Zocco M A, dal Verme L Zileri, Cremonini F, Piscaglia A C, Nista E C, Candelli M, Novi M, Rigante D, Cazzato I A, Ojetti V, Armuzzi A, Gasbarrini G, Gasbarrini A
Department of Internal Medicine, Catholic University of Rome, Rome, Italy.
Aliment Pharmacol Ther. 2006 Jun 1;23(11):1567-74. doi: 10.1111/j.1365-2036.2006.02927.x.
Aminosalicylates are the mainstay of therapy to prevent relapse of quiescent ulcerative colitis. The rationale for using probiotics is based on the evidence implicating intestinal bacteria in the pathogenesis of this disorder.
To evaluate the efficacy of Lactobacillus GG alone or in combination with mesalazine vs. mesalazine as maintenance treatment in ulcerative colitis.
187 ulcerative colitis patients with quiescent disease were randomized to receive Lactobacillus GG 18 x 10(9) viable bacteria/day (65 patients), mesalazine 2400 mg/day (60 patients) or Lactobacillus GG + mesalazine (62 patients). Disease activity index, endoscopic and histological scores were determined at 0, 6 and 12 months and in case of relapse. The primary end point was to evaluate sustained remission.
Overall analysis showed no difference in relapse rate at 6 (P = 0.44) and 12 months (P = 0.77) among the three treatment groups. However, the treatment with Lactobacillus GG seems to be more effective than standard treatment with mesalazine in prolonging the relapse-free time (P < 0.05).
Lactobacillus GG seems to be effective and safe for maintaining remission in patients with ulcerative colitis, and it could represent a good therapeutic option for preventing relapse in this group of patients.
氨基水杨酸制剂是预防静止期溃疡性结肠炎复发的主要治疗药物。使用益生菌的理论依据是有证据表明肠道细菌与该疾病的发病机制有关。
评估单独使用嗜酸乳杆菌GG或与美沙拉嗪联合使用对比美沙拉嗪作为溃疡性结肠炎维持治疗的疗效。
187例静止期溃疡性结肠炎患者被随机分为三组，分别接受每日18×10⁹活细菌的嗜酸乳杆菌GG治疗（65例患者）、每日2400mg美沙拉嗪治疗（60例患者）或嗜酸乳杆菌GG+美沙拉嗪治疗（62例患者）。在0、6和12个月以及复发时测定疾病活动指数、内镜和组织学评分。主要终点是评估持续缓解情况。
总体分析显示，三个治疗组在6个月（P = 0.44）和12个月（P = 0.77）时的复发率无差异。然而，嗜酸乳杆菌GG治疗在延长无复发时间方面似乎比美沙拉嗪标准治疗更有效（P < 0.05）。
嗜酸乳杆菌GG似乎对维持溃疡性结肠炎患者的缓解有效且安全，它可能是预防该组患者复发的一个良好治疗选择。
