柳氮磺吡啶结合地塞米松保留灌肠对中轻度溃疡性直乙状结肠炎疗效的影响
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摘要
目的评价柳氮磺吡啶结合地塞米松保留灌肠对中轻度溃疡性直乙状结肠炎疗效的影响。方法选择2014年10月至2016年11月唐山市中医医院治疗的溃疡性直乙状结肠炎病人100例,按随机数字表法分为两组,灌肠组50例病人采用柳氮磺吡啶结合地塞米松保留灌肠治疗,对照组50例病人采用口服柳氮磺吡啶治疗,比较两组病人治疗前后及治疗后2个月的疾病活动度(DAI)评分,比较两组治疗疗效及不良反应发生情况。结果两组治疗后及治疗后2个月的DAI水平较治疗前有较大幅度的下降,灌肠组在治疗后[(5.83±1.24)分]及治疗后2个月[(2.48±0.98)分]的DAI水平显著优于对照组[(4.71±1.12)、(3.86±1.04)分],差异有统计学意义(F_(组间)=3.39,P=0.031;F_(时间点)=10.23,P=0.000;F_(交互作用)=3.43,P=0.034);经过8周的治疗,灌肠组病人治疗有效率为96%,显著高于对照组84%的有效率(χ~2=4.000,P=0.046);灌肠组不良反应发生率为10%,显著低于对照组的28%(χ~2=5.263,P=0.022)。结论柳氮磺吡啶结合地塞米松保留灌肠治疗中轻度溃疡性直乙状结肠炎起效快,效果好,不良反应少,值得临床推广。
Objective To evaluate the efficacy of Sulfasalazine combined with Dexamethasone retention enema in the treatment of mild ulcerative anal-sigmoid colitis.Methods One hundred patients with ulcerative anal-sigmoid colitis who were treated in Tangshan Traditional Chinese Medicine Hospital from October 2014 to November 2016 were enrolled.According to the random number table method,patients were randomly assigned into two groups.Fifty cases in the enema group were treated with willow nitrogen sulfonyl pyridine combined with Dexamethasone retention enema,while 50 cases in the control group were treated with oral willow nitrogen sulfonyl pyridine.The disease activity index(DAI) scores of the two groups before and after treatment and 2 months after treatment,the curative effect and adverse reactions of the two groups were compared.Results The DAI levels of the two groups after treatment and 2 months after treatment were significantly lower than those before treatment.The levels of DAI in the enema group after treatment and 2 months after treatment were significantly higher than those in the control group [(5.83±1.24) points vs.(4.71±1.12) points,(5.83±1.24) points vs.(3.86±1.04) points,respectively],and the difference was statistically significant(F_(groups)=3.39,P=0.031;F_(time)=10.23,P=0.000;F_(Interaction effect)=3.43,P=0.034).After 8 weeks of treatment,the effective rate of the enema group was 96%,which was significantly higher than 84% of the control group(χ~2=4.000, P=0.046).The incidence of adverse reactions in enema group was 10%,which was significantly lower than 28% of the control group(χ~2=5.263,P=0.022).Conclusions Sulfasalazine combined with Dexamethasone retention enema in the treatment of mild ulcerative anal-sigmoid colitis has rapid effect,good efficacy and few adverse reactions,which is worthy of clinical promotion.
Objective To evaluate the efficacy of Sulfasalazine combined with Dexamethasone retention enema in the treatment of mild ulcerative anal-sigmoid colitis.Methods One hundred patients with ulcerative anal-sigmoid colitis who were treated in Tangshan Traditional Chinese Medicine Hospital from October 2014 to November 2016 were enrolled.According to the random number table method,patients were randomly assigned into two groups.Fifty cases in the enema group were treated with willow nitrogen sulfonyl pyridine combined with Dexamethasone retention enema,while 50 cases in the control group were treated with oral willow nitrogen sulfonyl pyridine.The disease activity index(DAI) scores of the two groups before and after treatment and 2 months after treatment,the curative effect and adverse reactions of the two groups were compared.Results The DAI levels of the two groups after treatment and 2 months after treatment were significantly lower than those before treatment.The levels of DAI in the enema group after treatment and 2 months after treatment were significantly higher than those in the control group [(5.83±1.24) points vs.(4.71±1.12) points,(5.83±1.24) points vs.(3.86±1.04) points,respectively],and the difference was statistically significant(F_(groups)=3.39,P=0.031;F_(time)=10.23,P=0.000;F_(Interaction effect)=3.43,P=0.034).After 8 weeks of treatment,the effective rate of the enema group was 96%,which was significantly higher than 84% of the control group(χ~2=4.000, P=0.046).The incidence of adverse reactions in enema group was 10%,which was significantly lower than 28% of the control group(χ~2=5.263,P=0.022).Conclusions Sulfasalazine combined with Dexamethasone retention enema in the treatment of mild ulcerative anal-sigmoid colitis has rapid effect,good efficacy and few adverse reactions,which is worthy of clinical promotion.
