Mesalamine capsules enhance the quality of life for patients with ulcerative colitis

Patients with ulcerative colitis tend to be young, potentially at peak lifetime productivity levels, and the disease can be devastating in its effects on the quality of life in these individuals. No treatment for ulcerative colitis can be comprehensively evaluated without careful attention to its impact on such psychosocial issues. The quality of life was evaluated in 374 ulcerative colitis patients using mesalamine capsules at 1 g, 2 g, and 4 g daily versus placebo in an 8-week, randomized, dose-response, placebo-controlled, double-blind, multicentre trial. Function-related quality of life parameters were assessed in this study, including five pertinent clinical symptoms and seven general life capabilities. These parameters have been previously shown to be valid, reliable, and responsive to the disease activity of ulcerative colitis. All of the parameters were recorded using a 10-cm visual analogue scale, except trips to the toilet which were recorded in patients' diaries. The mean change was calculated from baseline and endpoint data. Mesalamine at 2 g and 4 g daily was significantly superior to placebo in improving each of the 12 quality of life parameters (P < 0.05). These results indicate that controlled-release mesalamine significantly enhances the quality of life for patients with either left-sided ulcerative colitis or pancolitis.     

Test of an instrument to measure function-related quality of life in patients with ulcerative colitis

An instrument for measuring function-related quality of life (QOL) in patients with ulcerative colitis was tested for validity, reliability, and responsiveness, using concepts and statistical methods easily understandable for pharmaceutical researchers. For this 8-week study, 374 patients were randomised and received placebo or oral mesalazine (mesalamine) at 1g, 2g, or 4g daily. A 10cm visual analogue scale and patient diaries were used to measure the 12 QOL parameters at baseline and study termination. Physician's Global Assessment was measured at end-point and used to assess change in the disease state of each patient. Analysis of covariance was used to test the construct validity, reliability and responsiveness of the instrument. Construct validity (p less than or equal to 0.0001), reliability (p greater than 0.05), and responsiveness (p less than or equal to 0.0001) were established for all 12 parameters of the instrument. We conclude that the instrument demonstrated precision in measuring function-related QOL in patients with active ulcerative colitis. Furthermore, content validity was maximised by combining disease-specific and general questions in the instrument.     

中西医结合治疗溃疡性结肠炎临床疗效观察

目的观察四神丸加味汤联合柳氮磺胺吡啶治疗溃疡性结肠炎的疗效。方法将溃疡性结肠炎患者162例,随机分为治疗组及对照组,治疗组采用四神丸加味汤联合柳氮磺胺吡啶,对照组单纯应用西药,观察两组疗效。结果治疗组临床治愈率为54.1%,总有效率为92.9%;对照组临床治愈率为36.4%,总有效率为72.7%。两组比较,有显著性差异(P<0.05)。结论四神丸加味汤联合柳氮磺胺吡啶治疗溃疡性结肠炎疗效满意。     

三氧治疗对活动期溃疡性结肠炎患者免疫功能及氧化应激水平的影响

目的 研究医用三氧治疗系统对溃疡性结肠炎(UC)患者免疫功能紊乱及氧化应激水平的影响.方法 活动期UC患者64例,随机均分为三氧治疗组和对照组:对照组给予美沙拉嗪缓释片治疗;治疗组加用隔天一次医用三氧治疗系统治疗.两组均治疗30 d.观察治疗前后疗效、T细胞免疫功能以及氧化应激水平的变化.结果 治疗组临床综合总有效率明显高于对照组(90.6%vs.65.6%)(P<0.01).治疗组血清IgA、IgG水平显著降低(P<0.01),CD8+ T细胞水平增高,CD4+/CD8+比值降低(P<0.01),超氧化物歧化酶(SOD)水平明显升高,丙二醛(MDA)含量减少(P<0.05).结论 医用三氧复合美沙拉嗪缓释片治疗UC的临床疗效明显优于单用美沙拉嗪缓释片.     

