物不良反应发生率分别为8.33%和6.67%,差异无统计学意义(P>0.05)。结论柳氮磺胺吡啶联合复方谷氨酰胺治疗溃疡性结肠炎可以显著提高患者疗效,并且能够通过减少Resistin、YKL-40等炎性因子水平和增加PPARγ表达来缓解肠炎患者的炎症反应。

Objective To investigate the clincal efficacy and safety of sulfasalazine combined with compound glutamine in the treatment of ulcerative colitis and to investigate the changes of serum inflammatory factors resistin,chitinase 40(YKL-40),peroxisome proliferator-activated receptor(PPARγ).Methods Totally 120 patients with ulcerative colitis were randomly divided into control and treatment groups,60 cases in each group.Control group was given sulfasalazine,1 g each time,3 times a day oral.On the basis of control group,treatment group was given compound glutamine,1 g each time,3 times a day,and after half a month,the dose was reduced to 0.5 g each time,3 times a day,orally.Both groups was treatment for 2 months.The clincial efficacy,the changes in Mayo score,the levels of Resistin,YKL-40,PPARγand inflammatory factors in two groups were compared.Results After treatment,the total effective rates of treatment group and control group were 93.33%(56 cases/60 cases)and 60.00%(36 cases/60 cases),Mayo scores at 8 weeks were(5.07±2.08)and(7.40±2.14)points,the Resistin were(14.30±4.22)and(16.73±3.54)ng·mL^(-1),YKL-40 were(21.17±5.44)and(25.92±5.25)ng·mL^(-1),PPARγwere(47.19±3.63)%and(39.03±2.63)%,all with significant differences(all P<0.05).After treatment,the levels of inflammatory factors interleukin-6(IL-6),C reactive protein(CRP)and tumor necrosis factor-α(TNF-α)in treatment group were lower than those in control group,and the difference was statistically significant(all P<0.05).The incidence of adverse drug reactions in treatment group and control group were 8.33%and 6.67%,the difference was not statistically significant(P>0.05).Conclusion Sulfasalazine combined with compound glutamine can significantly improve the clincial effect of ulcerative colitis patients,and can relieve inflammatory reaction of enteritis by reducing the levels of inflammatory factors such as Resistin and YKL-40 and increasing the expression of PPARγ.