Clinical Efficiency Of Mesalazine Enemas In Treatment Of Mild To Moderate Distal Ulcerative Colitis

Background:The Etiology and pathogenesis of ulcerative colitis (UC) is not known, which maybe involve genetics,immunity,environment and other factors. The therapeutic methods of mild to moderate distal ulcerative colitis are local and oral therapy. Due to sulfasalazine (SASP) more side effects, mesalamine formulations have gradually become the drug of choice.Topical treatment of mild to moderate distal UC has been paid more and more attention in recent years.Objective:To evaluate the efficiency of mesalazine enemas in patients with distal ulcerative colitis(UC),and to explore its mechanism.Methods:Thirty-eight patients with active mild to moderate distal ulcerative colitis in accordance with inclusion criteria were randomly divided into trial group (n=19) and control group (n=19).The patients were treated by mesalazine enemas (4.0g,every night) and mesalazine sr granules (1.0g,four times a day) for4weeks.Compared their endoscopic findings,dates of clinical disappearence,disease active index(DAI), clinical curative effects and adverse reaction. The expression of Induction of nitric oxide synthase type (iNOS),nuclear factor-kappa B (NF-KB),interleukin-1β(IL-1β)in colonic mucosa was also detected by immunohistochemical staining.Results:The endoscopic findings,dates of clinical disappearence,disease active index(DAI), clinical curative effects were improved more in trial group than in control group (P<0.05). The expression of iNOS,NF-κB and IL-1β significantly decreased in trial group than that in control group(P<0.05). Safety profile and tolerability were very good for both groups and were not different(P>0.05).Conclusion:The mesalazine enemas have the advantage of more effective,higher safety,less time of symptoms than oral mesalazine sr granules in treatment of mild-to-moderately active distal UC.Mesalazine enemas is an effective agent probably by decreasing expression of iNOS,NF-KB and IL-1β.