应用5-氨基水杨酸保留灌肠治疗溃疡性结肠炎的临床效果

目的探讨5-氨基水杨酸保留灌肠治疗溃疡性结肠炎的临床效果。方法将118例溃疡性结肠炎患者随机分为两组,每组59例。对照组予以氢化可的松保留灌肠,观察组给予5-氨基水杨酸保留灌肠,对比两组治疗效果、临床症状缓解时间、结肠镜观察、大便常规改善情况。结果观察组治疗总有效率为94.9%,高于对照组的79.7%(P0.05);结肠镜改善率为71.2%、大便常规改善率为86.4%,明显高于对照组的47.5%、67.8%(P0.05);治疗后,观察组临床症状改善时间优于对照组,差异显著(P0.05)。结论溃疡性结肠炎患者采用5-氨基水杨酸保留灌肠治疗能有效缓解患者临床症状,提高治疗效果,安全性高。     

奥沙拉嗪治疗溃疡性结肠炎疗效观察

目的 观察国产奥沙拉嗪钠胶囊治疗轻、中度活动期溃疡性结肠炎的治疗效果，比较国产奥沙拉嗪钠胶囊与水杨酸偶氮磺胺吡啶(SASP)对轻、中度溃疡性结肠炎(活动期)的疗效和不良反应。方法 采用随机双盲方法验证56例轻中度溃疡性结肠炎(活动期)的疗效和不良反应，疗程为8周。结果 国产奥沙拉嗪钠胶囊的总有效率为85％，观察组患者在临床完全缓解率、内镜完全缓解率和组织学完全缓解率在治疗8周后均比治疗前明显改善，分别达75％、35％、48％，其疗效与对照组相比无明显差异。结论 国产奥沙拉嗪钠胶囊治疗活动期轻、中度溃疡性结肠炎有效，其结果与SASP相当，主要不良反应为腹泻，继续用药或合并使用抗腹泻药后，腹泻即消失。     

致康胶囊治疗溃疡性结肠炎的疗效观察

目的为探讨致康胶囊治疗溃疡性结肠炎临床疗效,将活动期溃疡性直肠、乙状结肠炎患者55例,分别给予致康胶囊或柳氮磺胺吡治疗。疗程结束后,致康胶囊治疗组完全缓解率和总有效率分别为86.7%和100%,柳氨磺胺吡啶组分别为48%和96.8%,两组完全缓解率有非常显著性差异(P<0.05)。致康胶囊组无明显不良反应,柳氮磺胺组出现恶心4例。结果显示,致康胶囊治疗溃疡性结肠炎有较好疗效,较传统的抗生素疗法治愈率高,不良反应小。     

双盲对比口服4-氨基水杨酸与5-氨基水杨酸缓释片剂维持治疗克隆回结肠炎的效果

4-氨基水杨酸(4-ASA)(又称对氨基水杨酸)是一种可大剂量用于治疗结核的较安全药物,属5-氨基水杨酸(5-ASA)的一种同分异构体。5-ASA目前用于治疗中度活动克隆病及活动性溃疡性结肠炎。由于4-ASA比5-ASA更稳定且有与5-ASA相当的抗炎作用,本文对一组静止期克隆回结肠炎病人作双盲、随机比较研究口服肠溶性4-ASA与5-ASA各1.5g/d     

复方苦参结肠溶胶囊治疗溃疡性结肠炎24例

[目的]观察复方苦参结肠溶胶囊治疗溃疡性结肠炎(湿热内蕴证)患者的临床疗效及安全性.[方法]采用随机、双盲双模拟、对照的方法共入组溃疡性结肠炎(湿热内蕴证)患者43例,其中试验组24例,对照组19例,试验组给予以复方苦参结肠溶胶囊及美沙拉嗪肠溶片模拟剂,对照组予以美沙拉嗪肠溶片及复方苦参结肠溶胶囊模拟剂,8周后对患者的中医症候积分、肠镜下表现、肠黏膜病理组织学炎症程度及Sutherland疾病活动指数积分等指标进行评价,并观察不良反应发生情况.[结果]2组患者经治疗后均能明显改善中医症候、肠镜下表现、肠黏膜病理组织学炎症程度及降低Sutherland疾病活动指数积分;2组均未发生严重不良反应.[结论]复方苦参结肠溶胶囊治疗轻、中度溃疡性结肠炎(湿热内蕴证)具有较好的治疗效果,同时具有较好的安全性,可以作为该病治疗的一种选择.     

