Park Sang Hyoung, Yang Suk-Kyun, Yang Dong-Hoon, Kim Kyung Jo, Yoon Soon Man, Choe Jae Won, Ye Byong Duk, Byeon Jeong-Sik, Myung Seung-Jae, Kim Jin-Ho
Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
Antimicrob Agents Chemother. 2009 Oct;53(10):4167-71. doi: 10.1128/AAC.00874-09. Epub 2009 Aug 10.
Intestinal tuberculosis (TB) continues to be a common disease worldwide. However, the optimal duration of anti-TB medication has not been well established. We therefore compared the efficacy of 6-month and 9-month therapy in the treatment of intestinal TB. Ninety patients definitely diagnosed with intestinal TB were randomized into 6-month (n = 45) or 9-month (n = 45) treatment groups, prospectively. The primary end point was complete response, defined as endoscopic healing of active lesions. Patients were followed up monthly for 3 months after therapy initiation, then every 3 months until the end of therapy, and finally 1 year later. Relapse was assessed 1 year after the end of therapy by patient interview and colonoscopy. Baseline characteristics were similar in the 6-month and 9-month groups. Intention-to-treat analysis revealed no significant differences between the two groups in complete response (6-month group, 93.3%; 9-month group, 91.1%; P = 1.00) or recurrence rate (6-month group, 2.4%; 9-month group, 0.0%; P = 1.00). Median follow-up duration was 39 months in the 6-month group and 32 months in the 9-month group. No surgery was performed on any patient in either group. In conclusion, the 6-month therapy was as effective as 9-month therapy in patients with intestinal TB and may have the additional benefits of reduced treatment cost and increased compliance.
肠结核在全球范围内仍是一种常见疾病。然而,抗结核药物的最佳疗程尚未明确确定。因此,我们比较了6个月和9个月疗程治疗肠结核的疗效。90例确诊为肠结核的患者被前瞻性地随机分为6个月治疗组(n = 45)和9个月治疗组(n = 45)。主要终点为完全缓解,定义为活动性病变的内镜下愈合。治疗开始后每月随访患者3个月,然后每3个月随访一次直至治疗结束,最后在治疗结束1年后进行随访。治疗结束1年后通过患者访谈和结肠镜检查评估复发情况。6个月治疗组和9个月治疗组的基线特征相似。意向性分析显示,两组在完全缓解率(6个月治疗组为93.3%;9个月治疗组为91.1%;P = 1.00)或复发率(6个月治疗组为2.4%;9个月治疗组为0.0%;P = 1.00)方面无显著差异。6个月治疗组的中位随访时间为39个月,9个月治疗组为32个月。两组患者均未接受手术治疗。总之,对于肠结核患者,6个月疗程与9个月疗程同样有效,且可能具有降低治疗成本和提高依从性的额外益处。