摘要
目的针对近期收治的1例常规治疗疗效不理想的溃疡性结肠炎患者,我们进行了证据检索和评价,以期找到更有效的治疗方法。方法计算机检索MEDLINE(1978～2004)、CBMdisc(1978～2004)及Cochrane图书馆(2004年第3期),查找5氨基水杨酸(5ASA)灌肠液治疗溃疡性结肠炎及与病情缓解有关的系统评价、临床随机对照试验等,并对所获证据进行评价。结果高质量的临床证据表明,5ASA灌肠液治疗溃疡性结肠炎及帮助病情缓解均优于口服5ASA及柳氮磺胺嘧啶局部灌肠治疗。据此临床证据,结合医生经验及病人意愿,对该例患者实施5ASA1g+生理盐水100mlqd,睡前保留灌肠治疗。1周后,患者临床症状明显缓解,腹泻基本停止,每天解黄色黏液便1～2次。肠镜复查,炎症较前明显减轻。出院后继续用上述方案维持治疗,每周2次。门诊随访1年,患者未再复发,也无明显副作用发生。结论5ASA灌肠液是控制溃疡性结肠炎活动期间病情及帮助缓解、减少复发的有效药物。
Objective To find the most effective treatment for a patient of ulcerative colitis whose therapeutic effect was not ideal by EBM practice. Methods We attempted to get the evidence of 5-amnnosalicylic acid enemas which was used to treat ulcerative colitis and maintain remission by searching MEDLINE(19782004)、CBMdisc(19782004) and The Cochrane Library(Issue 3, 2004) and the critical appraised evidence. Results We found that 5-amnnosalicylic acid enemas was more effective and better tolerated than oral 5-amnnosalicylic acid and topical sulfalazine in the treatment of ulcerative colitis confined to the distal colon. With the physicians' experiences and patients' preferences, we established a reasonable treatment protocol of enemas with 1 g 5-ASA added to the 100ml sodium chloride, qd. After one week, all the patient's symptoms were improved: Diarrhea relieved, and stool frequency decreased to 12 times per day. The colonoscopy showed that the inflammation was alleviated dramatically. The patient continued the same treatment after discharge. One year follow up showed that the symptoms of the patient did not relapse and there was no serious side effect of 5-ASA. Conclusion 5-aminosalicyclic acid enema is effective, well tolerated in the treatment of ulcerative colitis.
出处
《中国循证医学杂志》
CSCD
2005年第7期571-573,共3页
Chinese Journal of Evidence-based Medicine
关键词
溃疡性结肠炎
5-氨基水杨酸
循证治疗
副作用
Ulcerative colitis
5-aminosalicyclic acid enemas
Evidence-based treatment
Side-effects
