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目的:美沙拉嗪和糖皮质激素是治疗溃疡性结肠炎的常用药物,本文的目的是通过研究单独使用美沙拉嗪或联合糖皮质激素治疗溃疡性结肠炎的临床对照研究。方法:通过研究2003～2008年郑州大学第二附属医院的68例溃疡性结肠炎轻度-中度患者,随机分为两组。每组患者为34例,平均年龄分别为47.10,44.12岁。其中一组患者单独使用美沙拉嗪3 g/d,Tid,4 w;另一组患者使用美沙拉嗪3 g/d,Tid和糖皮质激素(氢化考的松200 mg,i.v.gtt 3～7 d后,改为口服的泼尼松30 mg/d),4 w。治疗前后通过Trueloveand Witts病理诊断和分级参照标准进行临床治疗评估。结果:68名患者用药4 w后,单独使用美沙拉嗪的34例患者有70.58%得到了完全缓解;另外使用美沙拉嗪和糖皮质激素的34例患者有88.23%完全缓解。通过临床试验发现美沙拉嗪联合糖皮质激素组缓解率明显高于单独使用美沙拉嗪组(P<0.05);并且明显减少了脓血便次数(P<0.05)。结论:通过美沙拉嗪和糖皮质激素联合应用更有效的提高溃疡性结肠炎活动期缓解率,减少临床症状。
Aims: Mesalazine and glucocorticoids are commonly used in the treatment of ulcerative colitis. The purpose of this paper is to investigate the clinical controlled study of ulcerative colitis by using mesalazine alone or in combination with glucocorticoids. Methods: A total of 68 patients with mild-moderate ulcerative colitis in the Second Affiliated Hospital of Zhengzhou University from 2003 to 2008 were randomly divided into two groups. Each group of 34 patients, the average age were 47.10,44.12 years old. One group of patients received mesalazine 3 g / d, Tid 4 w alone; the other group received mesalazine 3 g / d, Tid and glucocorticoid (hydrocortisone 200 mg, ivgtt 3 to 7 d, changed to oral prednisone 30 mg / d), 4 w. Before and after treatment by Trueloveand Witts pathological diagnosis and classification of reference standard clinical evaluation. RESULTS: After 68 weeks of treatment, 70.58% of 34 patients treated with mesalazine alone achieved complete remission after 4 weeks. In addition, 34 patients treated with mesalazine and glucocorticoid achieved complete remission at 88.23%. Through clinical trials, the response rate of mesalazine and glucocorticoid group was significantly higher than that of mesalazine alone (P <0.05), and the number of sepsis was significantly reduced (P <0.05). Conclusion: The combination of mesalazine and glucocorticoid can effectively improve the remission rate of ulcerative colitis and reduce the clinical symptoms.