穴位强化埋线疗法联合中药点滴灌肠治疗溃疡性结肠炎临床研究

目的 :观察穴位强化埋线联合中药灌肠治疗溃疡性结肠炎的临床疗效。方法:将86例溃疡性结肠炎患者随机分为穴位埋线组22例、中药灌肠组21例、联合治疗组22例和美沙拉嗪组21例,穴位埋线组采用穴位埋线治疗,中药灌肠组采用中药灌肠治疗,美沙拉嗪组给予美沙拉嗪肠溶片治疗,联合治疗组给予穴位埋线联合中药灌肠治疗,每组均治疗6个月。结果:穴位埋线组复发9例(40.9%),缓解时间(208±81)d,中药点滴灌肠组复发10例(47.6%),缓解时间(213±74)d,美沙拉嗪组复发10例(47.6%),缓解时间(209±77)d,穴位强化埋线疗法联合中药点滴灌肠组复发4例(18.2%),缓解时间(278±69)d,穴位强化埋线疗法联合中药灌肠组复发率、维持缓解时间均显著优于穴位埋线组、中药灌肠组、美沙拉嗪组(P0.05)。结论:穴位强化埋线联合中药灌肠治疗溃疡性结肠炎疗效确切,可显著提高维持缓解时间,降低复发率。     

Efficacy of topical mesalazine compared with clobetasol propionate in treatment of symptomatic oral lichen planus

OBJECTIVE: To compare topically applied mesalazine (5-aminosalicylic acid) to topically applied clobetasol propionate in the treatment of patients suffering from symptomatic oral lichen planus. DESIGN: Randomized controlled longitudinal investigation. PATIENTS AND METHODS: Twenty-five out-patients suffering from oral lichen planus and referred to the Department of Oral Pathology and Oral Medicine of the University of Milan, Italy, during the period January to August 1997. Patients were randomly allocated (Group A and Group B) to treatment with mesalazine 5% or clobetasol propionate 0.05%. The drugs were topically applied twice daily for 4 weeks. Discomfort and pain were evaluated by the patient before and after treatment using a Visual Analogue Scale from zero (no pain) to 10 (extreme pain). Results were statistically evaluated by a Mann-Whitney U test. RESULTS: The two pharmacological regimens obtained partial and complete absence of symptoms. In particular, the mesalazine tested group disclosed 57% complete absence of symptoms, 21.3% partial response and 9% no response. No statistically relevant difference has been detected between the two regimens. CONCLUSIONS: The results of this preliminary study, if confirmed by further investigations, suggest that mesalazine might be considered an alternative to clobetasol propionate for treatment of symptomatic oral lichen planus.     

Management of distal ulcerative colitis: frequently asked questions analysis

The majority of patients with ulcerative colitis have disease involving only the distal colon. Although 5-aminosalicylic acid (5-ASA, mesalazine) and corticosteroids remain the important drugs used in the management of distal colitis and proctitis, recent expansion of delivery options of 5-ASA and high level evidence regarding efficacy have led to a shift in treatment strategies. The availability of 5-ASA in enema, foam and suppository formulations has enabled optimization of delivery of 5-ASA to the affected mucosa. Such therapy has superior efficacy and fewer adverse effects compared with those of topical corticosteroids. Furthermore, rectal delivery is effective in the maintenance of remission. Consequently, new guidelines for the management of distal colitis have focussed more on rectal delivery and on optimizing 5-ASA dosage than previously. However, corticosteroids remain an important remission-inducing agent, and immune-modulating drugs play a clear role in prevention of relapse and in managing chronically active disease. The changes in guidelines have raised several management questions, many of which are addressed in this review.     

Delayed antiviral plus immunomodulator treatment still reduces mortality in mice infected by high inoculum of influenza A/H5N1 virus

The mortality of human infection by influenza A/H5N1 virus can exceed 80%. The high mortality and its poor response to the neuraminidase inhibitor oseltamivir have been attributed to uncontrolled virus-induced cytokine storm. We challenged BALB/c mice with 1,000 LD50 of influenza A/Vietnam/1194/04. Survival, body weight, histopathology, inflammatory markers, viral loads, T lymphocyte counts, and neutralizing antibody response were documented in infected mice treated individually or in combination with zanamvir, celecoxib, gemfibrozil, and mesalazine. To imitate the real-life scenario, treatment was initiated at 48 h after viral challenge. There were significant improvements in survival rate (P = 0.02), survival time (P < 0.02), and inflammatory markers (P < 0.01) in the group treated with a triple combination of zanamivir, celecoxib, and mesalazine when compared with zanamivir alone. Zanamivir with or without immunomodulators reduced viral load to a similar extent. Insignificant prolongation of survival was observed when individual agents were used alone. Significantly higher levels of CD4+ and CD8+ T lymphocytes and less pulmonary inflammation were also found in the group receiving triple therapy. Zanamivir alone reduced viral load but not inflammation and mortality. The survival benefits of adding celecoxib and mesalazine to zanamivir could be caused by their synergistic effects in reducing cytokine dysfunction and preventing apoptosis. Combinations of a neuraminidase inhibitor with these immunomodulators should be considered in randomized controlled treatment trials of patients suffering from H5N1 infection.     

