Mulder C J, Endert E, van der Heide H, Houthoff H J, Wiersinga W, Wiltink E H, Tytgat G N
Neth J Med. 1989 Aug;35(1-2):18-24.
Twenty-three patients with attacks of distal ulcerative colitis were treated randomly with either 2 or 3 mg of topically administered beclomethasone dipropionate (BDP) or 30 mg of prednisolone sodium phosphate (PP). The effect of the steroid enemas on adrenocortical function was assessed by ACTH tests, which were performed before and after treatment. Endoscopic, clinical and histological scores were comparable in the three treatment groups in this pilot trial. Fasting cortisol in the PP group decreased significantly from 0.47 +/- 0.12 mumol/l before to 0.22 +/- 0.14 mumol/l (P less than 0.05) after therapy; in the BDP group no significant changes were found. Urinary cortisol excretion in the PP group was not detectable after therapy; in the BDP group no changes were found. It is concluded that in the topical treatment of ulcerative colitis, BDP may be preferable to PP because it exerts a promising anti-inflammatory action without affecting adrenocortical function.
23例远端溃疡性结肠炎发作患者被随机分为两组，分别接受2毫克或3毫克局部应用的二丙酸倍氯米松（BDP）治疗，或30毫克泼尼松龙磷酸钠（PP）治疗。通过治疗前后进行的促肾上腺皮质激素（ACTH）试验评估类固醇灌肠剂对肾上腺皮质功能的影响。在这项初步试验中，三个治疗组的内镜、临床和组织学评分具有可比性。PP组空腹皮质醇从治疗前的0.47±0.12微摩尔/升显著降至治疗后的0.22±0.14微摩尔/升（P<0.05）；BDP组未发现显著变化。治疗后PP组尿皮质醇排泄量无法检测到；BDP组未发现变化。得出结论，在溃疡性结肠炎的局部治疗中，BDP可能比PP更可取，因为它具有良好的抗炎作用且不影响肾上腺皮质功能。
