瑞巴派特灌肠治疗溃疡性结肠炎疗效观察

将42例活动期溃疡性结肠炎患者随机分治疗组和对照组,治疗组用瑞巴派特、强的忪及黄连素灌肠,对照组用柳氮磺胺吡啶（SASP）、强的松及黄连素灌肠。结果治疗4周末治疗组显效率为71．4%,对照组为52．4％,两组疗效比较有统计学意义（P〈0．05）。认为用瑞巴派特灌肠治疗活动期溃疡性结肠炎有较好的疗效,值得临床推广应用。     

谷氨酰胺颗粒灌肠治疗溃疡性结肠炎疗效观察

溃疡性结肠炎及慢性结肠炎是原因不明的非特异性炎症性肠病,近年发病率明显上升,其病情迁延难愈,目前尚缺乏根治方法。本院消化内科对住院及门诊有典型的反复     

康复新联合瑞巴派特治疗溃疡性结肠炎的疗效观察

目的观察康复新联合瑞巴派特保留灌肠治疗溃疡性结肠炎的临床疗效。方法行电子结肠镜检查确诊的120例溃疡性结肠炎患者分为治疗组和对照组。治疗组用瑞巴派特+康复新+生理盐水混合后保留灌肠,每天1次;对照组用康复新+生理盐水保留灌肠,方法同治疗组。治疗12周后用结肠镜复查,观察其疗效和安全性。结果治疗组12周临床显效率、总有效率分别为71.0%和96.8%。对照组分别为44.8%和75.9%,两组有显著性差异(P<0.05)。结论康复新联合瑞巴派特保留灌肠治疗溃疡性结肠炎临床疗效显著。     

瑞巴派特灌肠治疗溃疡性结肠炎的疗效及其机制

目的探讨瑞巴派特灌肠治疗溃疡性结肠炎的疗效及机理。方法42例溃疡性结肠炎患者随机分为治疗组和对照组各21例。治疗组采用瑞巴派特＋强的松＋黄连素灌肠治疗,对照组采用柳氮磺胺吡啶＋强的松＋黄连素灌肠治疗,两组均治疗4周。治疗前后测定血清IL-8和IL-10水平。结果治疗组总有效率明显高于对照组（P〈0.05）;治疗组治疗后血清IL-8水平明显降低,IL-10明显升高,与对照组比较有统计学差异（P〈0.05或〈0.01）。结论瑞巴派特灌肠治疗溃疡性结肠炎有明显疗效,其治疗作用与改善患者细胞炎症因子平衡有关。     

瑞巴派特治疗十二指肠溃疡的疗效观察

为了探讨瑞巴派特治疗十二指肠溃疡的疗效,将102例十二指肠溃疡患者随机分为A、B、C3组,A组给予瑞巴派特+奥美拉唑+阿莫西林+克拉霉素;B组给予铝碳酸镁+奥美拉唑+阿莫西林+克拉霉素;C组给予硫糖铝+奥美拉唑+阿莫西林+克拉霉素.结果 显示在总S期和S2期获得率及溃疡直径减小程度等方面A组明显高于B、C两组.瑞巴派特是促进溃疡愈合疗效较高的药物.     

三黄汤加地塞米松保留灌肠治疗溃疡性结肠炎疗效观察

溃疡性结肠炎(UC)是一种以大肠黏膜和黏膜下层炎症为特点的原因不明的慢性炎症性疾病。近年来发病有上升的趋势，由于其反复发作，所以根治比较困难，对其治疗效果各家报道不一。我院自1992年1月至2002年12月对54例溃疡性结肠炎住院患者采用了三黄汤加地塞米松保留灌肠的治疗方法，取得较好疗效，现报告如下。     

保留灌肠治疗溃疡性结肠炎疗效观察

[目的]观察10%鸦胆子乳联合地塞米松保留灌肠治疗溃疡性结肠炎的临床疗效.[方法]10%鸦胆子乳50 ml加地塞米松5 mg混合充分摇匀,用18～20号肛管每晚经肛门插入保留灌肠2 h,1个月为1个疗程.如未治愈可进行第2个疗程治疗.疗程结束后均经结肠镜复查.[结果]48例患者经1个疗程治愈38例(78.5%),其中轻度32例,中度6例;好转10例(21.5%),其中中度6例,重度4例.伴腺瘤息肉2例,炎性息肉5例.1例腺瘤息肉经2个疗程灌肠治疗,腺瘤脱落,另1例腺瘤息肉者行肛肠科手术;5例炎性息肉经治疗均消失.其余病例均获临床治愈,其治愈率为97.5%.[结论]该疗效理想而可靠,简便易行,值得临床尝试和推广.     