牛磺酸对三硝基苯磺酸诱导的结肠炎大鼠肠纤维化的抑制作用

目的 探讨牛磺酸对三硝基苯磺酸(TNBS)诱导的结肠炎大鼠肠纤维化的影响.方法 32只SD大鼠均分为对照组、模型组、低剂量和高剂量牛磺酸组.对照组以0.9%氯化钠溶液灌肠,其余3组以TNBS灌肠诱导建立结肠炎模型.低剂量和高剂量牛磺酸组于造模前1周每日分别给予牛磺酸400和800 mg/kg干预,直至造模结束.观察大鼠临床表现及疾病活动指数(DAI),行结肠大体评分和组织学评分,检测大鼠结肠长度、结肠重量.测定结肠组织中羟脯氨酸(Hyp)、Ⅰ型胶原蛋白、转化生长因子-β1(TGF-β1)蛋白和mRNA、Smad3蛋白和mRNA水平.结果 与对照组相比,模型组大鼠体重减轻、DAI评分升高、结肠狭窄伴近端扩张、结肠长度缩短、结肠重量增加、大体评分也显著升高(P<0.01).牛磺酸干预后,大鼠体重、DAI评分、结肠长度等指标均有所改善.模型组纤维化评分为1.88±0.35.较对照组明显增加(0.25±0.46,P<0.01);低剂量和高剂量牛磺酸组纤维化评分分别为1.25±0.71和0.75±0.47,较模型组下降(P<0.05).模型组大鼠结肠Hyp、TGF-β1、Ⅰ型胶原蛋白、Smad3蛋白和mRNA含量均较低剂量和高剂量牛磺酸组明显上升(P值均<0.05).结论 牛磺酸能有效抑制TNBS诱导的结肠炎大鼠肠纤维化,其抗纤维化机制可能与下调TGF-β1、抑制TGF-β/Smad3通路有关,为解决克罗恩病肠纤维化和肠狭窄提供一定的实验依据.     

维药西帕依溃结安对大鼠溃疡性结肠炎模型组织中c-jun表达的影响

目的:探讨维药西帕依溃结安对溃疡性结肠炎模型大鼠结肠组织中即刻早期原癌基因c-jun表达的影响.方法:采用2, 4-二硝基氯苯(DNCB)与乙酸复合法制备大鼠溃疡性结肠炎模型, 分为5组进行实验. 应用RT-PCR和Western blot方法分别检测各组c-jun mRNA及其蛋白质表达.结果:在对大鼠溃疡性结肠炎模型治疗中, 维药西帕依溃结安大剂量治疗组中c-jun的蛋白质表达水平与生理盐水阴性对照组及5-氨基水杨酸组相比均明显下调, 差异有统计学意义(0.50±0.14 vs 0.84±0.44, 0.79±0.17, 均P <0.05).结论:维药西帕依溃结安可能是通过在转录后水平上降低c-jun在结肠中的表达来促进溃疡性结肠炎的愈合.     

中药疏肝健脾止痢方联合5-氨基水杨酸治疗慢性溃疡性结肠炎的临床疗效及其对血清TNF-α水平的影响

[目的]探讨中药疏肝健脾止痢方联合5-氨基水杨酸治疗慢性溃疡性结肠炎的临床疗效。[方法]选择110例慢性溃疡性结肠炎患者,随机分为治疗组和对照组。2组除给予相同的营养支持、饮食治疗及局部灌肠用药外,对照组给予5-氨基水杨酸,治疗组则在对照组基础上加用疏肝健脾止痢方,2组均治疗20d,随访2个月。观察临床症状改变以及治疗前后2组血清中TNF-α水平变化。[结果]治疗组总有效率高于对照组,改善情况明显优于对照组,表现为腹痛、腹泻、黏液脓血便症状好转或消失。治疗组治疗后TNF-α水平较对照组降低更显著(P<0.05)。[结论]中药疏肝健脾止痢方联合5-氨基水杨酸治疗慢性溃疡性结肠炎的临床疗效肯定,同时,疏肝健脾止痢方有助于降低患者血清TNF-α水平。     

源首胶囊、蒙脱石散和美沙拉嗪联合用药对溃疡性结肠炎疗效观察

目的探讨源首胶囊、蒙脱石散和美沙拉嗪联用对溃疡性结肠炎的疗效和安全性。方法选用本院收治2008年1月～2013年4月溃疡性结肠炎轻中度病例共52例,随机分为2组,对照组20例为常规使用美沙拉嗪与蒙脱石散,实验组32例,为在对照组基础上加用源首胶囊的三联用药,观察2组治疗反应及相关指标（有效率、症状改善时间、炎性指标改善率,内镜缓解情况及不良反应发生率）,用统计学方法分析有无统计学意义。结果实验组相较对照组在症状改善时间和炎性指标恢复时间等方面均有较明显优势,不良反应并没有表现出明显差异。结论以益生菌制剂、肠道黏膜保护剂和5-氨基水杨酸制剂三联用药,对慢性溃疡性结肠炎治疗反应优于美沙拉嗪合用肠道黏膜保护剂的二联用药,能更快地改善患者症状,有助于树立溃疡性结肠炎患者治疗信心。     