引文
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[11] 洪振宇.西医治疗溃疡性结肠炎的现状和进展[J].中国医药指南,2013,11(3):43-44.
[12] 张腾腾,顾康生.GLD与CHOP方案一线治疗外周T细胞淋巴瘤的疗效分析[J].安徽医药,2016,20(2):287-290.
[13] 杨荣梅.地塞米松联合柳氮磺吡啶灌肠治疗溃疡性结肠炎临床分析[J].黑龙江医药,2015,28(2):342-343.
[14] 马维雄.美沙拉嗪与柳氮磺吡啶治疗溃疡性结肠炎的临床疗效对比[J].临床医学研究与实践,2017,2(4):35-36.
[15] 张艳.改进保留灌肠方法对提高溃疡性结肠炎疗效的临床价值[J].现代医学,2014,42(10):1207-1209.
[16] 张明安.苦参黄连汤加地塞米松保留灌肠联合柳氮磺胺吡啶治疗溃疡性结直肠炎随机平行对照研究[J].实用中医内科杂志,2013,27(3S):75-76.
[17] 李宜华.美沙拉嗪与柳氮磺吡啶治疗溃疡性结肠炎的效果及安全性比较[J].中国当代医药,2014,21(7):57-59.
[2] 杨春梅.溃疡性直肠炎患者血清中γ-谷氨酰转肽酶水平与炎症的关系[J].标记免疫分析与临床,2017,24(6):635-638.
[3] 朱维铭,胡品津,龚剑峰.炎症性肠病营养支持治疗专家共识(2013·深圳)[J].胃肠病学,2015,20(2):97-105.
[4] 陈勇华,曹群奋,洪琼怪,等.黄芩汤辅助柳氮磺吡啶对溃疡性结肠炎患者血清TNF-α及白介素族水平影响研究[J].中华中医药学刊,2017,35(2):500-503.
[5] 王丽萍,马俊,宁晓梅.柳氮磺胺吡啶结合双料喉风散保留灌肠对溃疡性直乙状结肠炎疗效的影响[J].实用医学杂志,2013,29(12):2032-2034.
[6] 钟海彬.柳氮磺吡啶治疗溃疡性结肠炎的疗效观察[J].中国实用医药,2016,11(4):190-191.
[7] 欧雁方.活动期炎症性肠病患者英夫利西单抗治疗前后的外周血淋巴细胞亚群状况研究[J].安徽医药,2015,19(7):1387-1390.
[8] 胡中奎.溃疡性结肠炎患者46例治疗效果观察[J].临床医学研究与实践,2016,1(13):59,61.
[9] 范治国.溃疡性结肠炎的药物治疗研究进展[J].中国药房,2013,24(46):4387-4389.
[10] 周洪美,刘秀珍,牟文芝,等.益生菌联合柳氮磺胺吡啶灌肠治疗溃疡性结肠炎的临床观察[J].中华临床医师杂志(电子版),2010,4(9):1671-1672.DOI:10.3877 /cma.j.issn.1674-0785.2010.09.042.
[11] 洪振宇.西医治疗溃疡性结肠炎的现状和进展[J].中国医药指南,2013,11(3):43-44.
[12] 张腾腾,顾康生.GLD与CHOP方案一线治疗外周T细胞淋巴瘤的疗效分析[J].安徽医药,2016,20(2):287-290.
[13] 杨荣梅.地塞米松联合柳氮磺吡啶灌肠治疗溃疡性结肠炎临床分析[J].黑龙江医药,2015,28(2):342-343.
[14] 马维雄.美沙拉嗪与柳氮磺吡啶治疗溃疡性结肠炎的临床疗效对比[J].临床医学研究与实践,2017,2(4):35-36.
[15] 张艳.改进保留灌肠方法对提高溃疡性结肠炎疗效的临床价值[J].现代医学,2014,42(10):1207-1209.
[16] 张明安.苦参黄连汤加地塞米松保留灌肠联合柳氮磺胺吡啶治疗溃疡性结直肠炎随机平行对照研究[J].实用中医内科杂志,2013,27(3S):75-76.
[17] 李宜华.美沙拉嗪与柳氮磺吡啶治疗溃疡性结肠炎的效果及安全性比较[J].中国当代医药,2014,21(7):57-59.