瑞巴派特对门脉高压性胃病的临床疗效观察

目的 评价瑞巴派特对门脉高压性胃病的临床疗效及安全性。方法 将患者随机分为正常对照组、正常干预组、空白对照组及试验组各15例，其中正常干预组及试验组给予口服瑞巴派特治疗4周。观察治疗前后临床症状积分和内镜表现的变化。结果 治疗前试验组与空白对照组的症状积分无显著性差异，而药物治疗4周后试验组患者剑突下疼痛、上腹不适、烧心等症状明显缓解，与治疗前相比，差异有显著性（P〈0．01），腹胀虽有缓解，但不如前者明显（P〉0．05）；而空白对照组则症状无缓解；试验组的总有效率为85．7％。治疗前试验组有胃窦和／或胃体水肿糜烂，甚至呈mosaic样改变，治疗后这些表现明显改善。结论 瑞巴派特能改善门脉高压性胃病患者的临床症状及胃黏膜病变。     

瑞巴派特对提高胃溃疡愈合质量的实验研究

目的 比较瑞巴派特、奥美拉唑及两种药物联合应用干预大鼠胃溃疡愈合质量.方法 建立大鼠胃溃疡模型40只,均分为对照、瑞巴派特、奥美拉唑和瑞巴派特联合奥美拉唑组,7 d后观察大鼠胃溃疡大体形态,超声探察溃疡胃壁全层结构,局部组织学形态及检测黏膜白细胞介素(IL)-8,前列腺素(PG)E2和丙二醛(MDA)含量.结果 ①超声探查显示,对照组溃疡指数为(22.3±1.8)mm2,瑞巴派特组为(9.2±1.0)mm2,奥美拉唑组为(9.8±1.3)mm2,联合治疗组为(4.8±1.2)mm2.对照组均比用药组高(P值均＜0.05),瑞巴派特组和奥美拉唑组均比对照组降低(P值均＜0.05).②离体组织超声探查显示,对照组胃壁厚度明显增加、层次结构模糊消失,用药组胃壁厚度部分恢复正常、胃壁各层次结构部分重建.③组织学表现,用药组溃疡侵袭范围、炎性细胞浸润程度均明显轻于对照组,且周边黏膜再生程度明显优于对照组.④对照组胃黏膜IL-8为(1387.8±132.6)pg/ml,瑞巴派特组为(970.0±91.6)pg/ml,奥美拉唑组为(1102.2±76.9)pg/ml,联合治疗组为(934.4±110.2)pg/ml.对照组均比各用药组高(P值均＜0.05),瑞巴派特组与联合治疗组比奥美拉唑组明显降低(P值均＜0.05).⑤对照组胃黏膜MDA为(13.0±2.6)nmol/ml.瑞巴派特组为(8.5±4.8)nmol/ml,奥美拉唑组为(9.4±1.4)nmol/ml,联合治疗组为(4.6±1.4)nmol/ml.奥美拉唑组与瑞巴派特组均明显高于联合治疗组,且低于对照组(P值均＜0.05).⑥对照组胃黏膜PGE2为(55.0±22.5)pg/ml,瑞巴派特组为(103.5±12.5)pg/ml,奥美拉唑组为(96.9±7.0)pg/ml,联合治疗组为(235.5±26.0)pg/ml.奥美拉唑组与瑞巴派特组均明显高于对照组·且低于联合治疗组(P值均＜0.05).结论 与奥美拉唑相比,瑞巴派特同样能促进溃疡愈合进程,提高溃疡愈合质量;联合应用奥美拉唑,以不同机制同时作用于溃疡愈合过程,能更好地兼顾溃疡愈合的速度和质量.     

