关键词：溃疡性结肠炎；布地奈得；灌肠剂
【摘要 】 目的对比观察布地奈得(BUD)和氢化可的松(HD)灌肠治疗轻、中度远段溃疡性结肠炎(UC)的疗效及副作用；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。方法随机对照单盲观察BUD组12例，HD组19例UC患者。治疗2周，比较两组在临床症状、肠镜下、组织学及William疾病活动指数(DAI)几方面的变化；同时观察副作用，并通过检测清晨血浆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、肠镜下表现、组织学及DAI进步方面，差异无显著性意义(P>0.05)。HD组2例出现颜面及双下肢水肿，而BUD组无此副作用；清晨皮质醇浓度变化两组差异有显著性意义(P<0.05)。结论BUD和HD灌肠治疗远段UC，临床疗效相当，前者副作用小。
Effect of budesonide vs hydrocortisone enemas for
active distal ulcerative colitis
XIE Yan
( Department of Gastroenterlogy,First Affiliated Hospital,West China University of Medical Sciences,Chengdu 610041,China )
OUYANG Qin
( Department of Gastroenterlogy,First Affiliated Hospital,West China University of Medical Sciences,Chengdu 610041,China )
【 Abstract 】 Objectives 1, The efficacy of enemas with budesonide (BUD) and hydrocortisone (HD) for active distal ulcerative colitis was contrasted. 2, The method to test HD levels in blood and biopsied rectal mucosa was established. Methods 1, 31 patients with active distal ulcerative colitis were randomly and single - blindly divided to receive BUD (n=12) or HD (n=19)enemas for 2 weeks. Their clinical and endoscopic manifestations, histopathology and Williams disease active index (DAI) were compared. 2, High performance liquid chromatography (HPLC)was used to measure HD levels in plasma and rectal mucosa, morning blood for cortisol tested to know the condition of adrenal cortex. Results All improved satisfactorily in terms of above data with no significance (P >0.05). Pitting edema appeared on face and lower limbs in 2 cases who had HD enemas. Significant difference (P<0.05) was noted in morning cortisol levels between groups. Conclusion The management with BUD enema seems as effective as that with HD, moreover it induces less adverse effects.
【 Key words 】 Ulcerative colitis; Budesonide ； Enema
溃疡性结肠炎(ulcerativecolitis,UC)是一种病因未明的慢性结肠粘膜炎症 ......
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