Sulphasalazine retention enemas in ulcerative colitis: a double-blind trial

Thirty-four patients with ulcerative colitis completed a double-blind assessment comparing the efficacy of two weeks of treatment with nightly retention enemas containing 3 g sulphasalazine or placebo. Symptom grading, sigmoidoscopic appearance, rectal biopsy specimens, and diary records were used to assess benefit and side effects. The active drug conferred significant benefit compared with placebo as shown by several criteria, but this benefit was confined to patients not already taking sulphasalazine by mouth. Overall assessment showed improvement in 11 of the 16 patients (70%) given the active treatment but in only two of the 18 (11%) given placebo. No side effects attributable to the drug were observed, even in patients previously intolerant to oral preparations. The logical therapeutic role of sulphasalazine enemas in ulcerative colitis would appear to be in patients who experience side effects such as nausea, abdominal discomfort, or headaches when taking the drug by mouth.     

奥沙拉嗪联合蒙脱石散灌肠治疗溃疡性结肠炎疗效观察

目的：研究奥沙拉嗪联合蒙脱石散灌肠治疗活动期溃疡性结肠炎疗效。方法：将74例活动期左半溃疡性结肠炎患者分成联合灌肠组与对照组,每组均给予2.0g奥沙拉嗪,联合灌肠组灌肠液中加入1.0g蒙脱石散。每2周复查并记录大便性状、血生化检查、腹部体征以及症状变化,每4周复查结肠镜及病理组织学检查。结果：治疗8周后联合灌肠组30例显效（81.1%）,对照组22例显效（59.5%）,两组中未见无效病例。结论：奥沙拉嗪联合蒙脱石散灌肠治疗活动期左半溃疡性结肠炎疗效显著,增加了患者的依从性。     

奥沙拉嗪钠胶囊治疗溃疡性结肠炎的临床疗效

目的　以柳氮磺胺吡啶 (SASP)片对照 ,观察奥沙拉嗪钠胶囊治疗溃疡性结肠炎 (活动期 )的疗效及不良反应。方法　采用随机、双盲对照的设计进行临床试验。试验组 31例病人口服奥沙拉嗪钠胶囊每次 4粒 ,一日 2次 ,模拟SASP片每次 4片 ,一日 4次 ;对照组 2 7例病人口服SASP片每次 4片 ,一日 4次 ,模拟奥沙拉嗪钠胶囊每次 4粒 ,一日 2次。疗程 8周。结果　试验组 31例病人 8周后近期治愈 13例、显效 9例、有效 3例、无效6例 ,总有效率 70 .97% ( 2 2 / 31) ;对照组 2 5例病人 (包括 2 4例完成病例和 1例因无效脱落的病例 ) 8周后近期治愈 5例、显效 10例、有效 3例、无效 7例 ,总有效率 6 0 % ( 15 / 2 5 )。试验组 31例溃疡性结肠炎病人有 3例发生不良反应 ,不良反应发生率为 9.6 8% ;对照组 2 6例溃疡性结肠类病人 (包括 2 4例完成病例和 2例有不良反应的脱落病例 ) ,有 7例发生不良反应 ,不良反应发生率为 2 6 .92 %。两组不良反应发生率无统计学意义。结论　奥沙拉嗪钠胶囊治疗溃疡性结肠炎疗效与SASP相似     

奥沙拉嗪口服联合灌肠治疗溃疡性结肠炎疗效观察

目的观察奥沙拉嗪胶囊口服联合保留灌肠治疗溃疡性结肠炎（UC）的疗效和安全性。方法71例UC患者随机分为A（37例）、B（34例）两组,分别给予奥沙拉嗪和艾迪莎口服联合保留灌肠,给药4周。结果治疗后两组症状均显著改善（P〈0．05）,A组腹痛、腹泻及黏液血便的改善情况虽优于B组,但差异均无统计学意义（P〉0．05）;A组总有效率虽高于B组（95．9％vs91．2％）,但差异无统计学意义（P〉0．05）,但A组显效率显著高于B组（51．4％vs41．2％）（P〈0．05）;无严重不良反应。结论奥沙拉嗪和艾迪莎口服联合保留灌肠均有较好疗效,但奥沙拉嗪又表现出可提高显效率的优势。     

