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     

三种灌肠剂治疗左半结肠溃疡性结肠炎疗效观察

研究氢化可的松,对氨基水杨酸,水杨酸偶氮磺胺吡啶三种灌肠剂治疗左半结肠溃疡性结肠炎（ＵＣ）的疗效和安全性。方法用随机双盲对照方法对６２例ＵＣ病人分组治疗,以安慰剂为对照,疗程４周,观察临床症状,结肠镜和组织学炎症及疾病活动指数（ＤＡＩ）的改善情况。结果三种灌肠剂和对照组治疗后症状改善率分别为７５％、６８．７％、６８．７％和２１．４％（Ｐ〈０．０５）;结肠镜下炎症改善率下７５％、６８％、６１．５％和     

中西药灌肠兼内服治疗溃疡性结肠炎

溃疡性结肠炎是一种原因不明的慢性结肠炎,病变主要局限于结肠的粘膜,表现为溃疡和炎症。临床症状多为持续不愈或反复发作的腹痛、腹泻、粘液便或便秘,常伴有不同程度的全身症状,是胃肠病中的疑难病之一。笔者自1994年6月～1998年6月采用中西药灌肠为主,并配合中药辨证治疗本病取得了较好效果,现报告如下1　资料与方法1.1　临床资料:本组病例26例,其中男14例,女12例;年龄21～74岁,平均38.9岁;病程0.5～1年者6例;1～3年者12例;3年以上者8例。上述病例皆符合文献[1]诊断标准。1.2　治疗方法:灌肠液由黄芩、黄柏、大黄、苦参、丹参、薏苡仁、赤…     

中西药联合灌肠治疗溃疡性结肠炎

1989年以来共收治溃疡性结肠炎病人79例,采用中西药联合灌肠法治疗58例,并与21例口服柳氮磺胺吡啶组进行对照,现报告如下。     

美沙拉嗪灌肠剂治疗溃疡性结肠炎疗效观察

目的 探讨美沙拉嗪灌肠剂在溃疡性结肠炎(UC)治疗中的应用效果及其安全性.方法 选取住院治疗的轻、中度UC患者41例,随机分为两组;治疗组给予美沙拉嗪灌肠剂(含美沙拉嗪4.0 g)每晚1次保留灌肠1周;对照组地塞米松5 mg加入生理盐水60 ml每晚1次保留灌肠1周.两组均给予地塞米松10 mg加入生理盐水100 m1...     

溃疡性结肠炎灌肠治疗现状

溃疡性结肠炎 ( UC)病因未明 ,可能与免疫功能异常、炎症递质生成增多、氧自由基损伤及感染、精神因素有关 [1,2 ] ,迄今临床上仍缺乏特异的治疗手段 ,且全身用药疗程长 ,毒副作用大 ,患者不易耐受。而局部灌肠可避开胃酸的破坏 ,使药物直接作用在病变部位 ,具有安全有效、简便易行、不良反应少等特点。现就 UC灌肠治疗现状综述如下。1　适应证对于 UC病变局限在直肠、乙状结肠 ,尤其对 60cm以下病变肠段灌肠治疗较为适宜。可以保护局部有足够药物浓度和作用时间 ,在 Trule Gowitts病情划分中 ,轻中度患者可单独局部用药 ,而重度患者必…     

中药灌肠治疗慢性溃疡性结肠炎68例

慢性溃疡性结肠炎为临床常见疾病之一,是一种不明原因的直肠和结肠慢性炎性疾病,病程迁延,易于反复,长期不愈者易致癌变。目前临床尚无特效药物,我们以大黄三七芍药汤灌肠治疗,取得了较好效果,现将结果报告如下。１　资料与方法１．１　临床资料：全部病例均为我院肠道门诊１９８９年１月～１９９６年１月就诊患者,均符合１９９３年太原全国慢性非感染性肠道疾病学术研究会制定的标准,患者以持续或反复腹痛、腹泻、粘液脓血便为主症,经纤维结肠镜检查肠粘膜有溃疡及慢性炎症,大便涂片及培养排除溶组织阿米巴及其他病原体。将收集…     

中药灌肠治疗溃疡性结肠炎54例

中药灌肠治疗溃疡性结肠炎５４例吴志强王宏丽解放军３０４医院消化科北京市１０００３７主题词结肠炎，溃疡性结肠镜检查灌肠Ｓｕｂｊｅｃｔｈｅａｄｉｎｇｓｃｏｌｉｔｉｓ，ｕｌｃｅｒａｔｉｖｅｃｏｌｏｎｏｓｃｏｐｙｅｎｅｍａ分类号Ｒ５５６１对象和方法１．１...     

