The clinical efficacy of mesalazine and bifid-triple viable combination therapy in patients with ulcerative colitis

Abstract

Objective To observe the clinical efficacy of mesalazine and bifid-triple viable combination therapy in patients with ulcerative colitis (UC).Methods Thirty-eight UC patients were evenly divided into mesalazine group and combination group. Patients in mesalazine group were administrated with mesalazine (1.0 g/time,four times/day),and on the basis of this,the patients in combination group were added into bifid-triple viable (420 mg/time,three times/day).The course of treatment was eight weeks.The improvement of patients' clinical symptom and manifestation under colonoscope were observed at second day after hospitalization and eight weeks after medication.Mayo disease activity index was used for scoring.Before and after the treatment,the expression of intestinal mucosa nuclear factor kappa B (NF-κB),tumor necrosis factor-α (TNF-a) and cyclooxygenase-2 (COX-2) were tested by immunohistochemical staining and the levels of serum TNF-α,interleukin-8 (IL-8), interleukin-10 (IL-10) were determined by double antibody sandwich enzyme-linked immunosorbent assay.The level of serum superoxide dismutase (SOD) and malondialdehyde (MDA) was detected by nitrite method and thiobarbituric acid coloration method.Before and after treatment was compared with paired t-test,and qualitative data was analyzed with ordinal rank sum test.Results Mayo disease activity index score of the combination group decreased from 7.16±2.01 to 1.63± 1.30 while the mesalazine group from 7.42 ± 1.95 to 3.00 ± 1.25.The difference of reduction was statistically significant (t =2.093,P =0.043).The efficiency of the combination group was higher than that of mesalazine group (16/19 vs 10/19,Fisher's exact test,P=0.039).After treatment,the expressions of NF-κB,TNF-α and COX-2 in colonic mucosa of two groups were both lower than those of before treatment,and in combination group the decrease were more significant (t value was 2.262,2.607 and 2.522 respectively,P value was 0.027,0.012 and 0.014 respectively).After treatment,the concentration of IL-8 of mesalazine group and the combination group both significantly decreased,however IL-10 significantly increased. The difference between these two groups was statistically significant (t value of TNF-α,IL-8 and IL-10 was 4.244,6.858 and 6.802 respectively,all P＜ 0.01). After treatment,both SOD vitality of two groups increased compare with that before treatment,however the level of MDA was lower than that before treatment and the changes of combination group were more significant.Conclusion The combination therapy with mesalazine and bifid-triple viable can effectively suppress inflammatory response in mild and moderate ulcerative colitis,and bifid-triple viable may play a role as adjuvant therapy for patients with UC. Key words: Colitis, ulcerative; Cytokines; Reactive oxygen species; Mesalamine; Bifidobacterium ; Probiotics