Clinical study of long-term methotrexate in the treatment of ulcerative colitis with azathioprine ineffective intervention

Abstract

Objective To study the efficacy of long-term methotrexate (MTX) in the treatment of ulcerative colitis (UC) with azathioprine (AZA) ineffective intervention. Methods Ninety-two patients with UC ineffective in the treatment of AZA, were randomly divided into two groups, forty-six cases in each group. The control group was given intramuscular injection of MTX for one year. The control group was treated with placebo for half a year after having finished intramuscular injection of MTX for six months. We Compare the differences of clinical efficacy in two groups, and analyze the level of hemoglobin (HB), albumin (ALB), blood sink (ESR), C-reactive protein (CRP), platelet (PLT) in two groups, and learn the incidence of adverse reactions in the two groups. Results There was no significant difference in clinical curative effect between the two groups after six months (χ2=0.045; P>0.05).The total effective rate in the observation group after one year was higher than that for six months and that in control group (χ2 = 11.683 and 17.692 respectively; P 0.05). After 1 year of treatment, HB and ALB in the observation group were significantly higher than those in the control group, CRP, ESR and PLT were significantly lower than those in the control group (t=3.893, 6.240, 17.009, 9.971, 11.662 respectively, P 0.05). Conclusion MTX treatment of UC, which is ineffective in the treatment of azathioprine (AZA), can improve the nutritional status of the body, coagulation function, and reduce the body′s inflammatory response. It can control the disease and has high safety with a good clinical value. Key words: Methotrexate; Azathioprine; Ulcerative colitis; Ineffective intervention; Refractory