康复新液联合枯草杆菌二联胶囊辅助治疗活动期轻中度溃疡性结肠炎疗效观察

[目的]探讨康复新液联合枯草杆菌二联胶囊辅助治疗活动期轻中度溃疡性结肠炎(UC)的疗效及安全性。[方法]选取2012年2月~2015年8月我院消化内科收治的活动期轻、中度UC患者60例,随机分为治疗组和对照组,每组各30例。对照组患者单独使用美沙拉嗪治疗,治疗组患者在对照组基础上加用康复新液保留灌肠联合枯草杆菌二联胶囊口服治疗,疗程均为8周,比较2组患者临床疗效及疗程结束后肠镜复查结果。[结果]治疗组总有效率明显高于对照组(100%vs.83.3%,96.6%vs.76.7%),差异有统计学意义(P0.05);2组患者均未出现明显严重不良反应。[结论]康复新液联合枯草杆菌二联胶囊辅助治疗活动期轻中度UC的疗效较为显著,值得临床推广应用。     

Longterm olsalazine treatment: pharmacokinetics, tolerance and effects on local eicosanoid formation in ulcerative colitis and Crohn's colitis.

To examine pharmacokinetics and tolerance of long term administration of olsalazine (azodisalicylate), increasing doses of the drug were given for one year to 31 patients with ulcerative colitis (UC) and nine patients with Crohn's colitis (CC), refractory to, or intolerant of sulphasalazine, until sustained remission was obtained or a maximum of 4 g/day was reached. Colonic drug metabolism was studied by equilibrium in vivo dialysis of faeces. Complete azoreduction occurred in most cases. Concentrations of 5-aminosalicylic acid, but not N-acetyl-5-aminosalicylic acid, in faecal dialysates increased dose dependently. Serum concentrations disclosed no cumulation in the long term and olsalazine was well tolerated, although loose stools occurred transiently in some patients with extensive disease: this was associated with a larger proportion of unsplit olsalazine in the faecal dialysates. Patients with ulcerative colitis having a high prostaglandin E2 concentration (greater than ng/ml) determined by equilibrium dialysis of rectum, were less likely to benefit from treatment. Olsalazine is a very effective means of delivery of 5-aminosalicylic acid to the colonic mucosa in active disease. Use of the drug in controlled trials may be considered safe even in prolonged high dosage.     

Olsalazine or sulphasalazine in first attacks of ulcerative colitis? A double blind study.

Olsalazine (2 g/day) and sulphasalazine (3 g/day) were compared in a double blind three centre trial in 37 patients presenting with first attack of distal colitis. Sigmoidoscopic appearances, rectal biopsies, and symptom and stool diary records were used to assess benefit and adverse effects. Both groups showed a similar decrease in stool frequency (p less than 0.001). The proportion of unformed stools was also decreased, but to a lesser extent (p less than 0.05) in those taking olsalazine (78% v 55%; p less than 0.001) compared with those taking sulphasalazine (72% v 28%; p less than 0.001). There was a diminution in the proportion of stools containing blood in both groups (olsalazine: 61% v 22%; p less than 0.001/sulphasalazine: 67% v 37%; p less than 0.001). Sigmoidoscopic and histological appearances and clinical activity improved significantly and to a similar extent in both groups. Intolerance was encountered in two patients on olsalazine and four on sulphasalazine; intolerance to sulphasalazine being even higher (five of seven patients) in a preliminary study using a dose of sulphasalazine releasing the same amount of 5-aminosalicylic acid as 2 g olsalazine. Olsalazine was at least as effective as sulphasalazine in the treatment of new patients with distal colitis, and in a dose releasing an equivalent amount of 5-aminosalicylic acid was better tolerated.     

