Background:Ulcerative colitis(UC)is a chronic lifelong disease.The disease extent of UC can progress over time.This study aimed to assess whether cumulative inflammatory burden(CIB)is associated with disease extension...Background:Ulcerative colitis(UC)is a chronic lifelong disease.The disease extent of UC can progress over time.This study aimed to assess whether cumulative inflammatory burden(CIB)is associated with disease extension in distal UC(proctitis[E1]and left-sided colitis[E2])patients,and to develop a quantified indicator of CIB.Methods:In this retrospective study based on a prospective registry,distal UC patients receiving colonoscopies in Xijing Hospital(Xi’an,China)fromJanuary 2000 to May 2019 were studied.We developed a new score,namely the time-adjusted average Mayo endoscopic score(TA-MES),calculated as dividing the sum of the cumulative averageMES over a period of surveillance time by the length of the endoscopic examination interval,to quantify the CIB.Cox regression was used to identify other potential risk factors.Results:A total of 295 UC patients were followed for 1,487.02 patient-years.Among them,140 patients(47.5%)experienced disease extension.Multivariate analysis showed that the TA-MES was significantly associated with disease extension in E1(hazard ratio[HR],2.90;95%confidence interval[CI],1.58–5.33,P=0.001)and E2(HR,1.89;95%CI,1.16–3.09,P=0.011)patients.Other risk factors included hemoglobin of<90 g/L and appendiceal skip inflammation;the protective factors included age,E2 at diagnosis,former smoking,and 5-aminosalicylic acid dose.Otherwise,MES at diagnosis,maximal MES,and mean MES failed to estimate the risk of disease extension.Conclusion:TA-MES is a good quantified indicator of CIB and is independently associated with increased disease extension in distal UC patients.Whether the dynamic multiple scoring system could be used as a risk factor in other chronic relapsing–remitting diseases is a direction for future research.展开更多
目的 探讨中药灌肠联合温针灸治疗远端结肠型溃疡性结肠炎的疗效。方法 将90例远端结肠型溃疡性结肠炎患者分为3组。在常规西药基础上,中药灌肠组予以中药灌肠,温针灸组予以温针灸治疗,联合治疗组则予以中药灌肠联合温针灸治疗。比较3...目的 探讨中药灌肠联合温针灸治疗远端结肠型溃疡性结肠炎的疗效。方法 将90例远端结肠型溃疡性结肠炎患者分为3组。在常规西药基础上,中药灌肠组予以中药灌肠,温针灸组予以温针灸治疗,联合治疗组则予以中药灌肠联合温针灸治疗。比较3组患者的临床疗效、生化指标及炎症因子水平、中医症状评分、结肠镜评分、结肠组织病理评分、黏膜愈合及复发情况、不良反应。结果 联合治疗组临床治疗总有效率显著高于中药灌肠组及温针灸组( P <0.05);联合治疗组治疗后白细胞计数(WBC)、血小板(PLT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)水平均显著低于中药灌肠组及温针灸组( P <0.05);联合治疗组治疗后中医症状评分、结肠镜评分、结肠组织病理评分均显著低于中药灌肠组及温针灸组( P < 0.05);联合治疗组黏膜愈合率、复发率均显著优于中药灌肠组及温针灸组( P <0.05);3组不良反应发生率差异无统计学意义( P >0.05)。结论 中药灌肠联合温针灸治疗远端结肠型慢性溃疡性结肠炎的疗效显著,可显著改善中医症状,降低生化指标与炎症因子水平。展开更多
基金supported by the National Natural Science Foundation of China[grant numbers 81421003,81627807,81772650,81322037,81572302]National Key Research and Development Plan of China[grant number 2017YFC0908300]Independent Funds of the Key Laboratory[grant number CBSKL2015Z01].
文摘Background:Ulcerative colitis(UC)is a chronic lifelong disease.The disease extent of UC can progress over time.This study aimed to assess whether cumulative inflammatory burden(CIB)is associated with disease extension in distal UC(proctitis[E1]and left-sided colitis[E2])patients,and to develop a quantified indicator of CIB.Methods:In this retrospective study based on a prospective registry,distal UC patients receiving colonoscopies in Xijing Hospital(Xi’an,China)fromJanuary 2000 to May 2019 were studied.We developed a new score,namely the time-adjusted average Mayo endoscopic score(TA-MES),calculated as dividing the sum of the cumulative averageMES over a period of surveillance time by the length of the endoscopic examination interval,to quantify the CIB.Cox regression was used to identify other potential risk factors.Results:A total of 295 UC patients were followed for 1,487.02 patient-years.Among them,140 patients(47.5%)experienced disease extension.Multivariate analysis showed that the TA-MES was significantly associated with disease extension in E1(hazard ratio[HR],2.90;95%confidence interval[CI],1.58–5.33,P=0.001)and E2(HR,1.89;95%CI,1.16–3.09,P=0.011)patients.Other risk factors included hemoglobin of<90 g/L and appendiceal skip inflammation;the protective factors included age,E2 at diagnosis,former smoking,and 5-aminosalicylic acid dose.Otherwise,MES at diagnosis,maximal MES,and mean MES failed to estimate the risk of disease extension.Conclusion:TA-MES is a good quantified indicator of CIB and is independently associated with increased disease extension in distal UC patients.Whether the dynamic multiple scoring system could be used as a risk factor in other chronic relapsing–remitting diseases is a direction for future research.
文摘目的 探讨中药灌肠联合温针灸治疗远端结肠型溃疡性结肠炎的疗效。方法 将90例远端结肠型溃疡性结肠炎患者分为3组。在常规西药基础上,中药灌肠组予以中药灌肠,温针灸组予以温针灸治疗,联合治疗组则予以中药灌肠联合温针灸治疗。比较3组患者的临床疗效、生化指标及炎症因子水平、中医症状评分、结肠镜评分、结肠组织病理评分、黏膜愈合及复发情况、不良反应。结果 联合治疗组临床治疗总有效率显著高于中药灌肠组及温针灸组( P <0.05);联合治疗组治疗后白细胞计数(WBC)、血小板(PLT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)水平均显著低于中药灌肠组及温针灸组( P <0.05);联合治疗组治疗后中医症状评分、结肠镜评分、结肠组织病理评分均显著低于中药灌肠组及温针灸组( P < 0.05);联合治疗组黏膜愈合率、复发率均显著优于中药灌肠组及温针灸组( P <0.05);3组不良反应发生率差异无统计学意义( P >0.05)。结论 中药灌肠联合温针灸治疗远端结肠型慢性溃疡性结肠炎的疗效显著,可显著改善中医症状,降低生化指标与炎症因子水平。
