Naganuma M, Iwao Y, Ogata H, Funakoshi S, Takagi H, Nakano M, Hitotsumatsu O, Ezaki T, Hisamatsu T, Inoue N, Hibi T, Ishii H
Department of Internal Medicine, Keio University Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2001 Feb;98(2):151-6.
The efficacy and safety of mesalamine enema were examined in 20 patients with steroid-resistant or dependent, distal ulcerative colitis. Rectal bleeding disappeared in 3 (18%). 8 (50%) of 16 patients within 2 weeks and 4 weeks after the start of mesalamine enema treatment, respectively. Mean clinical activity index (CAI) score after the treatment was significantly reduced (8.1-->3.6, p < 0.001). Furthermore, Mean doses of oral corticosteroid after the treatment (7.3 mg) were also significantly lower than those before the treatment (12.8 mg) (p < 0.01). Four patients dropped out. Three patients could not retain the enemas because of abdominal discomfort and one patient had fever and rash. There were no significant differences in age, gender, disease duration, disease type, and mean doses of oral corticosteroid before the treatment between the response group (n = 8) and the non-response group (n = 8). However, clinical and endoscopic activities before mesalamine enema treatment in the non-response group (CAI 9.8, Matts score 8.0) were higher than those in the response group (CAI 6.4, Matts score 5.5). These results suggest that mesalamine enema is useful for mildly to moderately active distal ulcerative colitis by improving clinical symptoms and reducing corticosteroid.
对20例激素抵抗或依赖的远端溃疡性结肠炎患者进行了美沙拉嗪灌肠剂的疗效和安全性研究。3例（18%）患者的直肠出血消失。16例患者中，分别在美沙拉嗪灌肠治疗开始后2周和4周时，有8例（50%）患者的直肠出血消失。治疗后的平均临床活动指数（CAI）评分显著降低（8.1降至3.6，p<0.001）。此外，治疗后的口服糖皮质激素平均剂量（7.3mg）也显著低于治疗前（12.8mg）（p<0.01）。4例患者退出研究。3例患者因腹部不适无法保留灌肠剂，1例患者出现发热和皮疹。反应组（n=8）和无反应组（n=8）在年龄、性别、病程、疾病类型和治疗前口服糖皮质激素平均剂量方面无显著差异。然而，无反应组在美沙拉嗪灌肠治疗前的临床和内镜活动度（CAI 9.8，Matts评分8.0）高于反应组（CAI 6.4，Matts评分5.5）。这些结果表明，美沙拉嗪灌肠剂通过改善临床症状和减少糖皮质激素用量，对轻度至中度活动期远端溃疡性结肠炎有效。
