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目的观察美沙拉嗪肠溶片与硫唑嘌呤治疗激素抵抗型重症溃疡性结肠炎的临床疗效。方法 80例激素抵抗型重症溃疡性结肠炎随机分为对照组和试验组,每组40例。对照组口服硫唑嘌呤,每次100 mg,每天3次;试验组口服美沙拉嗪肠溶片,每次1 g,每天3次。2组疗程均为1个月。比较2组患者的临床疗效、临床应答情况、内镜下肠黏膜愈合情况、Mayo评分和实验室检查结果等。结果试验组总有效率为87.50%(35/40例),对照组总有效率为57.50%(23/40例),差异有统计学意义(P<0.05)。治疗后,试验组Mayo评分为(3.62±1.21)分,对照组为(3.92±1.53)分,差异无统计学意义(P>0.05);试验组平均腹泻次数为(2.52±1.34)次,对照组为(5.63±1.51)次,差异有统计学意义(P<0.05)。治疗后,试验组C-反应蛋白为(10.45±2.15)mg·L~(-1),红细胞沉降率(ESR)为(23.62±6.25)mm·h-1,对照组C-反应蛋白为(15.57±3.45)mg·L~(-1),ESR为(32.54±5.83)mm·h-1(P<0.05)。试验组出现白细胞计数减少2例,脱发1例,肝功能损伤1例,药物不良反应发生率为10.00%(4/40例);对照组出现白细胞计数减少4例,脱发2例,肝功能损伤3例,药物不良反应发生率为22.50%(9/40例),差异无统计学意义(P>0.05)。结论美沙拉嗪治疗激素抵抗型重症溃疡性结肠炎临床疗效较好,能有效控制炎症,极大提高患者的生存质量。
Objective To observe the clinical efficacy of mesalazine enteric-coated tablets and azathioprine in the treatment of steroid-resistant ulcerative colitis. Methods Eighty patients with steroid resistant severe ulcerative colitis were randomly divided into control group and trial group, 40 cases in each group. The control group oral azathioprine, each 100 mg, 3 times a day; test group oral mesalazine enteric-coated tablets, each 1 g, 3 times a day. 2 groups of treatment are 1 month. The clinical efficacy, clinical response, endoscopic intestinal mucosa healing, Mayo score and laboratory test results were compared between the two groups. Results The total effective rate was 87.50% (35/40) in the experimental group and 57.50% (23/40 cases) in the control group, the difference was statistically significant (P <0.05). After treatment, the Mayo score was (3.62 ± 1.21) in the test group and (3.92 ± 1.53) in the control group, with no significant difference (P> 0.05). The average number of diarrhea in the test group was (2.52 ± 1.34) Group (5.63 ± 1.51) times, the difference was statistically significant (P <0.05). The levels of C-reactive protein in test group were (10.45 ± 2.15) mg · L -1, erythrocyte sedimentation rate (ESR) was (23.62 ± 6.25) mm · h -1, 15.57 ± 3.45) mg · L -1, ESR was (32.54 ± 5.83) mm · h -1 (P <0.05). There were 2 cases of white blood cell count loss, 1 case of alopecia, 1 case of liver dysfunction, and 10.00% (4/40 cases) of adverse reactions in the test group. In the control group, there were 4 cases of white blood cell count loss, 2 cases of hair loss and liver injury 3 cases, the incidence of adverse drug reactions was 22.50% (9/40 cases), the difference was not statistically significant (P> 0.05). Conclusion Mesalazine is effective in treating hormone-refractory ulcerative colitis. It can effectively control the inflammation and greatly improve the quality of life of patients.