布地奈得和氢化可的松灌肠治疗溃疡性结肠炎的对比研究

目的:本实验对比观察布地奈得(BUD)和氢化可的松(HD)灌肠治疗轻中度远段溃疡性结肠炎(UC)的疗效 及副反应:建立高效液相色谱仪(HPLC)检测血和结肠粘膜中HD浓度的方法 方法:随机对照单(?)观察BUD组12例 HD组19例UC患者 治疗两周,比较两组在临床症状,结肠镜下,组织学及William疾病活动指数(DAI)几方面的变化同时观察副反应,并通过检测清晨皮质醇浓度来客观评价HD对肾上腺皮质的抑制作用 采用HPLC测定HD灌肠后不同时间血及肠粘膜活检组织中的该药浓度 结果:两组在临床症状,结肠镜下,组织学及DAI进步方面(?)L显著性差异(P>0.05)HD组2例出现颜面及双下肢水肿.而BUD组无此副反应:清晨皮质醇浓度变化两组有显著性差异(P<0.05)测出两例UC患者使用HD灌肠后粘膜及血中的药代学参数 结论:BUD和HD灌肠治疗(?)段UC临床疗效相当,前者副反应小 HD局部灌肠可能有部分全身作用

Budesonid vs Hydrocortisone Enemas in Active Distal Ulcerative Colitis

Background/Aims: The patients with active distal ulcerative colitis participated in a random single-blind trial for comparison between the effect and side effects of budesonide (BUD) enema with hydrocortisone (HD) enema and to establish the method of determining the HD level in blood and biopsied rectal mucosa. Methods: 12 patients received BUD and 19 received HD for 2 weeks. The effectiveness of the two drugs was evaluated by symptomatology, endoscopic findings, histology and Williams disease active index (DAI). At the same time, possible side effects were recorded The plasma cortisol was determined for measurement of inhibition of adrenal cortex. The HD concentrations in plasma and mucosa were measured by high-performance liquid chromatography (HPLC). Results There is no statistial difference between two groups (P>0.05) in clinical symptoms, endosopic. histological scoring and DAI two weeks after treatment. Two patients in the HD group had edema over the face and legs, whereas BUD group hadn't. Mean level of morning plasma cortisol was unchanged in the BUD group, whereas they were significantly suppressed in the HD group after 2 weeks (P<0.05) Conclusions: The effect of BUD enema is the same as HD in active distal ulcerative colitis, but with less systemic side effects or adrenal cortical suppression.