培菲康联合奥沙拉嗪治疗溃疡性结肠炎疗效观察

目的观察培菲康联合奥沙拉嗪治疗溃疡性结肠炎的临床疗效。方法肠镜确诊43例轻、中度溃疡性结肠炎患者随机分为治疗组(22例)和对照组(21例)。治疗组给予培菲康420 mg,口服,3次/d;奥沙拉嗪1.0,口服,4次/d。对照组予奥沙拉嗪1.0,口服,4次/d;疗程均为8周。治疗后,进行症状评分,复查肠镜取病理观察组织学变化。结果显效率、总有效率治疗组分别为40.9%和90.9%,对照组分别为28.6%和76.2%,经χ2检验差异均有显著意义(P<0.05)。结论培菲康联合奥沙拉嗪治疗溃疡性结肠炎的疗效优于单用奥沙拉嗪。     

复方5-氨基水杨酸控释胶囊治疗溃疡性结肠炎340例观察

目的 :为了探讨溃疡性结肠炎的药疗方案。方法 :对 380例溃疡性结肠炎病人分别接受复方 5 -氨基水杨酸 (5 -ASA)控释胶囊口服和安慰剂胶囊口服。结果 :疗效统计表明 :5 - ASA治疗组和安慰剂对照组的完全缓解率分别为 70 %和 10 % ,具有统计学意义 (P<0 .0 0 1) ;两组病人的溃疡性结肠炎活动指数下降分别为 1.5± 1.5和 7.6± 1.2 ,同样具有统计学意义 (P<0 .0 0 1)。结论 :5 - ASA控释胶囊口服对溃疡性结肠炎有理想的疗效。     

乌梅汤治疗溃疡性结肠炎70例分析

[目的]观察乌梅汤治疗溃疡性结肠炎的临床疗效。[方法]将70例溃疡性结肠炎(UC)患者随机分成2组,对照组采用奥沙拉秦胶囊0.5g/次,3次/d口服。治疗组在对照组用药的基础上加用乌梅汤治疗,观察比较两组的疗效。[结果]治疗8周后,治疗组的显效率及总有效率均高于对照组(P<0.05),而两组不良反应无统计学差异(P>0.05)。治疗后血红蛋白(Hgb)较治疗前明显上升、血沉(ESR)、C反应蛋白(CRP)较治疗前显著下降(P<0.01),而治疗组较对照组疗效更显著(P<0.01)。[结论]中西医结合治疗溃疡性结肠炎是一种安全有效的临床方法。     

美沙拉嗪联合灌肠综合治疗慢性溃疡性结肠炎的疗效观察

目的观察美沙拉嗪结合灌肠治疗慢性溃疡性结肠炎的临床疗效。方法将40例患者随机分为两组,每组各20例。对照组给予柳氮磺吡啶1 g/次,4次/d;治疗组给予美沙拉嗪口服,1 g/次,3次/d,同时配合灌肠（将庆大霉素16万U、思密达6 g及地塞米松5 mg加入60 mL生理盐水）,保留灌肠40 min,2次/d,2周为1个疗程。共观察2个疗程。结果两组疗效比较,对照组总有效率为60.0%,治疗组达85.0%,差异有统计学意义（P〈0.05）。两组患者治疗前后结肠镜下评分比较,治疗组较对照组明显改善（P〈0.05）。不良反应情况观察,对照组高达45.0%,治疗组为15.0%,较对照组明显降低（P〈0.05）。结论美沙拉嗪结合灌肠综合治疗慢性溃疡性结肠炎有较好的临床疗效,毒副作用小,患者依从性好,值得进一步研究推广。     

