美沙拉秦灌肠液和地塞米松保留灌肠对远端溃疡性结肠炎患者的疗效比较

Comparison of the efficiency of mesalazine and dexamethasone enema on patients with distal ulcerative colitis

目的评价美沙拉秦灌肠液和地塞米松保留灌肠在远端溃疡性结肠炎中的疗效和不良反应。方法选取西安交通大学第二附属医院消化内科2019年1月至2020年12月治疗的86例轻中度溃疡性结肠炎患者作为研究对象,采用随机分组法将患者分为治疗组和对照组各43例。对照组采用每日1次美沙拉秦灌肠液睡前保留灌肠,对照组采用每日1次地塞米松睡前保留灌肠,2组均治疗4周。分别比较两组的症状消失时间、结肠镜下评分、血清炎性指标、Mayo评分及不良事件的发生。结果治疗组症状消失时间早于对照组[(16.3±6.3)d比(18.4±7.2)d],差异有统计学意义(P<0.05)。治疗4周后,治疗组与对照组肠镜下评分均较治疗前下降,且治疗组评分下降更多,[(2.95±2.17)比(3.27±2.31)],差异有统计学意义(P<0.05)。治疗后2组ESR、CRP水平较治疗前明显降低,且治疗组低于对照组,[(25.43±1.37)比(27.31±1.01)、(4.56±0.51)比(5.11±0.43)],差异有统计学意义(P<0.05)。Mayo评分较治疗前明显降低,且治疗组低于对照组[(1.87±1.76)比(2.11±1.58)],差异有统计学意义(P<0.05)。治疗组并发症的发生率低于对照组[14.0%(6/43)比16.3%(7/43)],差异有统计学意义(P<0.05)。结论相比较地塞米松,灌肠美沙拉秦灌肠液治疗轻中度溃疡性结肠炎,能更有效的缓解临床症状,降低炎症因子水平,减少并发症发生率,提高患者生活质量。

Objective To compare the efficacy and tolerance of mesalazine and dexamethasone enema in distal ulcerative colitis(UC)patients.Methods From January 2019 to December 2020,86 patients with mild to moderate left-sided ulcerative colitis treated in Department of Gastroenterology of the Second Affiliated Hospital of Xi’an Jiaotong university were selected.They were randomly divided into therapy group and control group,with 43 cases in each group.The therapy group was treated with mesalazine enema liquid retention enema before sleep,and the control group was treated with dexamethasone enema.Both groups were treated for 4weeks.The disappearance time of clinical symptoms,colonoscopy score,levels of inflammatory factors(ESR、CRP),Mayo score and complications were compared between the two groups.Results The disappearance time of clinical symptoms of the therapy group was earlier than that of the control group[(16.3±6.3)d vs(18.4±7.2)d](P<0.05).After treatment,the colonoscopy scores of the therapy group were lower than that of control group[(2.95±2.17)vs(3.27±2.31)],and those of the therapy group were lower than those of the control group(P<0.05).After treatment,the levels of ESR,CRP of the two groups were significantly lower than those before treatment[(25.43±1.37)vs(27.31±1.01),(4.56±0.51)vs(5.11±0.43)](all P<0.05).Mayo scores of both groups were significantly lower than those before treatment[(1.87±1.76)vs(2.11±1.58)],and those of the therapy group were lower than those of the control group(P<0.05).The incidence of complications of the therapy group was lower than that of the control group[14.0%(6/43)vs 16.3%(7/43)],and the difference was statistically significant(P<0.05).Conclusion Compare to dexamethasone enema,Mesalazine enema at intestines in the treatment of mild to moderate left-sided ulcerative colitis can effectively alleviate clinical symptoms,reduce the levels of pro-inflammatory factors,reduce the incidence of complications,and improve patients’quality of life.