双歧杆菌三联活菌联合英夫利西单抗对中重度溃疡性结肠炎患者免疫功能的影响

目的观察中重度溃疡性结肠炎(UC)应用双歧杆菌三联活菌联合英夫利西单抗治疗的效果。方法选取2017年3月至2018年9月我院收治的92例UC患者,采用随机数字表法分为观察组和对照组各46例。对照组单用英夫利西单抗,观察组为双歧杆菌三联活菌与英夫利西单抗联合治疗。比较2组T细胞亚群、体液免疫指标[免疫球蛋白(Ig)G、IgA及IgM]。结果 2组治疗后CD8~+下降,CD4~+、IgG、IgA均上升,且观察组变动幅度大于对照组,差异有统计学意义(P<0.05)。治疗后的CD8~+、CD4~+、IgG、IgA、IgM,与同组治疗前比较,差异有统计学意义(P<0.05)。结论针对中重度UC患者,应用双歧杆菌三联活菌与英夫利西单抗联合治疗可加快T细胞水平恢复正常,改善体液免疫。     

Paracetamol metabolism in patients with ulcerative colitis

Aims The capacity for sulphation of phenols appears to be impaired in the colonic mucosa of patients with ulcerative colitis. The aim of the present study was to investigate the systemic capacity for sulphation of phenols in patients with ulcerative colitis assessed by the metabolic clearances of paracetamol to the sulphate, glucuronide and glutathione derived metabolites.
Methods Ten patients with ulcerative colitis and 10 control subjects received a single oral dose of paracetamol (1  g). Venous blood samples were collected frequently for pharmacokinetic determinations (one compartment model). Urine was collected for 24  h. Plasma samples were analysed for parent drug and urine samples for parent drug and metabolites by h.p.l.c. Partial metabolic clearances were calculated as the fractional urinary recovery of each conjugate multiplied by the apparent oral clearance of paracetamol.
Results The apparent oral clearance of paracetamol and the partial clearances of its metabolites were not significantly different between the two study groups. Median value and the corresponding 25th and 75th percentiles for the clearance of the sulphate metabolites were 93.6 (82.5–138.8)  ml  kg⁻¹  h⁻¹ and 77.4 (75.5–99.1), patients with ulcerative colitis and control subjects, respectively.
Conclusions These results do not indicate a general impairment of the systemic capacity for sulphation of paracetamol in patients with ulcerative colitis.     

中医药治疗溃疡性结肠炎的研究进展

目的 了解中医药治疗溃疡性结肠炎的研究文献特点,探讨溃疡性结肠炎的中医药治疗用药规律。方法 从中医对溃疡性结肠炎的病机、分型、辨证论治及现代中医在溃疡性结肠炎治疗中新的方剂的研究和应用方面进行了综述,并且还论述了中西医结合治疗溃疡性结肠炎的研究。结果 中医药也是治疗溃疡性结肠炎的有效方法;还可配合西药治疗,可改善症状、提高疗效。结论 中医药治疗溃疡性结肠炎具有独特的优势,且副作用小,安全性高,加减灵活,适合于长期应用。     

Impact of atypical antipsychotics on quality of life in patients with schizophrenia

Schizophrenia is a long-term disabling illness that affects approximately 1% of the population. Its course is generally chronic with acute psychotic exacerbations that may require frequent hospitalisations. The clinical picture includes a range of symptoms such as delusions, hallucinations, agitation, suspiciousness, hostility, conceptual disorganisation, blunted affect, emotional and social withdrawal, lack of spontaneity, poverty of speech and a wide range of neurocognitive deficits. Over the past 50 years, antipsychotic medications have emerged as the cornerstone of management in concert with other important interventions, such as psychosocial and economic support and rehabilitation efforts. However, the unrivalled role of conventional antipsychotic medications has been continuously challenged by the wide range of adverse effects of these medications and their lack of usefulness in the treatment of neurocognitive deficits as well as deficit and negative symptoms. In addition, the lack of subjective tolerability of these agents and their negative impact on quality of life have complicated management for a large number of patients. Over the last 15 years, several new atypical antipsychotic medications have been introduced, including amisulpride, remoxipride, risperidone, sertindole, olanzapine, zotepine, quetiapine, ziprasidone and aripiprazole. In general, the new antipsychotics have shown themselves to be at least comparable in efficacy to conventional antipsychotics but with superior subjective tolerability and a more favourable adverse effect profile. The majority of quality of life studies involving new antipsychotic agents have evaluated the benefits of risperidone, olanzapine and clozapine; only a few studies have examined the effects of other new antipsychotics. While most of these studies have methodological and design limitations, the weight of evidence from them nevertheless points to a trend towards a more positive impact on quality of life with atypical agents. A number of recommendations can be made. First, more independent well designed and controlled studies are urgently needed to evaluate the effects of antipsychotic therapy on quality of life in patients with schizophrenia. New comparative studies should explore not only the differences between new and old antipsychotics but also identify any potential differences between individual new agents. The role of cost-effectiveness studies such as cost utility approaches in schizophrenia needs to be revisited, notwithstanding the fact that these types of studies have been reported to be feasible in schizophrenia. Finally, quality-of-life-based pharmacoeconomic studies of antipsychotic agents should not concentrate solely on cost reduction or containment, as it is likely that in order to maximise the benefits of new antipsychotic medications, greater expenditure on rehabilitation programmes and other support services will be necessary in the short-term at least.     