美沙拉秦治疗溃疡性结肠炎的疗效观察

目的研究美沙拉秦（惠迪）治疗溃疡性结肠炎（uc）的治疗疗效。方法收集2007年3月-2008年6月在我院治疗的活动性UC病人112例,随机分为治疗组62人和对照组50人。治疗组患者服用惠迪每次1．0g,4次／d,疗程4周,缓解后改为2g,继续服用4周;对照组服用柳氮磺胺吡啶（SASP）每次1．0g,4次／d,疗程4周,缓解后改为2g,继续服用4周。比较治疗组和对照组患者的临床症状、生化和免疫学指标,以及肠镜下的改变。结果治疗8周后,发现惠迪和柳氮磺胺吡啶（SASP）都可有效控制UC患者的临床症状（总有效率为88．7％和80．O％）,治疗2周后,惠迪比SAsP能更迅速缓解患者的临床症状。惠迪对患者的肝、肾功能无影响,治疗后血细胞沉降率和C反应蛋白的水平显著降低（P〈0．05）,而且不良反应发生率明显低于SASP（P〈0．01）。结论惠迪是一种能有效控制活动性UC的药物,不良反应少。     

云南白药辅助治疗溃疡性结肠炎的开放随机对照研究

目的研究云南白药在活动期溃疡性结肠炎（UC）诱导缓解中的作用。方法将221例活动期UC患者按照完全随机化的 方法分为云南白药组和对照组,随访26周,记录患者诱导缓解的时间,以及诱导缓解前后血清学指标（WBC、HGB、PLT、CRP） 的改变,进行统计分析综合评价云南白药对于UC患者辅助治疗作用。结果221例活动期UC患者中有78例患者应用云南白 药辅助治疗。云南白药组中位缓解时间为9周（95% CI：8.293-9.707）,明显少于对照组（13周,95% CI：11.855-14.145）,差异具 有统计学意义（P<0.001）。病变范围、病情活动度、治疗方案分组下云南白药组与对照组中位缓解时间分别为：E1、E2、E3组为 7、11周（P=0.09）,10、13周（P=0.04）,9、14周（P<0.001）;轻、中、重度活动组为9、10周（P=0.568）,9、14周（P<0.001）,11、20周（P= 0.001）;美沙拉嗪、激素、类克组为9、12周（P<0.001）,9、13周（P=0.001）,7、14周（P=0.04）。COX比例风险回归模型分析可知, 云南白药为活动期UC患者诱导缓解治疗的保护因素,应用云南白药辅助治疗的患者诱导缓解时间将缩短2.283倍（95% CI： 1.697-3.070,P<0.001）。结论对于活动期UC患者,在标准治疗的基础上,辅以云南白药治疗,可以缩短患者诱导缓解的时间, 早期缓解症状,提高生活质量。     

中药内服与灌肠治疗活动期溃疡性结肠炎的临床疗效

目的 观察中药自拟方肠愈宁内服配合灌肠方保留灌肠对活动期溃疡性结肠炎(ulcerative colitis，UC)患者临床症状及病理组织学的影响，并评价其临床疗效及安全性。 方法 选择2014年1月-2016年6月黑龙江中医药大学附属第一医院肝脾胃病科收治的活动期UC患者，共68例，采用随机数字表法将其分为对照组和治疗组，每组各34例。2组患者均给予必要的常规内科治疗，在此基础上治疗组予中药自拟方肠愈宁内服配合灌肠方保留灌肠，内服中药每日1剂，2次/d，早晚饭后半小时温服；灌肠中药每日1剂，每晚睡前灌肠1次。对照组予美沙拉嗪肠溶片口服，1 g/次，4次/d，2组均治疗1个月。治疗后评价2组患者临床主要症状积分、结肠黏膜评分，并对比其临床疗效，观察不良反应。选择SPSS 19.0统计软件对数据进行分析。 结果 经治疗后，治疗组和对照组临床总有效率分别为85.29%、61.77%，治疗组显著优于对照组(P<0.05)。2组患者经治疗后腹痛、腹泻、黏液脓血便症状积分，结肠黏膜内镜评分较治疗前均有明显降低(均P<0.05)，且治疗组治疗后腹痛、腹泻、黏液脓血便症状积分，结肠黏膜内镜评分较同期对照组明显降低(均P<0.05)。 结论 中药自拟方肠愈宁内服配合灌肠方保留灌肠治疗活动期UC疗效确切，能明显改善患者腹痛、腹泻、黏液脓血便等主要症状，修复结肠黏膜损伤，促进溃疡愈合，且无明显不良反应。      