白葛芩连汤治疗直肠型溃疡性结肠炎107例

目的:观察白葛芩连汤治疗直肠型溃疡性结肠炎的临床疗效。方法:将107例符合直肠型溃疡性结肠炎的患者随机分为治疗组107例和对照组100例。对照组给予生理盐水清洁灌肠,之后直肠塞入美沙拉嗪栓,每次2枚。每天1次。治疗组采用自拟白葛芩连汤中药内服加保留灌肠后直肠塞入美沙拉嗪栓治疗。观察两组患者的临床疗效。结果:治疗组有效率为98%,对照组有效率为72%,两组有效率比较,差异有统计学意义(P0.05)。结论:白葛芩连汤治疗直肠型溃疡性结肠炎临床疗效显著,临床症状改善明显。     

惠迪对强直性脊柱炎患者外周血IFN-γ、IL-17、IL-4的影响和临床研究

目的：探讨惠迪肠溶片对强直性脊柱炎患者外周血干扰素（IFN）-γ、白细胞介素（IL）-17、IL-4的影响,评价惠迪肠溶片治疗AS的临床疗效。方法：采用自身前后对照,纳入病例口服惠迪肠溶片,2片/次,3次/d。用ELISA的方法测定血清IFN-γ、IL-17、IL-4含量,比较用药前后的变化。结果：AS患者经惠迪肠溶片治疗后,外周血IFN-γ、IL-17的含量显著降低（P〈0.05）,IL-4水平改变无显著差异。结论：惠迪肠溶片能降低强直性脊柱炎患者血清IFN-γ和IL-17水平,从而抑制AS患者体内异常活跃的T细胞功能,对AS有治疗作用。     

美沙拉嗪与培菲康联合治疗对溃疡性结肠炎患者血清TNF-α、IL-10的影响

目的探讨美沙拉嗪与培菲康联合治疗对溃疡性结肠炎(UC)患者血清TNF-α、IL-10的影响。方法 38例UC患者,随机分为两组:对照组和治疗组,各19例。对照组给予美沙拉嗪治疗,治疗组在此基础上加用培菲康,疗程均为2个月。治疗前后采用双抗体夹心酶联免疫吸附法测定血清TNF-α、IL-10的水平,并观察两组患者临床症状改善情况。结果治疗组和对照组治疗后TNF-α的水平较治疗前均明显降低(P<0.05),IL-10较治疗前均明显升高(P<0.05);两组治疗前后差值比较,差异也有统计学意义(P<0.05)。治疗组患者临床症状评分下降程度明显大于对照组(P<0.05),差异有统计学意义。结论艾迪莎联合培菲康较单独使用艾迪莎治疗能够降低患者血清TNF-α、提高IL-10的水平。     

The adherence to the therapy in inflammatory bowel disease: beyond the number of the tablets

Objectives: The therapy of the inflammatory bowel diseases is quite complex. A partial compliance increases the relapse probability and the health expenditure. The aim of the study is to correctly study the adherence to the therapy in a single centre eliminating the bias of a different relationship of trust with different doctors.

Materials and methods: We conducted a blind prospective study on the adherence evaluated for mesalazine.

Results: Three hundred and seventy-six patients were included in the final analysis. Of the patients, 57.4% never missed a single dose of mesalazine, 29.3% missed one or two doses, 7.4% missed three to four doses, 5.9% missed more than five doses. A greater adherence among males (p?=?.015) and, in ulcerative colitis, among the group with a disease duration of <2 years compared to the one with a disease duration between 2 and 5 years (p?=?.04) were found. In Crohn’s diseases, among the patients who had never undergone to surgical interventions, the adherence was 49.6%, compared to 51.9% among patients who underwent to one surgical resection and 78.6% among patients underwent to multiple surgical resections (p?=?.001).

Conclusions: The factors influencing the adherence to the therapy are only partly related to the prescribed therapy, but also to factors affecting the patient life: to increase the adherence rate it would be necessary not only interventions on the posology but also the psychological support to the patient at the time of the visit.     

美沙拉嗪联合双歧杆菌三联活菌治疗溃疡性结肠炎的效果

目的探讨美沙拉嗪联合双歧杆菌三联活菌治疗溃疡性结肠炎的效果。方法回顾性分析2018年1月至2020年1月本院收治的100例溃疡性结肠炎患者的临床资料,根据治疗方法将患者分为单独治疗组(n=50,美沙拉嗪单独治疗)与联合治疗组(n=50,美沙拉嗪联合双歧杆菌三联活菌治疗)。比较两组患者的临床疗效、血清炎性因子水平、免疫功能。结果联合治疗组的治疗总有效率高于单独治疗组(P<0.05)。治疗后,两组的血清IL-6、IL-8、hs-CRP及TNF-α水平均降低,且联合治疗组低于单独治疗组(P<0.05)。治疗后,两组的血清IgA、IgG、IgM水平、CD8+均降低,CD3+、CD4+及CD4+/CD8+均升高,且联合治疗组优于单独治疗组(P<0.05)。结论相较于美沙拉嗪单独治疗,美沙拉嗪联合双歧杆菌三联活菌治疗溃疡性结肠炎的效果更显著。     

美沙拉嗪缓释片联合低分子肝素治疗溃疡性结肠炎的效果及对高凝状态影响

目的 探讨美沙拉嗪缓释片联合低分子肝素治疗溃疡性结肠炎的效果及对高凝状态的影响.方法 选择60例溃疡性结肠炎患者,按照随机数字表法分为两组,每组30例.对照组给予美沙拉嗪缓释片,观察组给予美沙拉嗪缓释片+低分子肝素,比较两组的总有效率、症状评分、血清炎症因子指标、血液流变学指标、不良反应发生率.结果 治疗2周后,观察组...