维生素D联合柳氮磺吡啶治疗溃疡性结肠炎临床应用价值研究  

Combination of vitamin D and sulfasalazine for ulcerative colitis

作　　者：窦海鹏 赵丹华 姚兴伟[1] Dou Haipeng;Zhao Danhua;Yao Xingwei(Department of Anorectal Surgery,Handan First Hospital,Handan 056000,Hebei,China;Department of Gastrointestinal Surgery,Affiliated Hospital of Hebei Engineering University,Handan 056000,Hebei,China)

机构地区：[1]邯郸市第一医院肛肠外科,河北邯郸056000 [2]河北工程大学附属医院胃肠外科,河北邯郸056000

出　　处：《结直肠肛门外科》2021年第1期35-39,共5页Journal of Colorectal & Anal Surgery

基　　金：河北省医学科学研究重点课题计划(20171106)。

摘　　要：目的探讨维生素D(VD)联合柳氮磺吡啶(SASP)治疗溃疡性结肠炎(UC)的临床应用价值。方法纳入2018年3月至2020年3月邯郸市第一医院收治的88例UC患者为研究对象,采用随机数字表法将88例UC患者分为观察组(n=44,采用VD联合SASP治疗)和对照组(n=44,采用SASP治疗)。比较两组疗效、不良反应发生情况、肠黏膜主要菌群及肠道屏障功能指标【血清丙二醛(MDA)、二氨氧化酶(DAO)及超氧化物歧化酶(SOD)】的差异。结果88例患者均按要求完成治疗。观察组治疗4周后总体疗效优于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率(观察组9.1%vs.对照组13.6%)比较差异无统计学意义(P>0.05)。治疗前,两组双歧杆菌属、埃希菌属、肠球菌属、梭菌属及双歧杆菌/肠杆菌比值(B/E)、肠道屏障功能指标(MDA、DAO及SOD)比较差异均无统计学意义(均P>0.05);治疗4周后,观察组双歧杆菌属、梭菌属、双歧杆菌/肠杆菌比值(B/E)及血清SOD水平高于对照组,埃希菌属水平、血清MDA和DAO水平低于对照组,差异均有统计学意义(均P<0.05)。结论VD联合SASP治疗UC可在不明显增加治疗不良反应的前提下提高疗效,并有助于调节肠道菌群,改善肠道屏障功能。Objectives To investigate the effect of combining vitamin D with sulfasalazine for ulcerative colitis(UC).Methods Eighty-eight patients with UC were recruited from Handan First Hospital between March 2018 and March 2020.Patients were randomly assigned to treatment group(n=44,receiving a combination of vitamin D and sulfasalazine)and control group(n=44,receiving sulfasalazine only).Efficacy,adverse events,gut flora,and intestinal barrier function were compared between the two groups.Intestinal barrier function was evaluated by serum levels of malondialdehyde(MDA),diamine oxidase(DAO),and superoxide dismutase(SOD).Results All 88 patients completed the treatment course.Overall efficacy at 4 weeks was better in the treatment group than in the control group(P<0.05).The incidence of adverse events was 9.1%in the treatment group and 13.6%in the control group,with no significant differences between them(P>0.05).Counts of Bifidobacterium,Escherichia,Enterococcus and Clostridium,Bifidobacterium/Enterobacter ratio(B/E),and serum levels of MDA,DAO,and SOD before treatment did not differ significantly between the two groups(P>0.05).At 4 weeks,compared with the control group,the treatment group had significantly higher counts of Bifidobacterium and Clostridium,lower serum levels of SOD,significantly higher B/E,and significantly lower counts of Escherichia and lower serum levels of MDA and DAO(P<0.05).Conclusion In patients with UC,the combination of vitamin D and sulfasalazine improves efficacy without increasing the risk of adverse events.It can adjust gut flora and improve intestinal barrier function.

关 键 词：溃疡性结肠炎 维生素D 柳氮磺吡啶 肠道菌群 肠道屏障功能 

分 类 号：R574.62[医药卫生—消化系统]