Rectal administration of d-alpha tocopherol for active ulcerative colitis： A preliminary report

AIM： To investigate the anti-oxidant and antineutrophil recruitment effects of rectal d-alpha （d-α） tocopherol administration on mild and moderately active ulcerative colitis （UC）.
METHODS： Fifteen patients with mild and moderately active ulcerative colitis were enrolled in an openlabel study of d-α tocopherol enema （8000 U/d） for 12 wk. All patients were receiving concomitant therapy with 5-aminosalicylic acid derivatives （5-ASA） and/or immunomodulator medications. Endoscopic evaluation was performed at baseline and after 4th and 12th weeks. Disease activity was measured with the Mayo disease activity index （DAI） and remission was defined as DAI of ≤ 2 with no blood in stool. Clinical response was defined as a DAI reduction of ≥ 2.
RESULTS： At the end of 12th week, the average DAI score significantly decreased compared to the beginning of the study （2.3 ± 0.37 vs 8 ± 0.48, P 〈 0.0001）. One patient was withdrawn after 3 wk for being unavailable to follow-up. On the 4th week of therapy, 12 patients showed clinical response, 3 of whom （21.4%） achieving remission. After 12 wk, all 14 patients responded clinically to the therapy and remission was induced in 9 of them （64%）. No patient reported adverse events or was hospitalized due to worsened disease activity.
CONCLUSION： This preliminary report suggests that rectal d-α tocopherol may represent a novel therapy for mild and moderately active UC. The observed results might be due to the anti-inflammatory and anti-oxidative properties of vitamin E.     

Retrograde spread of 5-aminosalicylic acid enemas in patients with active ulcerative colitis

In an attempt to know the exact retrograde spread of high-dosage 5-aminosalicylic acid enemas, we have studied eight patients with active left-sided colitis, by adding a small amount of barium sulfate to the enemas and by checking the spread radiologically after 15 minutes, 1 hour, and 6 hours. Four grams of 5-aminosalicylic acid in 100-ml enemas and 4 gm in 200-ml enemas were used. The same experiment was repeated in a subsequent attack, with enemas labeled with technetium-99m and checked by scintiscans in five of these patients. We always have observed a volume-dependent spread of enemas but, interestingly, in the patients studied with technetium-99m there was always a wider spread than that which was detected with barium enemas. In all five patients, 100-ml enemas reached the splenic flexure. In two patients with total colitis, a progression of 100-ml technetium-99m enemas was performed in the transverse colon, but the maximum opacity remained in the left side. We can conclude that 4 gm of 5-aminosalicylic acid in 100-ml enemas can be suitable for treating patients with left-sided colitis, and will represent a valid addition for patients with more extensive colitis.     

A controlled randomized trial of budesonide versus prednisolone retention enemas in active distal ulcerative colitis

Sixty-four patients with active distal ulcerative colitis participated in a multicentre, randomized, investigator-blind trial to compare the effect of budesonide enema, 2 mg/100 ml, with prednisolone disodium phosphate enema, 31.25 mg/100 ml. Budesonide is a new potent corticosteroid with a rapid first-pass elimination. The patients were treated for 4 weeks, and the efficacy of the drugs were evaluated by sigmoidoscopy, histology, and subjective symptoms after 2 and 4 weeks. After 4 weeks of treatment 16 of 31 patients (52%) receiving budesonide enema had healed endoscopically, compared with 8 of 33 (24%) (p = 0.045) receiving prednisolone enema. Budesonide was superior to prednisolone in terms of both significantly improved sigmoidoscopic and histologic scores and subjective symptoms evaluated by visual analogue scales. The patients receiving prednisolone had a significant depression of endogenous cortisol levels during the treatment period, but not the patients receiving budesonide. Budesonide enema seems to be a promising therapy for active distal ulcerative colitis and causes no adverse reactions.     

Treatment of distal ulcerative colitis with beclomethasone enemas: High therapeutic efficacy without endocrine side effects

Sixteen patients with 18 attacks of distal ulcerative colitis were treated randomly with either 0.5 mg topically administered beclomethasone dipropionate (BDP) or 5 mg betamethasone phosphate (BMT). The effect of the steroid enemas on adrenocortical function was examined by ACTH tests, which were performed before and 20 days after treatment. At completion of the trial, a marked suppression of the adrenocortical function was found in seven of eight patients treated for nine attacks with BMT but not in any patients in the BDP group (P<0.01). The mean posttreatment basal and stimulated plasma cortisol levels in the BMT group were significantly lower as compared with the BDP group. The overall therapeutic response assessed by score systems was comparable in the two treatment groups. It is concluded that, in the topical treatment of ulcerative colitis, BDP is preferable to BMT because it exerts an equal anti-inflammatory action without affecting adrenocortical function.     

赛霉安保留灌肠治疗溃疡性结肠炎近期疗效观察

目的 观察赛霉安保留灌肠治疗轻、中度溃疡性结脾性炎的疗效。方法 对３２例轻、中度未端溃疡性结肠炎病人随机分赛霉安治疗组（２０例）和地塞米松治疗组（１２例）中肠治疗１疗程后评估疗效。结果 症状缓解率和内镜缓解率赛霉安治疗组均迷９０％（１８／２０）,地塞米松治疗组为３８．３％（１０／１２）,两组差异无显著性意义（Ｐ〉０．０５）。结论 赛霉安是一种纯中药制剂,局部治疗轻、中度溃疡性结肠炎有较好疗效。与地     

三种神经肽在活动期溃疡性结肠炎中的表达及意义

目的研究三种神经肽在溃疡性结肠炎（UC）及正常结肠黏膜中的差异表达变化及意义。方法运用免疫组织化学方法测定血管活性肠肽（VIP）、P物质（SP）和生长抑素（SS）在43例溃疡性结肠炎及13例正常结肠黏膜中的表达。结果UC中VIP和SS较正常组织表达下降,而SP表达较正常组织增加。结论VIP、SP及SS参与UC的发病过程,且与腹泻的次数存在一定关联性。     

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。