二氯醋酸二异丙胺治疗非酒精性脂肪性肝病的随机双盲临床研究

目的 研究二氯醋酸二异丙胺治疗非酒精性脂肪性肝病的临床疗效和安全性。方法 用随机双盲多中心剂量半行对照的临床试验设计选择非酒精性脂肪性肝病患者，分别用二氯醋酸二异丙胺高剂量(120mg／d)和低剂量(60mg／d)治疗8周，观察其疗效和安全性。结果 本试验共有l27例患者人选，高剂量组63例，低剂量组64例。术见脱落病例，剔除4例，剔除率3．1％，实际完成病例数l23例，高剂量组6l例，低剂量组62例。治疗后8周高剂量组和低剂量组临缶床疗效总有效率分别为87．8％和79．6‰(P=0．2536)，内氨酸氨基转移酶复常总有效率分别为55．7％和69．4％(P=0．0807)，血脂总有效率分别为67．2％和67．7％(P=O．9320)，B超脂肪肝影像学榆查总有效率分别为51．7％和43．5％(P=O．2879)，两组比较，差异均尢统计学意义。两组患者中各有1例发生不良反应，高和低剂量组的发生率分别为1．6％和1．6％，表现为口干，未见严重的不良反应。结论 二氯醋酸二异丙胺可安全有效地用于治疗非酒精性脂肪性肝病。     

帕罗西汀对轻-中度溃疡性结肠炎伴焦虑/抑郁的疗效评价

目的评价帕罗西汀辅助治疗轻-中度溃疡性结肠炎伴焦虑/抑郁的疗效。方法将30例轻-中度溃疡性结肠炎(UC)伴焦虑/抑郁患者随机分成2组(每组15例),分别接受5-氨基水杨酸和5-氨基水杨酸+帕罗西汀治疗;所有患者治疗前后均进行临床活动指数(CAI)、内镜指数(EI)和焦虑/抑郁测试,并比较治疗后的改善情况。结果治疗后5-氨基水杨酸+帕罗西汀组的CAI(腹泻和腹痛)和焦虑/抑郁评分较5-氨基水杨酸组显著下降(P<0.05,P<0.001),而EI和其他表现与5-氨基水杨酸组无显著差异(P>0.05)。结论对于轻-中度UC伴焦虑/抑郁的患者,帕罗西汀能改善焦虑/抑郁,通过减轻腹泻和腹痛而促进临床缓解,可作为辅助用药之一,但对组织学表现无改善作用。     

Efficacy and tolerability of diclofenac dispersible in painful osteoarthrosis

Summary A multicentre, twelve-week, double-blind, randomized trial was conducted to evaluate the efficacy and tolerability of diclofenac dispersible in patients suffering from osteoarthrosis of the knee and/or hip. Symptomatic adult patients (N=129) of either sex were treated with diclofenac dispersible or the conventional enteric-coated tablet of diclofenac sodium 50 mg orally, thrice daily. Both formulations of diclofenac led to comparable and clinically significant reductions in the intensities of pain at rest and during activity within 1 week of therapy initiation. More than 70% of patients in both treatment groups had no or mild pain on full passive movement by the end of the study with the Lequesne Index showing a reduction of around 50% from initial values. Overall assessments of efficacy by the patient and the investigator indicated a positive response rate for both diclofenac formulations ranging between 71% and 82%. The proportion of patients reporting adverse effects, predominantly gastro-intestinal, was slightly higher in the dispersible group, 40.3%, compared to 37.3% with enteric-coated diclofenac sodium.     

Reduction in gastric mucosal hemorrhage and ulceration with chronic high-level dosing of enteric-coated aspirin granules two and four times a day

When administered on a chronic high-dosage regimen, enteric-coated aspirin granules produced significantly less gastric damage than plain aspirin or aspirin-antacid combinations. Clinically meaningful damage occurred in all subjects receiving plain aspirin, 93% of those receiving aspirin-antacid combination and only 27% and 20% of those receiving enteric-coated aspirin granules qid and bid, respectively. All three aspirin formulations were taken as 1 g qid (4 g/day) and an additional group received enteric granules administered as 2 g bid (4 g/day). Gastric damage was assessed by means of endoscopy carried out after seven days of treatment. Enteric granules are equally safe when administered on a bid or qid regimen (at same total daily dosage) and, in a bid regimen, should provide a compliance advantage for patients on high-dose therapy for diseases such as rheumatoid arthritis.Address for reprint requests: Procter & Gamble, Professional Services Division, P.O. Box 86, Cincinnati, Ohio 45201.     

