Observe The Effect Of High-does Mesalazine Enema In Treating Of Moderate-to-severe Ulcer Colitis

Backgrounds and aims Ulcer colitis is a chronic nonspecific inflammatory bowel disease.Its main clinical manifestations show recurrent episodes of diarrhea,abdominal pain and mucous abscess,and its features are long duration,recurrent attacks,and difficulty in radical treatment,which bring great difficulties to clinical treatment.In recent years,with the development and research of new technologies and the continuous improvement of treatment methods,the new 5-amino salicylic acid preparation develops rapidly,and engender many new preparations such as mesalazine granule preparation,mesalazine enema and mesalazine suppository etc.The experimental,s mainly aim is observing the effect of new salicylic acid preparation that mesalazin combined oral and large dose mesalazine enema in treating of moderate-to-severe ulcer colitis curativeMethods We select the 85 cases of patients with ulcerative colitis in finally and divided them into the experimental group(n=43)and the control group(n=42)by randomly digital table.One case of the experimental group is shed in finally.The experimental group receives combined mesalazine oral and enema treatment and the control group receives only oral mesalazine treatment.We observed the clinical symptoms,the endoscopic remission of the overall and local mucosal healing rate,MAYO score and the adverse reactions after 2 weeks,4weeks,8weeks of treatment.We also compare the two groups with difference.Results Conclusions 1.The rapid curative effect of large dose of mesalazine: In the clinical symptom remission rate: the clinical symptom remission rate of the experimental group with the combined therapy treatment after 2 weeks,4 weeks,8 weeks are 83.3% ? 90.5% and 90% respectively.however,the clinical symptom remission rate of the contral group with the single oral therap are 64.3%?73.8%?85%,p1 = 0.047,P2,= 0.046 P3 =0.332,The clinical symptom remission rate in the experimental group after 2weeks VS 4weeks was P4=0.345,the clinical symptom remission rate in the experimental group after 2weeks VS 4weeks was P5=0.633..In the healing mucosal rate: the healing mucosal rate of the experimental group is obtained in76.2%?83.3% ? 85% and in 50%?61.9%?75% of the control group after 2 weeks,4 weeks,8 weeks,P1=0.013?P2=0.028?P3=0.414.The mucosal healing rate in the experimental group after 2weeks VS 4weeks was P4=0.272,the mucosal healing rate in the experimental group after 2weeks VS 4weeks was P5=0.429.In the Local analysis of mucosal healing rate,we find that the mucosal healing rate of the whole colon in the experimental group 72.7% is significantly better than that of the control group at 40.9%(P<0.05).In the local analysis of patients with no remission in endoscope,we find that in the experimental group,there were 5 patients with distal colonic(direct sigmoid colon)partial remission(the remission rate was 50%),while the control group had 2 patients with distal colon partial remission(9.6%),P <0.05.The analysis of the lesion activity: the MAYO score of the experimental Group score was 3.40 lower than the control group 4.33±1.408 after 2 weeks(P<0.05).and the MAYO score of the experimental Group score was 1.81±1.418 lower than the control group 2.60±1.270,after 4 weeks(P<0.01).In adverse reactions: there are 5 patients in the experimental group with adverse reactions during the 8 weeks of treatment,and 3 in the control group have adverse reactions(P > 0.05).2.The effect of large dose mesalazine and conventional dose salazosulfazoline enema: Compared with Salazosulfonypyridine enema(the control group):the clinical response rate of experimental group(the salad oxazine enema group)was 83.3% compared with the control group 72.7%,P1 =0.470 after 2 weeks.mucosal healing rate of the experimental group was 76.2%,compared with 69.6% in the control group,P = 0.230.the MAYO scorein the experimental groups was 3.4 ±1.499,while the control group was 4.39± 1.694,P = 0.009 after 2weeks.adverse reactions: the adverse reactions in the experimental group was 7%,and the adverse reactions was 15.2% in the control group,P < 0.01).Conclusions(1)Combined with high dose mealazine enema in treatment of severe ulcerative colitis is significantly better than single oral therapy.(2)Combined therapy can quickly relieve clinical symptoms and heal mucosa in a short time.(3)The optimal duration of treatment for severe ulcerative colitis was 2-4 weeks by using combined high-dose mealazine enema.(4)There was no significant increase in the incidence of adverse reactions in the combined large doses mesalazine enema and single oral therapy(5)The large dose of mealazine enema can rapidly heal the mucosa of the severe ulcerative colon compared with the conventional dose of sulfazosulfazoline enema(6)The large dose of mesalazine can significantly reduce the activity of the lesion compared with sulfazosulfopyridine enema.(7)The large dose of mesalazine is more safe than sulfazosulfonypyridine enema.