仙方活命饮加减治疗溃疡性结肠炎（活动期）84例临床观察

目的：观察仙方活命饮加减治疗溃疡性结肠炎（活动期）临床疗效。方法：采用仙方活命饮加减口服治疗本病45例;并设对照组（关沙拉嗪肠溶片,口服）观察39例,疗程4W。结果：治疗组证候疗效有效率84．44％,对照组为71．79％（P〈0．05）;治疗组肠镜疗效有效率75．56％,与对照组相似（P〈0．05）。结论：仙方活命饮加减治疗溃疡性结肠炎（活动期）疗效明显,开拓了中医治疗该病的临床思路。     

Systemic levels of free 5-aminosalicylic acid depend on the nature of the 5-aminosalicyclic acid derivative and not on disease activity or extent in patients with inflammatory bowel disease

Introduction  Several new derivatives of sulphasalazine that make use of its active moiety, 5-aminosalicylic acid (5-ASA), have been introduced for the treatment of inflammatory bowel disease (IBD). In rats short term intravenous administration of 5-ASA has been associated with nephrotoxicity. A number of cases of nephrotoxicity have been reported recently in IBD patients taking oral maintenance treatment with 5-ASA compounds. Objective  To study the urinary and serum levels of acetylated 5-ASA (Ac-5-ASA) and the unacetylated 5-ASA (5-ASA) in patients with IBD maintained on sulphasalazine, olsalazine and mesalazine (pH dependent release form). We also sought correlation between levels of 5-ASA, clinical disease activity and extent of disease. Methods  We studied 79 patients (male, n=30; female, n=49) with established IBD [ulcerative colitis (UC), n=48; Crohn’s disease (CD), n=31], 72 maintained on 5-ASA compounds (sulphasalazine = 27; olsalazine = 28; mesalazine = 17) and 7 patients were receiving no medication. Urinary and serum analysis of 5-ASA was performed by high performance liquid chromatography (HPLC). Clinical disease activity was quantified using simple index of Harvey and Bradshaw. Results  Patients receiving mesalazine had significantly higher levels of serum free 5-ASA compared to those who were receiving olsalazine and sulphasalazine (mesalazine mean ± SEM; range; 2.84 ±1.21 (0.00–16.00) vs olsalazine 0.45 ±0.18 (0.00–16.20); μmol/L; p< 0.04; sulphasalazine 0.37 ±0.25 (0.00−3.74); p< 0.03). Similarly levels of urinary free 5-ASA were significantly higher in patients maintained on mesalazine compared to those on olsalazine or sulphasalazine (mesalazine 219 ±80.43 (0.00−1050) vs olsalazine 33.3 ± 17.23 (0.00–317) μmol/L; p< 0.01; and sulphasalazine 15 ±8.86 (0.00–192); p< 0.05). However, no significant difference was observed in the levels of urinary free 5-ASA between olsalazine and sulphasalazine. No significant difference was observed in the levels of free-5-ASA in UC patients with left sided disease and those with extensive disease. Furthermore, no significant difference was observed in the levels of serum and urinary 5-ASA in CD patients with ileo-colic disease and colonic disease. Urinary and serum free-5-ASA did not correlate with the clinical disease activity. Conclusion  Systemic absorption of 5-ASA from sulphasalazine and olsalazine is relatively low. However, pH-dependent mesalazine formulations may release their contents rapidly in the small intestine and proximal colon resulting in higher plasma and urinary concentrations of free.5-ASA. The effects of free 5-ASA on renal function in the human require further evaluation.     