联合用药保留灌肠治疗溃疡性结肠炎26例疗效观察

溃疡性结肠炎主要采用内科治疗，其目的是控制急性发作，维持缓解，减少复发，防治并发症。药物治疗常选用氨基水杨酸制剂、糖皮质激素及免疫抑制剂，多采用口服及静脉给药。我们2002-03／2004-01应用联合用药保留灌肠治疗溃疡性结肠炎26例，取得了较好的临床效果，现总结报告如下。     

Successful treatment of severe pouchitis with rebamipide refractory to antibiotics and corticosteroids： A case report

The antibiotics,metronidazole and ciprofloxacin,arethe first-line treatment for pouchitis.Patients who donot respond to antibiotics or conventional medicationsrepresent a major challenge to therapy.In this report,we have described a successful treatment of severerefractory pouchitis with a novel agent,rebamipide,known to promote epithelial cell regeneration andangiogenesis.A 27-year-old male with ileo-anal pouchsurgery presented with worsening anal pain,diarrhea,and abdominal pain.The patient was diagnosed tohave pouchitis and was given metronidazole togetherwith betamethasone enema(3.95 mg/dose).However,despite this intensive therapy,the patient did notimprove.On endoscopy,ulceration and inflammationwere seen in the ileal pouch together with contactbleeding and mucous discharge.The patient was treatedwith rebamipide enema(150 mg/dose)twice a day for 8 wkwithout additional drug therapy.Two weeks after therebamipide therapy,stool frequency started to decreaseand fecal hemoglobin became negative at the 4~(th) wk.Atthe end of the therapy,endoscopy revealed that ulcers inthe ileal pouch had healed with no obvious inflammation.The effect of rebamipide enema was dramatic and wasmaintained throughout the 11-mo follow-up.The patientcontinued to be in remission.No adverse effects wereobserved during the treatment or the follow-up period.The sustained response seen in this case with severeand refractory pouchitis indicates that agents,whichpromote epithelial cell growth,angiogenesis and mucosaltissue regeneration,are potential therapeutic agents forthe treatment of refractory colorectal lesions.     

自拟消溃肠炎散治疗溃疡性结肠炎临床疗效观察

[目的]观察自拟消溃肠炎散治疗溃疡性结肠炎(UC)的疗效.[方法]将80例UC患者随机分为2组,对照组采用口服柳氮磺胺吡啶片4 g/d与甲硝唑100 ml加地塞米松5 mg保留灌肠,治疗组采用自拟消溃肠炎散中药保留灌肠.[结果]总有效率对照组为77.5％,治疗组为97.5％,治疗组疗效优于对照组(P＜0.05).[结论]自拟消溃肠炎散保留灌肠治疗UC疗效明显,有促进溃疡愈合的作用.     

瑞巴匹特预防葡聚糖硫酸酯钠诱发的小鼠结肠炎疗效观察及作用机制初探

目的近年氧自由基在溃疡性结肠炎(UC)发病过程中作用受到关注,一种新型的黏膜保护剂瑞巴匹特被认为具有清除氧自由基的作用,有望成为治疗溃疡性结肠炎的新药物。本文观察瑞巴匹特灌肠和灌胃治疗葡聚糖硫酸酯钠(DSS)诱发的小鼠结肠炎效果并探讨可能的作用机制。方法 3%DSS予8周龄雄性BALB/c小鼠自由饮用7 d制成小鼠结肠炎模型。予DSS前5 d开始瑞巴匹特(45 mg/kg/d)灌肠或灌胃治疗直到造模结束,处死小鼠取结肠组织,测量小鼠体重、结肠长度,进行大体和病理评分,分光光度法测定髓过氧化物酶、丙二醛含量,免疫组化法测定核因子κB(NFκB)表达水平,RT-PCR法测定过氧化物酶体增殖体激活受体γ(PPARγ)mRNA表达。结果与安慰剂对照组比较,瑞巴匹特灌肠和灌胃治疗组小鼠大体和病理评分显著改善,髓过氧化物酶活性、丙二醛含量、NFκB活性明显降低,PPARγmRNA的表达显著升高。结论瑞巴匹特可有效预防DSS诱发的小鼠结肠炎,其抑制炎症作用至少部分与清除氧自由基,从而维持局部PPARγ表达和抑制NFκB活性有关。     

