目的 观察美沙拉嗪结合灌肠治疗慢性溃疡性结肠炎的临床疗效.方法 将40例患者随机分为两组,每组各20例.对照组给予柳氮磺吡啶1 g/次,4次/d;治疗组给予美沙拉嗪口服,1 g/次,3次/d,同时配合灌肠(将庆大霉素16万U、思密达6 g及地塞米松5 mg加入60 mL生理盐水),保留灌肠40 min,2次/d,2周为1个疗程.共观察2个疗程.结果 两组疗效比较,对照组总有效率为60.0%,治疗组达85.0%,差异有统计学意义(P ＜ 0.05).两组患者治疗前后结肠镜下评分比较,治疗组较对照组明显改善(P ＜ 0.05).不良反应情况观察,对照组高达45.0%,治疗组为15.0%,较对照组明显降低(P ＜ 0.05).结论美沙拉嗪结合灌肠综合治疗慢性溃疡性结肠炎有较好的临床疗效,毒副作用小,患者依从性好,值得进一步研究推广.%Objective To observe the clinical efficacy of Mesalazine combined with enema in the treatment of chronic ul-cerative colitis. Methods 40 patients were randomly assigned to two groups, with 20 cases in each group. Patients in the control group were given Sulfasalazine 1 g every time, 4 times a day; patients in the treatment group were given oral administration of Mesalazine (1 g every time, 3 times a day), in conjunction with enema (gentamicin 160 000 U, Smectite up to 6 g and Dexamethasone 5 mg added to 60 mL of normal saline). Enema was retained 2 times a day, 40 min each time and 2 weeks each treatment course. The two groups were observed for two courses. Results Total effective rate was 60.0% in the control group and 85.0% in the treatment group, showing significantly differences (P < 0.05). Colonoscopy score improvement was significantly better in the treatment group than in the control group (P < 0.05). Treatment group showed significantly lower adverse reactions rate (45.0%) than seen in the control group (15.0%)(P < 0.05). Conclusion Mesalamine combined with enema shows good treatment efficacy in the treatment of ulcerative colitis, and also has few side effect and good patient compliance, thus is worthy of further investigation and promotion.
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