复方苦参结肠溶胶囊治疗湿热内蕴型溃疡性结肠炎多中心、随机、双盲、对照研究

目的 观察复方苦参结肠溶胶囊治疗溃疡性结肠炎(ulcerative colitis, UC)湿热内蕴证的临床疗效及安全性,并同美沙拉嗪缓释颗粒(艾迪莎)进行比较。     

肠炎康联合美沙拉嗪治疗溃疡性结肠炎

目的:比较肠炎康联合美沙拉嗪与美沙拉嗪治疗溃疡性结肠炎的疗效,为临床治疗溃疡性结肠炎提供合理用药的建议.方法:将吉林大学第一医院2010年6月-2011年5月门诊收治的溃疡性结肠炎患者90例,随机分为治疗组45例和对照组45例,分别接受肠炎康联合美沙拉嗪与美沙拉嗪的治疗方法,用药后对两组的治疗有效率、结肠镜下形态变化及C-反应蛋白及血沉等进行比较,评价其疗效及安全性.结果:两组治疗后的有效率、结肠镜下形态变化比较均具有统计学意义(P＜0.05).结论:肠炎康联合美沙拉嗪的疗效优于美沙拉嗪,值得临床推广应用.     

Design of a colonic delivery system based on cationic polymethacrylate (Eudragit E100)-mesalamine complexes

In this work, the design and evaluation of a colonic drug delivery system containing mesalamine (M) is presented. The main goal was to enable M to reach the first part of the colon, where the drug could then be released. To facilitate this, a tablet core was coated with two thin layers. The first compounded by chitosan, which was responsible for core protection in the small intestine until it reached the colon. Once at the colon, microbiological enzymatic activity of the caecal content would degrade the Ch layer, thus triggering drug release. The second layer, the outer one, was compounded with Eudragit L100 (EL), with its function being to avoid the dissolution of the Ch-covered core along the gastro intestinal tract (GIT). In order to achieve a modulated drug release, carbomer P934 (1%) was also included. Dissolution studies showed that the formulation seemed to behave as predicted. The amount of M released from the coated tablet was less than 10% at pH?=?1.2 and 6.8. However, when the coated tablet was evaluated in a medium with a caecal content of pH?=?7.4, the M delivery was immediately triggered owing to enzymatic activity of the microflora. In this medium, ～ 60% of M was released in a period of 3?h. Although these results are promising, further studies are still necessary to evaluate the possible in vitro/in vivo correlations.     

New medical strategies for the management of acute diverticulitis

Acute diverticulitis, defined as acute inflammation of a colonic diverticulum, is a common emergency presentation managed by both surgeons and physicians. There have been advances in the medical treatments offered to patients in recent years. Factors predisposing individuals to the development of acute diverticulitis include obesity, smoking, lack of physical activity and medication use, such as NSAIDs. Although widely used, there is limited evidence on the efficacy of individual antibiotic regimens and antibiotic treatment may not be required in all patients. Mesalazine seems to be the only effective treatment for the primary prevention of acute diverticulitis. Finally, evidence of effective measures for the prevention of recurrence is lacking. Furthermore, high-quality randomized controlled trials are required for medical treatments in patients with acute diverticulitis, if management is to be evidence based.     

巴柳氮钠联合康复新液治疗溃疡性结肠炎的临床疗效观察

目的观察联合应用巴柳氮钠和康复新液治疗溃疡性结肠炎的临床疗效。方法将溃疡性结肠炎58例随机分为治疗组30例和对照组28例,治疗组口服巴柳氮钠和康复新液治疗,对照组口服美沙拉嗪颗粒治疗。结果治疗组在治疗后的完全缓解率明显高于对照组（P〈0.05）,治疗后脓血便以及腹胀症状较对照组明显减轻（P〈0.05）,两组间不良反应对比类似。结论巴柳氮联合康复新液灌肠治疗溃疡性结肠炎可有效改善相关症状,临床疗效稳定可靠,是一种值得临床推广应用的治疗方法。     

美沙拉嗪联合低分子肝素治疗溃疡性结肠炎临床疗效观察

目的：观察美沙拉嗪联合低分子肝素治疗溃疡性结肠炎的临床疗效。方法：选择40例中重度溃疡性结肠炎患者,随机分为两组：A组为对照组,20例,美沙拉嗪,4g／d,日四次口服治疗,B组为实验组,20例,美沙拉嗪,4g／d,日四口服,联合低分子肝素,5000单影日二次皮下注射1周治疗。2周后观察治疗前后的结肠镜下改变及血清CRP变化。结果：实验组的总有效率高于对照组,但无明显统计学差异;实验组的完全缓解率高于对照组且有统计学意义。实验组的血清CRP水平明显降低,随访6个月后仍维持较低水平。结论：在中重度溃疡性结肠炎治疗中,美沙拉嗪联合低分子肝素临床疗效要优于单用美沙拉嗪,完全缓解率高,且远期疗效较好。     