益生菌联合柳氮磺吡啶治疗溃疡性结肠炎的临床观察

目的 评价联合应用益生菌和柳氮磺吡啶治疗溃疡性结肠炎的疗效.方法 溃疡性结肠炎62例随机分成益生菌联合柳氮磺吡啶治疗组(n=31)和柳氮磺吡啶对照组(n=31),比较两组治疗效果、治疗前以及治疗3个月后患者的临床症状评分以及结肠粘膜的炎症评分、随访6个月的复发情况和药物不良反应进行评价.结果 治疗组总有效率93.55％,显著高于对照组77.42％ (P＜ 0.05);两组在治疗前的临床症状评分、结肠粘膜炎症的评分差异均无统计学意义(P＞0.05),治疗3个月后2组的临床症状评分、结肠粘膜炎症的评分均有明显减轻(P＜0.01),但治疗组临床症状、结肠粘膜炎症的缓解程度优于对照组(P＜0.01),且两组的不良反应轻微.结论 联合应用益生菌和柳氮磺吡啶较单独使用柳氮磺吡啶治疗溃疡性结肠炎具有更好的疗效且安全,并能降低复发率.     

美沙拉嗪联合锡类散、云南白药及地塞米松保留灌肠治疗溃疡性结肠炎

目的探讨美沙拉嗪联合锡类散、云南白药及地塞米松保留灌肠治疗溃疡性结肠炎（UC）的疗效。方法144例UC患者随机分为对照组和治疗组,每组各72例,对照组给予美沙拉嗪1．0g／次,3次／d,治疗组在对照组基础上联合锡类散1．Og,云南白药2．0g,地塞米松5mg保留灌肠,每晚1次,疗程为4周,比较两组患者的临床疗效及结肠镜下表现,采用Mayo疾病活动指数进行评分,并比较治疗期间两组患者不良反应率。结果治疗组临床疗效明显优于对照组（P〈0．05）;两组Mayo疾病活动指数均下降,但治疗组下降更明显（P〈0．05）;两组治疗前后结肠镜下评分比较,治疗组在促进黏膜修复、愈合方面明显优于对照组（P〈0.05）。结论应用美沙拉嗪口服联合锡类散、云南白药及地塞米松保留灌肠治疗溃疡性结肠炎疗效确切,值得临床推广。     

Controlled trial of long term oral potassium supplements in patients with mild hypertension

A 15 week randomised double blind placebo controlled trial of oral potassium supplements (48 mmol daily) was conducted in 37 patients who had mildly increased blood pressure and a normal dietary intake of sodium. After a two month run in and a one week baseline period the patients were randomly assigned to receive either potassium supplements (n = 18) or placebo (n = 19). By the third week of treatment blood pressure in the actively treated group had decreased significantly compared with that in the placebo group, though the decrease reached its maximum after 15 weeks. Urinary potassium excretion increased significantly in the group who received potassium supplements, but no significant changes were found in plasma sodium and potassium concentrations or in urinary sodium excretion. In a subgroup of 13 patients who underwent a further nine weeks of treatment with oral potassium supplements at half of the previous dose (24 mmol daily) their blood pressure, at the end of this second study period, was still significantly lower compared with their baseline value but not with that of the placebo group. These results show that moderate oral potassium supplements are associated with a long term reduction in blood pressure in patients who have mild hypertension.     

金双歧联合柳氮磺胺吡啶治疗溃疡性结肠炎疗效观察

目的评价微生态制剂金双歧联合柳氮磺胺吡啶治疗溃疡性结肠炎的临床疗效。方法52例内镜确诊为病变在直肠、乙状结肠的轻、中度溃疡性结肠炎患者随机分为对照组（25例）及治疗组（27例）。对照组予柳氮磺胺吡啶（SASP）1．0g，口服，4次／d；治疗组予金双歧4，0g，灌肠，1次／晚，并予柳氮磺胺吡啶1．0g，口服，4次／d，疗程均为6周。治疗后进行症状评分，对药物疗效进行评价，同时复查肠镜取病理观察组织学的变化。结果在临床症状、肠镜下表现、组织学进步方面（总有效率分别为88．0％和63．0％，80．0％和51．9％，76.0％和48．1％）。经X^2检验差异均有显著意义（P〈0．05）。结论金双歧联合柳氮磺胺吡啶治疗溃疡性结肠炎（UC）疗效满意。较单用柳氮磺胺吡啶好。     

