Efficacy comparison of seton sequential treatment with different drugs for perianal fistula of active Crohn′s disease
10.3760/cma.j.cn101480-20200217-00014
- VernacularTitle:挂线序贯不同药物治疗活动期克罗恩病肛瘘的临床疗效比较
- Author:
Juan HAN
1
;
Xueliang SUN
;
Zongqi HE
;
Shuguang ZHEN
;
Jun DU
;
Jinglu TONG
;
Yunfei GU
;
Ke WEN
Author Information
1. 苏州市中西医结合医院肛肠科 215101
- Publication Type:Journal Article
- Keywords:
Crohn′s disease;
Perianal fistula;
Seton;
Sequential treatment;
Anti-tumor necrosis factor-α monoclonal antibody;
Immunosuppressant;
Infliximab;
Azathioprine
- From:
Chinese Journal of Inflammatory Bowel Diseases
2020;04(4):316-321
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical efficacies of seton sequential treatment with different drugs for perianal fistula of active Crohn′s disease (CD) .Methods:Clinical data of 42 active CD patients with anal fistula undergoing seton sequential treatment in Suzhou Hospital of Traditional Chinese Medicine and Suzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2017 to December 2018 were retrospectively analyzed. According to seton sequential drugs, patients were divided into IFX group ( n = 11) , azathioprine group ( n = 14) and mesalazine group ( n = 17) . The pre- and post-operative symptoms, laboratory tests, disease activity indexes (CDAI and PDAI) , anal self-control (Wexner) score were compared among 3 groups. Results:Forty-two patients were followed up with a median time of 24 months (12-34 months) . The proportions of healing and effectiveness of anal fistula patients were 90.9%, 71.4% and 35.3% in the IFX group, azathioprine group and mesalazine group respectively. There was a significant difference in anal fistula healing among 3 groups ( P = 0.020) . The CDAI scores after treatment in IFX group, azathioprine group and mesalazine group were lower than those scores before treatment [ (96.66 ± 51.23) points vs (170.12 ± 52.67) points, (142.11 ± 79.68) points vs (196.82 ± 81.10) points, (179.91 ± 42.06) points vs (208.02 ± 42.60) points, all P<0.05]. There was a significant general difference in CDAI score among the 3 groups ( P = 0.005) . And the CDAI score after treatment in mesalazine group was obviously higher than that in IFX group ( P<0.05) . The PDAI scores after treatment in IFX group and azathioprine group were lower than those scores before treatment [ (1.71 ± 0.91) points vs (9.91 ± 3.53) points, (3.81 ± 2.40) points vs (10.07 ± 2.67) points, both P<0.05]. There was a significant general difference in PDAI score among IFX group, azathioprine group and mesalazine group [ (1.71 ± 0.91) points vs (3.81 ± 2.40) points vs (10.45 ± 2.84) points, P<0.001] and the PDAI scores after treatment gradually increased (all P<0.05) . Conclusions:Seton sequential treatment with drug is an effective method for the treatment of perianal fistula of active Crohn′s disease. IFX and azathioprine are suitable for the choice of sequential drugs.
