| Introduction:Ulcerative colitis is chronic nonspecific recurrent inflammation ofthe colonic mucosa and submucosa. The etiology may be associated with immunity,heredity, infection and intestinal flora. Most of the patients with UC need medicationssuch as aminosalicylic acid glucocorticoid and immunosuppressor. But there areseveral problems like low remission rate, high recurrence rate, adverse drug reactions.Lyophilized Saccharomyces boulardii (Sb) is a proprietary yeast preparation. It iscurrently the only yeast probiotic that has demonstrated efficacy in controlled clinicaltrials. Sb belongs to the group of simple eukaryotic cells (such as fungi and algae) andthus differs from bacterial probiotics that are prokaryotes. Sb could tolerate gastricacid and cholic acid,it will not be damaged by antibiotic. Preliminary studies haveevaluated the effect of Sb in patients with inflammatory bowel disease (IBD). Abeneficial effect in the maintenance of remission in ulcerative colitis has also beenreported. Sb could prevent the pathogen invading or transplanting, modulate immuneresponse, improve barrier effect and permeability of the intestinal mucosa. So as toimprove the symptoms of the UC patients, prevent recurrence.Objective:With the therapeutic effect of Sb recognized, it may be worthwhile tostudy its potential efficacy in patients with further well-designed clinical trials andadditional translational research studies. Eg.the dose, the time and the combinedtherapy with other drugs. Here, we compare the therapeutic effect of Sb combinedwith mesalazine on UC patients with mesalazine independently.Methods:Excluding intestinal tract infection, DM, severe complications,postoperative colon, female in pregnancy or lactation period, multiple organdysfunction patients, taking other probiotics during the treatment, and patients ofnon-compliance.60patients aged18to75years old with mild to moderate degree ofUC were divided to2groups,combination group30cases(male12,female18) and mesalazine group30cases(male14,female16).Combination group received Sb3sachets daily in3divided doses and Mesalazine8sachets in4divided doses for8weeks,the control group received Mesalazine8sachets in4divided doses for8weeks.Clinical remission rate=(complete remission cases plus effective cases)/all cases.Complete remission: the symptoms was gone and the colon endoscopy showed thecolon mucosa normal; effective:the symptoms almost gone and the colon endoscopyshowed the colon mucosa mild inflammation or polyps; invalid:the symptoms wasnot disappeared and neither the colon endoscopy nor the histopathology improved.Clinical symptom grade(CSG) endoscopy grade(EG) and histopathology grade(HG)were recorded pre-and post-the treatment. For all studies, data are expressedas X S.Measurement data by a T-test and enumeration data by a chi-square test withstatistical significance.Comparisons are accepted for P<0.05.Results:(1) The grade(CSG8.23±1.81,EG2.13±0.35, HG1.67±0.48) ofcombination group pre-the treatment and grade(CSG7.87±1.87,EG2.17±0.59, HG1.73±0.45) of mesalazine group pre-the treatment had no significantly difference（P>0.05）.(2) The CSG of combination group after two week’s treatment(7.2±1.61) wassignificantly lower than those pre-the treatment(P<0.05), The CSG of mesalazinegroup after two week’s treatment(7.00±1.51) had no significantly decreased thanthose pre-the treatment(P>0.05).(3)The CSG of combination group after four week’s treatment(4.63±1.79) wassignificantly lower than those pre-the treatment(P<0.05). The CSG of mesalazinegroup after four week’s treatment(6.00±1.17) was significantly decreased than thosepre-the treatment(P<0.05).(4) The grade of combination group post-the treatment(CSG3.57±1.87, EG1.47±0.57, HG0.97±0.56, Total Grade6.00±2.59) was significantly lower thanthose of mesalazine group post-the treatment(GSG4.83±1.29, EG1.57±0.63, HG1.3±0.47, Total Grade7.83±2.15).(5) The clinical remission rate in the combination group(46.7%) wassignificantly higher than the mesalazine group(20.0%) after8weeks`treatment(P<0.05).Conclusion:Studies evaluating Sb-combination got better effect on improving clinical symptoms endoscopy grades and histopathology grades, taking effect morequickly than using Mesalazine individually. |
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