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【摘要】 目的：研究保留灌腸联合美沙拉嗪治疗活动期溃疡性结肠炎TNF-α、IL-8及预后的影响。方法：选择2016年1月-2017年1月笔者所在医院收治的99例活动期溃疡性结肠炎进行研究分析，按照抛硬币法将其分为观察组（50例）和对照组（49例），对照组患者给予口服美沙拉嗪治疗，4次/d，1.0 g/次，而观察组则在对照组治疗的基础上增加保留灌肠治疗，两组患者的治疗疗程均为2个月。比较分析两组患者治疗前后血清中TNF-α、IL-8的变化情况，以及治疗前后的Baron评分、IBDQ评分、中医证候积分和临床效果。结果：观察组患者的总有效率为96.0%，高于对照组的77.6%，差异有统计学意义（P<0.05）;治疗后，观察组治疗后腹痛、腹泻、黏液血便等中医证候积分、Baron评分、血清中TNF-α及IL-8水平均显著低于对照组，差异均有统计学意义（P<0.05）;观察组治疗后情感功能、社会功能、肠道症状及全身症状评分均显著高于对照组，差异均有统计学意义（P<0.05）。结论：保留灌肠联合美沙拉嗪治疗活动期溃疡性结肠炎的临床效果显著，不仅能有效改善患者血清中TNF-α、IL-8表达水平，而且还能显著改善患者的生命体征及预后。

【关键词】 保留灌肠 美沙拉嗪 活动期溃疡性结肠炎 TNF-α IL-8

doi：10.14033/j.cnki.cfmr.2019.28.001 文献标识码 A 文章编号 1674-6805（2019）28-000-04

Expression of TNF-α and IL-8 in Patients with Active Ulcerative Colitis Treated with Enema Combined with Mesalazine and Its Effect on Prognosis/ZHANG Jianrong， ZENG Huan. //Chinese and Foreign Medical Research， 2019， 17（28）： -4

[Abstract] Objective： To study the effects of retention enema combined with Mesalazine on TNF-α， IL-8 and prognosis in patients with active ulcerative colitis. Method： Ninety-nine patients with active ulcerative colitis treated in our hospital from January 2016 to January 2017 were selected and divided into observation group （50 cases） and control group （49 cases） according to the coin method. The control group was given oral administration of Mesalazine， 4 times per day， 1.0 g for once time. On this basis， the observation group combined retention enema treatment. The two groups of patients were treated for two months. The serum TNF-α and IL-8 in the patients before and after treatment， the Baron score， IBDQ score， TCM syndrome score and clinical effect before and after treatment were compared between the two groups. Result： The total effective rate was 96.0%， which was higher than 77.6% in the control group， the difference was statistically significant （P<0.05）. The  TCM syndrome scores such as abdominal pain， diarrhea， mucus and blood stool， the levels of serum TNF-α and IL-8 after treatment were significantly lower than those in the control group， the differences were statistically significant （P<0.05）. The scores of affective function， social function， intestinal symptoms and systemic symptoms were significantly higher in the observation group than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： Retention enema combined with Mesalazine in the treatment of active ulcerative colitis has a significant clinical effect， not only can improve the serum TNF-α， IL-8 expression levels， but also can significantly improve the patients vital signs and prognosis.

[Key words] Retention enema Mesalazine Active ulcerative colitis TNF-α IL-8

First-authors address： Wuwei Peoples Hospital， Wuwei 733000， China

潰疡性结肠炎是一种直肠和结肠的非特异性肠炎，其具体由何种原因导致而成，临床尚未完全明确，该病症多局限于直结肠和黏膜下层，且在活动期最主要的临床表现就是腹痛、腹泻及黏液血便等，同时也有不同程度的全身症状发生，溃疡性结肠炎具有发病率高、病程长、难根治的特点[1-2]，故该病症严重影响患者的身心健康及生活质量，相关研究表明，在溃疡性结肠炎中促炎与抗炎细胞因子失去平衡将直接影响该病症的发生及发展情况，但临床常规使用的免疫抑制剂及糖皮质激素药物均对患者有不同程度的副作用，且一旦停止用药，病情就容易复发[3]。国内研究表明，美沙拉嗪也逐步用于治疗溃疡性结肠炎之中，但单纯使用该药物的临床效果也不是很理想[4]。……