Disposition of Mesalazine from Mesalazine-Delivering Drugs in Patients with Inflammatory Bowel Disease,with and without Diarrhoea

Rijk MCM, van Schaik A, van Tongeren JHM. Disposition of mesalazine from mesalazine-delivering drugs in patients with inflammatory bowel disease, with and without diarrhoea. Scand J Gastroenterol 1992;27:863-868.

The disposition of mesalazine from the azo compounds sulphasalazine and olsalazine (Dipentum^®) and from the slow-release mesalazine drugs Pentasa^®, Asacol^®, and Salofalk^® was studied in 20 patients with inflammatory bowel disease. Ten of them had diarrhoea, and 10 had normal stools. On the last 2 days of a 7-day maintenance treatment with each of the study drugs urine and faeces were collected for determination of mesalazine, acetyl-mesalazine, and unsplit azo compound. In patients with and without diarrhoea the urinary and the faecal excretion of acetyl-mesalazine was lowest during treatment with olsalazine. The proportion of acetyl-mesalazine in faeces was highest during treatment with Pentasa in both groups. The presence of diarrhoea was associated with a decrease in the proportion of acetyl-mesalazine in faeces during treatment with all drugs, not significant only for Pentasa. The proportion of unsplit azo compound in faeces increased in the case of diarrhoea to almost 50%. It is concluded that in patients with inflammatory bowel disease diarrhoea substantially influences the disposition from ail these drugs except Pentasa.     

敛疡汤保留灌肠治疗溃疡性结肠炎临床研究

目的：探讨敛疡汤保留灌肠治疗溃疡性结肠炎的临床疗效。方法：选取溃疡性结肠炎患者50例,随机分为治疗组和对照组,每组各25例,两组均予以参白汤口服,治疗组采用敛疡汤保留灌肠,对照组采用美沙拉嗪缓释颗粒保留灌肠,疗程均为3个月,观察两组有效率、疾病活动指数及结肠镜下评分情况,并记录不良反应。结果：两组有效率比较,无显著差异（ P >0.05）;两组治疗前后的疾病活动指数及结肠镜下评分均较治疗前明显改善,差异有统计学意义（P <0.05）,且治疗组优于对照组（P <0.05）;治疗组未见不良反应,对照组不良反应发生率16.0%。结论：敛疡汤保留灌肠治疗溃疡性结肠炎效果显著,且不良反应少。     

美沙拉嗪并氟哌噻吨美利曲辛对难治性肠易激综合征的治疗效果

目的 观察美沙拉嗪联合氟哌噻吨美利曲辛治疗难治性腹泻型肠易激综合征（I BS）病人的临床效果。方法 选取84例难治性腹泻型IBS病人,随机分为对照组和治疗组各42例。对照组给予美沙拉嗪治疗,治疗组同时给予氟哌噻吨美利曲辛治疗,疗程均为4周。结果 治疗组总有效率为95.2%,显著高于对照组的71.4%,差异有显著性（V2=6.010,P〈0.05）。结论 美沙拉嗪联合氟哌噻吨美利曲辛治疗难治性I BS临床效果显著,可有效缓解症状,宜在临床推广。     

美沙拉秦治疗溃疡性结肠炎的多中心研究

目的：观察美沙拉秦对我国溃疡性结肠炎病人的疗效。方法：溃疡性结肠炎病人１００例，其中４１例单纯溃疡性直肠炎为栓剂组，其他５９例为片剂组。栓剂组（男性２４例，女性１７例，年龄４３±ｓ１１ａ）予美沙拉秦栓剂１．０ｇ纳肛，ｂｉｄ，疗程８ｗｋ；片剂组（男性２９例，女性３０例，年龄４４±１４ａ）予美沙拉秦缓释片０．５～１．０ｇ，ｐｏ，ｔｉｄ～ｑｉｄ，疗程８ｗｋ；疗程结束后复查肠镜并作活检。结果：２组病人治疗后肠镜及组织学所见均显著改善，栓剂组总有效率为９８％，片剂组为９５％，前者无不良反应，后者不良反应轻微。结论：美沙拉秦治疗我国溃疡性结肠炎疗效显著而又安全。