竹沥胶囊与沐舒坦祛痰作用的临床研究

目的比较口服竹沥胶囊与沐舒坦祛痰作用的临床疗效和安全性。方法随机将160例急、慢性支气管炎的患者,分为竹沥胶囊组（治疗组）83例,口服竹沥胶囊,0.5g/次,3粒/次,3次/d;沐舒坦组（对照组）77例,口服氨溴索片,30mg次,3次/d。两组疗程均为10d。结果①临床综合疗效：治疗组和对照组的临床控制率分别为54.2%,54.5%,总有效率分别为89.1%,89.6%;②祛痰单项指标：治疗组痰液性质、痰量、咳痰难易程度的消失率分别为60.2%,65.1%,55.4%;平均消失天数分别为8.0±2.6,9.1±2.2,9.1±2.8,对照组消失率则分别为59.7%,64.9%,61.0%;平均消失天数分别为8.3±2.7,9.2±2.4,8.4±2.8,两组单项指标症状评分均显著下降,单项指标均无显著性差异（P〉0.05）;③治疗组与对照组的不良反应发生率分别为4.8%和11.7%（P〉0.05）。结论口服竹沥胶囊对急、慢性支气管炎祛痰作用与沐舒坦基本等效,进一步的临床疗效和安全性尚须作更为严格的大规模、多中心、双盲临床试验。     

复方比黑马尔江胶囊治疗胃食管反流病的疗效与安全性研究

ObjectiveTo compare the clinical efficacy and safety of compound Bihmarjan capsule and esomeprazole magnesium enteric-coated tablets on gastroesophageal reflux disease. MethodsThis study was an open, randomized and positive controlled trial. 120 patients with gastroesophageal reflux disease were participated in this study. According to the random number table, the patient is randomly divided into three groups, namely, group A is the lower dose group of compound Bihmarjan capsules, group B is the high dose group of Bihmarjan capsules, and group C is the Esomeprazole Magnesium Enteric-coated Tablets group. Group A were given 2 g (5 capsules) of compound Bihmarjan capsules 3 times daily; group B were given 4 g (10 capsules) of compound Bihmarjan capsules 3 times daily; group C were given 40 mg of Esomeprazole Magnesium Enteric-coated Tablets once daily. They were on medication for 4 weeks. Follow up was done in second and fourth weeks of the study. The clinical efficacy and incidence of adverse events were analyzed. ResultsIn three groups,77.5%, 87.5% and 90% of patients reported significant improvement of clinical symptom on Gerd-Q score respectively. The total clinical efficacy of group A and group B was 84.75%, and the total incidence of adverse event was 2.5%. there was no significant difference between group B and C in the clinical efficacy (P＞0.05), when the clinical efficacy of group A was worse than other two group (P＜0.05). The incidence of adverse events in group A and B were lower than group C (P＜0.05). ConclusionThe clinical efficacy of high dose Bihmarjan capsules is similar to Esomeprazole and the incidences of adverse event is lower than control group. Bihmarjan capsules have therapeutic potentials in the treatment of gastroesophageal reflux disease.     

Randomised controlled trial of azathioprine and 5-aminosalicylic acid for treatment of steroid dependent ulcerative colitis

BACKGROUND AND AIMS: There are limited evidence based data concerning the use of azathioprine in ulcerative colitis. We aimed to compare the efficacy of azathioprine and oral 5-aminosalicylic acid in inducing remission of steroid dependent ulcerative colitis. METHODS: Seventy two patients with steroid dependent ulcerative colitis were admitted to this investigator-blind study. Steroid dependence was defined as a requirement for steroid therapy > or =10 mg/day during the preceding six months, with at least two attempts to discontinue the medication. The disease had to be clinically and endoscopically active at study entry, and all patients were taking systemic prednisolone (40 mg/day). Patients were randomised to receive azathioprine 2 mg/kg/day or oral 5-aminosalicylic acid 3.2 g/day, for a six month follow up period. The outcome of the treatment was defined as (1) success, indicating induction of clinical and endoscopic remission and steroid discontinuation, or (2) failure, indicating the absence of clinical and endoscopic remission and therefore the need for at least one further cycle of systemic steroids to control symptoms, apart from the initial one, or colectomy. RESULTS: Significantly more patients in the azathioprine than in the 5-aminosalicylic acid group had clinical and endoscopic remission, and discontinued steroid therapy, both in the intention to treat (azathioprine v 5-aminosalicylic acid: 19/36 patients (53%) v 7/36 (21%); odds ratio (OR) 4.78 (95% confidence interval (CI) 1.57-14.5)) and per protocol (azathioprine v 5-aminosalicylic acid: 19/33 patients (58%) v 7/34 (21%); OR 5.26 (95% CI 1.59-18.1)) analysis. CONCLUSIONS: Azathioprine is significantly more effective than 5-aminosalicylic acid in inducing clinical and endoscopic remission and avoiding steroid requirement in the treatment of steroid dependent ulcerative colitis.