中药0708对溃疡性结肠炎大鼠肠道菌群失调及免疫功能低下的调整作用

目的探讨中药合剂对实验性大鼠结肠炎的微生态失调、免疫功能的影响,寻找治疗溃疡性结肠炎的中药合剂。方法用乙酸诱发大鼠实验性结肠炎模型,筛选具有免疫增强作用的补益类中药制成的常态中药,分别于第7天,第10天,第14天分批剖腹取肠道内容物及结肠病变肠段,培养后观察肠道双歧杆菌、乳酸杆菌、肠杆菌、肠球菌4种正常菌群变化,肉眼及苏木素-伊红(HE)染色后观察肠黏膜损伤及治疗组的修复情况,同时用免疫组织化学法测定各组T细胞亚群的数量。结果中药0708能扶植肠道正常菌群生长,促进肠黏膜损伤修复,控制肠道菌易位,各项指标与自然恢复组比较差异有统计学意义(P<0.05)。结论此组常态中药可以扶植肠道正常菌群生长,调整肠道微生态失调、修复肠道黏膜损伤、增强免疫功能。     

健康教育对肝硬化患者生活质量的影响

目的探讨健康教育对肝硬化患者生活质量的影响,以提高肝硬化患者的生活质量。方法对2007年6月至2009年6月住院的60例肝硬化患者从饮食、活动、心理、用药、出院等方面给予健康指导。结果健康教育后患者遵医行为、健康生活方式、健康活动行为、治疗满意度及生活质量均明显提高,与健康教育前比较,差异有统计学意义(P<0.05)。结论对肝硬化患者在药物治疗同时进行有效的健康教育是稳定病情、提高患者生活质量的切实有效的措施。     

溃疡性结肠炎患者体内新型IL因子表达研究

目的探讨溃疡性结肠炎(UC)患者体内新型IL因子表达。方法选取2014年1月~2016年12月收治的溃疡性结肠炎患者50例作为观察组,另选择我院同期健康体检者50例作为对照组,测定两组体内外周血清中白细胞介素-17(IL-17)、白细胞介素-21(IL-21)、白细胞介素-22(IL-22)、白细胞介素-23(IL-23)等主要炎性因子含量及不同程度的UC患者体内IL因子的表达,并进行统计学分析。结果观察组患者血清中IL-17、IL-21、IL-22、IL-23等炎性因子均明显高于健康对照组,且差异有统计学意义(P<0.05);重度UC患者血清中IL-17、IL-21、IL-22、IL-23等炎性因子均明显高于轻中度UC患者,且差异有统计学意义(P<0.05);50例溃疡性结肠炎治疗后外周血清IL-17、IL-21、IL-22、IL-23等炎性因子表达水平明显低于治疗前,且差异有统计学意义(P<0.05)。结论 UC患者外周血清中IL-17、IL-21、IL-22、IL-23水平明显升高,与疾病活动度密切相关,可预测UC发展或评估治疗效果。     

中药联合SASP灌肠治疗溃疡性结肠炎疗效观察

目的观察中药联合SASP灌肠治疗溃疡性结肠炎的疗效。方法63例溃疡性结肠炎患者分成治疗组32例和对照组31例,治疗组给予中药粉剂和SASP灌肠治疗,对照组给予SASP或5-ASA口服治疗。观察患者8周后主观评价治疗有效率、内镜下溃疡性结肠炎病变改善有效率、2年后复发率。结果治疗组和对照组主观评价治疗有效率分别为90.6%、67.7%;治疗组和对照组内镜下溃疡性结肠炎病变改善有效率分别为87.5%、64.5%;治疗组和对照组2年后复发率分别为25%、54.8%。两组主观评价治疗有效率、内镜下溃疡性结肠炎病变改善有效率、2年后复发率有显著差异。结论中药联合SASP灌肠疗效理想而可靠,简单易行,值得临床推广。     

蒙中药合用治疗溃疡性结肠炎的体会

近年来国内溃疡性结肠炎(UC)发病率逐年上升趋势(1),临床上20-40岁年龄多见,探索有效的治疗方法逐渐提上日程。溃疡性结肠炎是一种慢性非特异性的结肠炎,具有反复发作的特点。笔者采用蒙中药结合治疗本病22例,取得较好的疗效。现汇报如下:1、临床资料1.1诊断依据依据1993年全国慢性非感染性肠道疾病太原会议溃疡性结肠炎的诊断标准(2)。