Analysis of therapeutic effects of 284 patients with ulcerative colitis

Objective To analyze the clinical efficacy of different medication and routes of administration on ulcerative colitis( UC) patients. Methods 284 UC patients,who were admitted to the Department of Gastroenterology at the First Affiliated Hospital of Dalian Medical University from 1. 1. 2010 to 1. 1. 2015,were included in this study. According to different regimens,patients with mild-to-moderate severity or moderate-to-severe severity were divided into 6 groups: Sulfasalazine( SASP) group,Mesalazine group,oral Mesalazine + Mesalazine enema / suppository group,oral Mesalazine +Glucosteroids( GCS) enema group,intravenous GCS group and Infliximab( IFX) group. Administration methods can be summarized as systemic application( oral / intravenous dosage) and topical usage( enema / suppository). Comparison of therapeutic effects between different medication and routes of administration were conducted. Overall response rate( ORR) =remission rate + effective rate. Results( 1) For mild-to-moderate cases,Mesalazine was better than SASP( 92. 06%,vs. 68. 18%,P 0. 01); oral Mesalazine + Mesalazine enema / suppository was the best regimen( 95. 16%),followed by oral Mesalazine( 92. 06%); while oral Mesalazine + GSC enema was found least effective( 90. 63%),P 0. 05.( 2) For moderate-to-severe cases,IFX was better than GCS( 100% vs. 90. 63%,P 0. 05).( 3) Patients with refractory ulcerative colitis( RUC) can be rescued with longer duration of GCS,transition to immunosuppressants / biologicals and surgery.( 4) Safety: Incidence of adverse events( AEs) for SASP,Mesalazine and IFX was 27. 27%,2. 13% and 6. 67%,respectively. Conclusion( 1) For mild-to-moderate cases,oral Mesalazine + Mesalazine enema / suppository is the best regimen.( 2) IFX is better than GCS for moderate-to-severe cases.( 3) RUC patients can be managed with longer duration of GCS,transition to immunosuppressants / biologicals and surgery.( 4) Drug therapy is relatively safe,and has low incidence of AEs.