| Background: Ulcerative colitis(UC) is an inflammatory bowel disease. It is a majorpathogeny of the digestive system diseases and the chronic diarrhea. Since it presents arising trend, more observant considerations are focused on it in China in recent years. Itsetiology and pathogenesis has not been investigated clearly yet. The etiology is considered tobe the interaction of multiple factors of immune, genetic, environmental, bacterial and viralinfections, alternation of intestinal flora, and other results. The clinical treatment is focusedon the anti-inflammatory and the regulation of immune, but it receives poor effect with morecomplications and there is no breakthrough in the curation of this disease. Some satisfactoryclinical results are met by the application of montmorillonite powder in retention enema forthe treatment of ulcerative colitis in recent years. It is considered possibly thatmontmorillonite powder acting as a gastrointestinal mucosal protective agent with a strongprotection and adsorption capacity covers the mucous membrane, which repairs andstrengthens the role of gastrointestinal mucosa barrier withstanding the intestinal mucosalimmune inflammatory responses induced by the attack of the pathogen. This study adopts anew drug retention enema irsogladine maleate which is developped by the Japan NipponShinyaku Corporation combined with anti-inflammatory therapy aiming for discoveringmore effective treatment for the ulcerative colitis by mucosal protective agent and improvingthe quality of ulcer healing to investigate a better effective treatment of ulcerative colitis bythe integrated programmes.Objective: The patients with the colon of ulcerative colitis qualified the descendingcolon and the following are treated with the new mucosa protection agent irsogladine and thetraditional mucosa protection agent montmorillonite powder retain enema treatmentrespectively on the basis of the current anti-inflammatory treatment. The clinical mitigationrate performance including the diarrhea, the constipation, the mucous pus blood, theabdominal pain, the tenesmus, the abdominal distension, the general symptoms and theimprove situation of enterosarcoma signs and the integrated treatment are observed. Thecurative effect is evaluated by the comparison of irsogladine and montmorillonite powder inthe treatment ulcerative colitis.Methods: The54patients who are diagnosed as the descending colon and the following active ulcerative colitis by the clinical manifestation, the electronic colonoscopy, thehistopathological and the laboratory examination between October2010and January2012inthe hospital. The patients are divided into the treatment group and the control grouprandomly. Both the two groups are given the same common treatment:1. Mesalazine1.0g,tid, po, for the mild to moderate patients, taking after the meal; methylprednisolone for thesevere patients with40mg, qd, vid, and then when the symptom relieves after7-10dprednisone tablets50mg, qd, po, taken after a meal. The amount is gradually reducedaccording to the illness.2. The bifidobacterium tetravaccine tablets1.5g, tid, po. Thetreatment group: retention enema with the solution of irsogladine4mg, mesalazine1.0g,gentamicin160,000units soluted in100ml physiological saline one time every night.Control group: retention enema with the solution of montmorillonite powder6g, mesalazine1.0g, gentamicin160,000units soluted in100ml physiological saline one time every night.The two groups of the clinical symptoms, the enterosarcoma signs and the colonoscopyimprove rates are observed after four weeks. The intergrated effects are taken to compareand evaluate the treatment of the two drugs. Measurement data are t test, count data areanalyzed by chi-square test and p<0.05as significant difference.Results:1. In the clinical symptoms aspect, the treatment group takes the advancesover the control group obviously on the diarrhea, the mucous pus blood, the abdominal pain,the tenesmus and the mitigation rate of the general symptoms. The results of the treatmentgroup are95.7%(22/23),96%(24/25),94.1%(16/17),84.6%(11/13) and90%(9/10) andthe results of the control group are73.9%(17/23),75%(18/24),61.5%(8/13),40%(4/10)and44.4%(4/9) respectively. The differences present as statistically significant(P<0.05). Butthe mitigation rates of the treatment group with the respect of the constipation and theabdominal distension are60.0%(3/5)and66.7%(6/9) respectively which presents nostatistically significant when compared with the control group as the results are66.7%(2/3),66.7%(4/6) respectively.2. In the enterosarcoma symptoms aspect, the mitigation rates intotal for the treatment and control groups are96.4%and73.1%respectively. The differencespresent as statistically significant(P<0.05). The Significant efficiency of the treatment groupis53.6%(15/28), which is significantly higher than the control group26.9%(7/26). Thedifferences present as statistically significant(P<0.05).3. In the comprehensive effect, Thetotal effective rate is96.4%for the treatment group, which takes the advantage over that ofthe control group as76.9%distinctly. The differences present as statisticallysignificant(P<0.05). And the efficiency of the overall effect for the treatment group is 50%(14/28), which is significantly higher than that for the control group as23.1%(6/26).The differences present as statistically significant(P<0.05). Neither the treatment and controlgroups are found adverse effects apparently.Conclusion:1. The efficiency of the combined treatment with the mucosa protectionagent irsogladine on the foundation of common anti-inflammatory treatment for the patientslimited to the descending colon and the following active ulcerative colitis is satisfactory.There are statistically significant in the differences in terms of the alleviating diarrhea,mucous pus blood, the abdominal pain, the tenesmus and the general symptoms which arehigher than the control group combined with traditional mucosa protection agentmontmorillonite powder, but no significant differences in mitigating the constipation and theabdominal distension.2. The improvement rate under the enterosarcoma signs of thecombined treatment with the mucosa protection agent irsogladine for the patients limited tothe descending colon and the following active ulcerative colitis is obviously superior to thecontrol group combined with traditional mucosa protection agent montmorillonite powder onthe foundation of common anti-inflammatory treatment. The therapy can improve thesignificant efficiency under the colonoscopy conspicuously.3. The comprehensiveeffectivity result indicates that the therapy that the mucosa protection agent irsogladinecombined with the common anti-inflammatory treatment for the patients limited to thedescending colon and the following active ulcerative colitis is ideal and effective. Theeffectivity is much better than the the montmorillonite powder group. There are no adverseeffects apparently. |
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