Study On The Effects Of Selenium Yeast Combined With Mesalazine On Oxidative Stress In Patients With Ulcerative Colitis

Purpose: Ulcerative colitis(UC)is a chronic inflammatory disease of the colon.The cause is unknown.Intestinal oxidative stress damage is an important pathogenesis of UC.Selenium is the active center of human glutathione peroxidase(GSH-Px).Appropriate intake of selenium can increase the level of selenium in the human body and increase the activity of GSH-Px,thereby achieving the effect of scavenging free radicals and anti-oxidation.This study aims to observe the clinical efficacy of selenium yeast combined with mesalazine in the treatment of patients with mild to moderate ulcerative colitis,evaluate its short-term efficacy,and provide new research directions for the treatment of ulcerative colitis.METHODS: Seventy patients with ulcerative colitis who attended the Department of Gastroenterology of the First Affiliated Hospital of Hebei North University in Zhangjiakou City during 2019.12-2020.12 were consecutive selected,and these patients were diagnosed clearly based on clinical manifestations and endoscopic examination,and classified into mild and moderate according to modified Mayo classification.Both groups were given nutritional support and enema treatment,including mesalazine and selenium yeast tablets in the combination group and mesalazine alone in the control group,and both groups received continuous treatment for 4weeks.The clinical curative effect,stool routine,stool count,ESR,and serum levels of malondialdehyde(MDA)and gluthathione peroxidase(GSH-Px)were compared before and after treatment.Five cases dropped out during treatment and follow-up,including two cases in the combination group and three in the control group.65 patients completed the treatment follow-up,33 in the combination group and 32 in the control group.RESULTS: Compare the baseline data between the combination group and the control group,there was no statistical difference between the two groups.The total effective rate of the combination group is 96.97% and the control group’s is 81.25%.The effect of treatment with selenium yeast in the combination group was significantly better than that in the control group,X~2=0.034,P=0.037,and the difference was statistically significant(P<0.05).The positive rate of Occult Blood Test before treatment was96.97% and after treatment was 30.30% in the combination group,while the positive rate of Occult Blood Test before treatment was 87.5% and after treatment was 59.38% in the control group.The combination group was better than the control group,T=0.018,P=0.017,and the difference was statistically significant(P<0.05).Compared with the number of defecation before and after treatment,the number of defecation in the combination group changed from(4.39±1.94)to(1.67±0.74),and in the control group changed from(4.56±1.76)to(2.06±0.80).The combination group was better to the control group,Z=4.094,P=0.043,the difference was statistically significant(P<0.05).The ESR was(26.12±12.97)mm/h before treatment and(12.09±6.35)mm/h after treatment in the combination group,and(25.13±13.26)mm/h before treatment and(16.22±13.26)mm/h after treatment in the control group.The combination group was better than the control group,T=-2.173,P=0.034,and the difference was statistically significant(P<0.05).Compared with malondialdehyde(MDA)level before and after treatment,the malondialdehyde(MDA)level in the combination group changed from(5.92±0.42)U/L to(4.08±0.28)U/L,and in the control group changed from(5.82±0.28)U/L to(5.35±0.29)U/L.The combination group was better to the control group,T=-17.782,P=0.000,and the difference was statistically significant(P<0.05).The glutathione peroxidase(GSH-Px)level was(84.65±4.74)U/L before treatment and(96.70±5.43)U/L after treatment in the combination group,and(84.33±4.05)U/L before treatment and(92.01±4.77)U/L after treatment in the control group.The combination group was better to the control group,T = 3.697,P = 0.017,and the difference was statistically significant(P<0.05).CONCLUSION: Treatment with selenium yeast combined with mesalazine in patients with ulcerative colitis can improve oxidative stress damage in patients,mainly manifested in the decrease of MDA and increase of GSH-Px.It can improve patients’ clinical symptoms,and have reference value for clinical improvement of treatment.