Primary sclerosing cholangitis--a report of 2 cases

Primary Sclerosing Cholangitis (PSC) is a rare cholestatic condition seen locally. Its etiology is unknown and it is commonly associated with ulcerative colitis, another rare condition seen locally. In this report, 2 patients with PSC, both Indian males, had ulcerative colitis and in one PSC was diagnosed some 15 years later. An interesting feature common to both patients was that of intra-hepatic ductal involvement. Percutaneous transhepatic cholangiogram (PTC) and Endoscopic Retrograde Cholangio-Pancreatogram (ERCP) showed characteristic stricturing and beading of the intra-hepatic ducts.     

美沙拉嗪栓治疗溃疡性结肠炎28例临床疗效观察

目的:观察美沙拉嗪栓治疗溃疡性结肠炎(UC)的临床疗效。方法:选择56例轻、中度溃疡性结肠炎患者,随机分为两组:实验组28例,予美沙拉嗪栓塞肛,1枚/次,1次/d;对照组28例,予口服柳氮磺吡啶片(Alicylazosulfapyridine,SASP)1.0g,4次/d口服。疗程为8周。结果:美沙拉嗪栓塞肛治疗UC比口服SASP效果明显。实验组治疗过程中不良反应的发生率明显低于对照组。结论:在轻、中度溃疡性结肠炎治疗中,美沙拉嗪栓塞肛治疗UC临床疗效优于口服柳氮磺吡啶片,且不良反应少。     

A controlled trial of tacrine in Alzheimer's disease. The Tacrine Study Group.

OBJECTIVE--To compare efficacy and safety of tacrine hydrochloride with placebo in patients with probable Alzheimer's disease. DESIGN--A 12-week, double-blind, placebo-controlled, parallel-group study. SETTING--Outpatients at 23 centers. PATIENTS--Men and women with probable Alzheimer's disease, at least 50 years old, mildly to moderately impaired, without other significant medical conditions. INTERVENTIONS--In the initial 6 weeks, patients received placebo, 20 mg/d of tacrine, or 40 mg/d of tacrine. In the second 6 weeks, half received the same treatment and half increased tacrine dose: those receiving placebo increased to 20 mg/d, those receiving 20 mg/d increased to 40 mg/d, and those receiving 40 mg/d increased to 80 mg/d. PRIMARY OUTCOME MEASURES--Alzheimer's Disease Assessment Scale (ADAS) cognitive component and clinician-rated Clinical Global Impression of Change (CGIC). RESULTS--Four hundred sixty-eight patients entered. After 12 weeks, dose-related improvement was significant on the ADAS cognitive (P = .014), clinician-rated CGIC (P = .014), and caregiver-rated CGIC (P = .006). Comparison of 80 mg/d with placebo showed significant improvement on the ADAS cognitive (P = .015), clinician-rated CGIC (P = .016), and caregiver-rated CGIC (P = .028). Significant effects appeared as early as 6 weeks on the ADAS cognitive and caregiver-rated CGIC. Among patients receiving 80 mg/d of tacrine, 51% achieved a four-point or greater improvement of the ADAS cognitive component after 12 weeks of treatment. Reversible asymptomatic transaminase elevations greater than three times normal occurred in 25% of patients. Other treatment-related events included nausea and/or vomiting (8%), diarrhea (5%), abdominal pain (4%), dyspepsia (3%), and rash (3%). CONCLUSIONS--These results confirm the efficacy and safety of tacrine in some patients with Alzheimer's disease. After 12 weeks, the magnitude of the treatment effect is clinically important and recognized by the physician and caregiver. Liver toxicity is reversible and easily detected by weekly alanine aminotransferase determinations.