Therapeutic regimen of Crohn’s disease: effect of Infliximab combined with mesalazine on intestinal flora and inflammatory indexes in patients

Abstract Objective To study the clinical efficacy of infliximab (IFX) in combination with mesalazine in patients with Crohn’s disease (CD). Methods This retrospective analysis study included 197 patients with CD who were treated in Haiyan People's Hospital and Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University our hospital between March 2023 and March 2024, and were divided into two groups according to the different treatments recorded in the electronic medical record system: 82 cases in the control group (mesalazine) and 115 cases in the observation group (IFX combined with mesalazine treatment). The intestinal flora (bifidobacteria, Lactobacillus, Enterococcus, Enterobacteriaceae), serum indicators (tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), hemoglobin concentration (HGB), platelets (PLT), Th1, Th2, Th1/Th2), major symptoms and stool status (disappearance of abdominal pain, disappearance of diarrhea, stool frequency and stool normalization), clinical efficacy and complication situation were evaluated. Results The number of bifidobacteria and lactobacilli in the observation group was higher than that in the control group, and the difference was statistically significant (P < 0.05); TNF-α, CRP, ESR, PLT, Th1 and Th1/Th2 were lower than those in the control group, but HGB and Th2 were higher than those in the control group, and the difference was statistically significant (P < 0.05); After treatment, the rate of abdominal pain disappearance, diarrhea disappearance and normal stool rate were higher than that of the control group, and the number of stools was lower than that of the control group, with statistically significant differences (P < 0.05); the total clinical effective rate of the observation group (92.17% vs. 80.49%) was higher than that of the control group, with statistically significant difference (P < 0.05); the overall incidence rate of adverse reactions of the observation group (8.70% vs. 7.32%) was higher than that of the control group, but the difference was not statistically significant (P > 0.05). Conclusion IFX combined with mesalazine demonstrates superior clinical efficacy compared to mesalazine monotherapy in patients with Crohn’s disease. This combination effectively improves intestinal microbiota balance, reduces inflammation, modulates immune responses, and alleviates clinical symptoms without significantly increasing adverse events.