美沙拉嗪、枯草杆菌二联活菌肠溶胶囊联合用于轻、中度溃疡性结肠炎患者的疗效观察
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摘要
目的探讨枯草杆菌二联活菌肠溶胶囊、美沙拉嗪联合治疗轻、中度溃疡性结肠炎(UC)患者的临床价值。方法选择2017年3月至2018年1月入我院治疗的74例轻、中度UC患者,随机分为对照组37例(美沙拉嗪治疗)和观察组37例(美沙拉嗪+枯草杆菌二联活菌肠溶胶囊治疗),观察两组患者症状缓解、相关检验指标改善等情况。结果治疗后,观察组患者IL-17、IL-23、TNF-α、CRP、IgG、IgA水平均显著低于对照组(P<0.05),腹痛、腹泻、黏液脓血便缓解时间均显著短于对照组,Rachmilewitz评分低于对照组(P<0.05);观察组治疗总有效率(97.30%)显著高于对照组(81.08%)(χ~2=5.045,P<0.05),两组不良反应总发生率比较差异无统计学意义(χ~2=0.16,P>0.05)。结论联合使用美沙拉嗪、枯草杆菌二联活菌肠溶胶囊治疗轻、中度UC,可有效减轻炎症反应,改善机体免疫功能,使患者临床症状获得更快改善,总疗效更优。
Objective To explore the clinical value of Bacillus subtilis and Enterococcus faecium enteric-coated capsules combined with mesalazine in the treatment of mild to moderate ulcerative colitis(UC).Methods Totally 74 patients with mild to moderate UC admitted to our hospital from March 2017 to January 2018 were randomly divided into control group(n=37,treated with mesalazine) and observation group(n=37,treated with mesalazine+Bacillus subtilis and Enterococcus faecium enteric-coated capsules).The relief of symptoms and improvement of related test indexes of the two groups were observed.Results After treatment,the levels of IL-17,IL-23,TNF-α,CRP,IgG and IgA in observation group were significantly lower than those in control group(P<0.05).The relief time of abdominal pain,diarrhea,mucus,pus and blood stool in observation group was significantly shorter than that in control group.Rachmilewitz score was lower than that in control group(P<0.05).The total effective rate of observation group(97.30%) was significantly higher than that of control group(81.08%)(χ~2=5.05,P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(χ~2=0.16,P>0.05).Conclusion The combined use of mesalazine with Bacillus subtilis and Enterococcus faecium enteric-coated capsules in the treatment of mild to moderate UC can effectively alleviate inflammation,improve immune function,and improve the clinical symptoms of patients faster,with better overall efficacy.
Objective To explore the clinical value of Bacillus subtilis and Enterococcus faecium enteric-coated capsules combined with mesalazine in the treatment of mild to moderate ulcerative colitis(UC).Methods Totally 74 patients with mild to moderate UC admitted to our hospital from March 2017 to January 2018 were randomly divided into control group(n=37,treated with mesalazine) and observation group(n=37,treated with mesalazine+Bacillus subtilis and Enterococcus faecium enteric-coated capsules).The relief of symptoms and improvement of related test indexes of the two groups were observed.Results After treatment,the levels of IL-17,IL-23,TNF-α,CRP,IgG and IgA in observation group were significantly lower than those in control group(P<0.05).The relief time of abdominal pain,diarrhea,mucus,pus and blood stool in observation group was significantly shorter than that in control group.Rachmilewitz score was lower than that in control group(P<0.05).The total effective rate of observation group(97.30%) was significantly higher than that of control group(81.08%)(χ~2=5.05,P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(χ~2=0.16,P>0.05).Conclusion The combined use of mesalazine with Bacillus subtilis and Enterococcus faecium enteric-coated capsules in the treatment of mild to moderate UC can effectively alleviate inflammation,improve immune function,and improve the clinical symptoms of patients faster,with better overall efficacy.
引文
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[9]窦红宇,孙滨滨,丁珂,等.美沙拉嗪口服联合龙血竭散灌肠治疗溃疡性结肠炎疗效及对患者生活质量的影响[J].中国现代医学杂志,2014,24(34):81-85.
[10]张利利,赵英政,常廷民,等.枯草杆菌二联活菌胶囊对溃疡性结肠炎患者Th17/Treg细胞表达的影响[J].广东医学,2014,35(3):448-450.
[11]Song EM,Lee HS,Park SH,et al.Clinical characteristics and long-term prognosis of elderly onset ulcerative colitis[J].JGastroenterol Hepatol,2018,33(1):172-179.
[12]梁勇,颜丽萍,苏林,等.枯草杆菌二联活菌对溃疡性结肠炎大鼠的作用及机制[J].中国老年学杂志,2017,37(1):27-29.
[2]程华,李雪梅,杨爱萍,等.美沙拉嗪治疗溃疡性结肠炎的临床疗效及对ESR,PLT,D-二聚体影响的多中心研究[J].中国生化药物杂志,2014,3(9):134-136,139.
[3]牛斌斌,叶树凤,陈宝余,等.美沙拉嗪颗粒联合康复新液治疗溃疡性结肠炎的Meta分析[J].中成药,2014,36(11):2275-2279.
[4]Castelli AA,Estrada JJ,Kaminski JP.Patient with ulcerative colitis and abdominal pain[J].JAM A Surg,2018,153(3):642-643.
[5]刘凯,熊晶晶,刘梅,等.酪酸梭菌、美沙拉嗪、蒙脱石散对溃疡性结肠炎大鼠血IL-6、IL-8、IL-10及TNF-α水平的影响[J].免疫学杂志,2015,31(11):931-936.
[6]周全魁,龚杰.美沙拉嗪和柳氮磺吡啶对溃疡性结肠炎患者肠黏膜中TLR4和NF-κb表达的影响[J].中国现代医学杂志,2015,25(1):34-36.
[7]Stawowczyk E,Kawalec P.A systematic review of the cost-effectiveness of biologics for ulcerative colitis[J].Pharmacoeconomics,2018,36(4):419-434.
[8]牟海军,陈幸幸,周光群,等.美沙拉嗪肠溶片治疗激素抵抗型重症溃疡性结肠炎的临床研究[J].中国临床药理学杂志,2016,32(21):1950-1952,1963.
[9]窦红宇,孙滨滨,丁珂,等.美沙拉嗪口服联合龙血竭散灌肠治疗溃疡性结肠炎疗效及对患者生活质量的影响[J].中国现代医学杂志,2014,24(34):81-85.
[10]张利利,赵英政,常廷民,等.枯草杆菌二联活菌胶囊对溃疡性结肠炎患者Th17/Treg细胞表达的影响[J].广东医学,2014,35(3):448-450.
[11]Song EM,Lee HS,Park SH,et al.Clinical characteristics and long-term prognosis of elderly onset ulcerative colitis[J].JGastroenterol Hepatol,2018,33(1):172-179.
[12]梁勇,颜丽萍,苏林,等.枯草杆菌二联活菌对溃疡性结肠炎大鼠的作用及机制[J].中国老年学杂志,2017,37(1):27-29.