蒋琦 刘怡 吴巧艳 胡春玖 胡祺英 姚雪洁

[摘要] 目的 觀察美沙拉嗪结合益生菌用于治疗溃疡性结肠炎的疗效。 方法 随机选取2015年5月～2017年5月我院收治的溃疡性结肠炎患者60例，依据治疗方法不同分为美沙拉嗪结合益生菌治疗组（结合治疗组，n=30）和美沙拉嗪单独治疗组（单独治疗组，n=30）两组，统计分析两组患者的临床症状评分、内镜下评分、血清CRP水平、临床疗效、不良反应发生情况及复发情况。 结果 与治疗前比较，两组患者治疗后的临床症状评分、内镜下评分、血清CRP水平均显著降低（P<0.05）；治疗后与单独治疗组比较，结合治疗组患者的临床症状评分、内镜下评分、血清CRP水平均显著降低（P<0.05）。结合治疗组患者治疗的总有效率93.3%（28/30）显著高于单独治疗组63.3%（19/30）（P<0.05），复发率13.3%（4/30）显著低于单独治疗组33.3%（10/30）（P<0.05），但两组患者的不良反应发生率6.7%（2/30）、10.0%（3/30）比较，差异不显著（P>0.05）。 结论 美沙拉嗪结合益生菌用于治疗溃疡性结肠炎的疗效较美沙拉嗪单独治疗显著，同时还更能有效改善患者临床症状，降低患者血清CRP水平、复发率，且不良反应少，值得在临床推广应用。

[关键词] 美沙拉嗪；益生菌；溃疡性结肠炎；不良反应

[中图分类号] R574.62 [文献标识码] B [文章编号] 1673-9701（2018）15-0037-04

Observation on the curative effect of mesalazine combined with probiotics in the treatment of ulcerative colitis

JIANG Qi LIU Yi WU Qiaoyan HU Chunjiu HU Qiying YAO Xuejie

Department of Gastroenterology， Ningbo First Hospital， Ningbo 315010， China

[Abstract] Objective To observe the efficacy of mesalazine combined with probiotics in the treatment of ulcerative colitis. Methods 60 patients with ulcerative colitis who were admitted to our hospital from May 2015 to May 2017 were selected randomly. These patients were divided into two groups according to the treatment method： mesalamine combined with probiotic group（combination therapy group， n=30） and mesalamine alone treatment group （n=30）. The clinical symptom score， endoscopic score， serum CRP level， clinical efficacy， incidence of adverse reactions and recurrence in both groups were statistically analyzed. Results Compared with those before treatment， the clinical symptom score， endoscopic score and serum CRP level were significantly lower in both groups after treatment（P<0.05）； After treatment， clinical symptom score， endoscopic score and serum CRP level were significantly lower in the combination therapy group than those in the treatment alone group（P<0.05）. The total effective rate in the combination therapy group was 93.3%（28/30）， significantly higher than 63.3%（19/30） in the treatment alone group（P<0.05）. The recurrence rate was 13.3%（4/30）， significantly lower than that of 33.3%（10/30） in the treatment alone group（P<0.05）. However， the incidence rates of adverse reactions in the two groups was 6.7%（2/30） and 10.0%（3/30） respectively， which were not significantly different（P>0.05）. Conclusion The efficacy of mesalazine combined with probiotics in the treatment of ulcerative colitis is more significant than that of mesalazine alone. At the same time， it is also more effective in improving the clinical symptoms， reducing the serum CRP level and recurrence rate in the patients， and will not increase the patients' adverse reactions to a great extent， so it is worthy of promotion and application in clinical settings.

[Key words] Mesalazine； Probitics； Ulcerative colitis； Adverse reactions

溃疡性结肠炎常发生在直肠及结肠部位，属于一种慢性、非特异性、炎性反应性疾病，腹痛、腹泻、便血等是其主要临床症状，其具体发病机制尚不完全明确[1]。通常情况下，溃疡性结肠炎患者有腹泻、黏液血便等病史，若没有得到及时有效的治疗，则会发生继发性感染，严重的情况下还可能有器质性病变向结肠肿瘤转化等恶性后果发生[2]。近年来，研究表明[3]，肠道菌群失调可能影响溃疡性结肠炎的发病，而益生菌能够缓解临床症状。在溃疡性结肠炎的治疗中，美沙拉嗪是临床常用药物之一，有文献报道显示[4]，美沙拉嗪结合益生菌治疗溃疡性结肠炎临床疗效显著。……