柳氮磺吡啶口服联合仙白汤灌肠治疗溃疡性结肠炎疗效观察

[目的]观察柳氮磺吡啶(SASP)口服联合仙白汤灌肠治疗溃疡性结肠炎(UC)的临床疗效.[方法]将活动期轻、中度UC患者分为2组:灌肠组50例、对照组30例.灌肠组采用口服SASP联合仙白汤灌肠治疗;对照组单用SASP口服治疗;治疗2周后观察2组患者的大便次数、黏液血便、腹痛症状改善情况,并行结肠镜及组织病理学检查.[结果]灌肠组腹痛、便次、黏液血便症状改善平均时间分别为4.6 d、5.88 d、4.92 d,对照组分别为6.6d、8.4d、7.4d,(P＜0.01);治疗后复查肠镜,对照组总有效率为73.33％,灌肠组为96.00％(P＜0.01);总体评估,灌肠组完全缓解14例,有效32例,无效4例,总有效率为92.00％,对照组依次为6、16、8例、73.33％,2组比较差异有统计学意义(P＜0.01).[结论]SASP联合仙白汤灌肠治疗UC可快速缓解症状、促进溃疡愈合,控制UC的活动期,比单用SASP更能控制炎症急性发作,疗效更显著.     

Aspirin-induced small bowel injuries and the preventive effect of rebamipide

AIM:To evaluate the influence of taking low-dose aspirin for 4 wk on small intestinal complications and to examine the preventive effect of rebamipide.METHODS:This study was conducted as a single-center,randomized,double-blind,cross-over,placebo-controlled study.Eleven healthy male subjects were enrolled.Each subject underwent video capsule endos-copy after 1 and 4 wk of taking aspirin and omepra-zole,along with either rebamipide or placebo therapy.The primary endpoint was to evaluate small bowel damage in ...     

Plasma fibrinogen in ulcerative colitis: The effect of disease activity and nicotine therapy in a randomised controlled trial

BACKGROUND: Smoking increases plasma fibrinogen and cardiovascular risk whereas transdermal nicotine may not. Fibrinogen is an acute phase protein and may reflect disease activity in ulcerative colitis. AIMS: To examine the effect of topical nicotine on plasma fibrinogen and any relationship between fibrinogen and ulcerative colitis disease activity. PATIENTS: Forty-eight non-smokers with moderately active ulcerative colitis. METHODS: Patients were randomised to 6 mg nicotine enema or placebo for 6 weeks, followed by open nicotine therapy for 4 weeks. Plasma fibrinogen was measured at baseline and after 6 and 10 weeks; at each assessment sigmoidoscopy with a rectal biopsy was performed. RESULTS.: At 6 weeks median plasma fibrinogen was 3.30 g/l on nicotine compared to 3.05 g/l on placebo, P = 0.90 when adjusted for baseline values. There was a correlation between fibrinogen and the UC disease activity index (UCDAI) at weeks 0 and 10, P = 0.036 and 0.033, respectively, and between fibrinogen and sigmoidoscopic grade at each assessment, P = 0.014, 0.021 and 0.034. Changes in fibrinogen did not correlate with changes in disease severity. CONCLUSIONS: There was no significant effect of nicotine enemas, in either direction, on plasma fibrinogen-this was raised in moderately active UC and correlated with the sigmoidoscopic grade of colitis and the UCDAI; however, fibrinogen was not sufficiently sensitive to be of practical clinical value.     

经内镜下结肠置管灌肠治疗广泛型中度溃疡性结肠炎的应用研究

目的 评价经肠镜下置管灌肠对广泛结肠型中度溃疡性结肠炎的有效性以及安全性.方法 回顾性收集2016年3月至2020年2月于上海市第十人民医院确诊的中度溃疡性结肠炎患者142例,男性89例,女性53例,其中16例患者接受肠镜下置管术灌肠作为治疗组,经倾向值匹配(1:3)得到48例传统药物治疗患者作为对照组.治疗组给予肠镜...