Wong Karen, Bressler Brian
Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada.
Drugs. 2008;68(17):2419-25. doi: 10.2165/0003495-200868170-00002.
Crohn's disease is a chronic inflammatory condition with a relapsing-remitting disease course. Treatment often requires both induction and maintenance strategies. The management of mild to moderate Crohn's disease is challenging because the natural history of mild disease is not known and effective treatment options are limited. In this article, our objective is to provide a brief overview of the evidence supporting current therapies in the treatment of mild to moderate luminal Crohn's disease and to explore a few of the newer therapeutic options. As induction agents for mild to moderately active Crohn's disease, there is reasonable evidence to support the use of budesonide for terminal ileal and right colonic disease, and sulfasalazine for colonic disease. Although budesonide can be used in the short term (3-6 months) for maintenance of quiescent disease, there are no effective therapies for the long-term maintenance of mild to moderate Crohn's disease. Mesalazine appears to have no role in either the treatment of active or quiescent disease. Currently, there is insufficient data to draw conclusions on the potential role of antibacterials, probiotics or prebiotics.
克罗恩病是一种具有复发-缓解病程的慢性炎症性疾病。治疗通常需要诱导和维持策略。轻度至中度克罗恩病的管理具有挑战性，因为轻度疾病的自然病程尚不清楚，且有效的治疗选择有限。在本文中，我们的目的是简要概述支持当前治疗轻度至中度肠腔型克罗恩病疗法的证据，并探讨一些较新的治疗选择。作为轻度至中度活动性克罗恩病的诱导剂，有合理证据支持布地奈德用于末端回肠和右半结肠疾病，柳氮磺胺吡啶用于结肠疾病。虽然布地奈德可在短期内（3 - 6个月）用于维持静止期疾病，但对于轻度至中度克罗恩病的长期维持治疗尚无有效疗法。美沙拉嗪似乎对活动性或静止期疾病的治疗均无作用。目前，关于抗菌药物、益生菌或益生元的潜在作用，数据不足，无法得出结论。
