Poynard T
Service d'hépato-gastro-entérologie, hôpital Antoine-Béclère, Clamart.
Rev Prat. 1990 Feb 21;40(6):553-5.
Contrary to a still widely held belief, there is no explicative or clinical evidence that corticosteroid therapy has undesirable effects on the digestive tract causing, in particular, gastric or duodenal ulcers. From a meta-analysis of all published randomized, double-blind trials comparing corticosteroids with placebos, it appeared that the prevalence of peptic ulcers was 0.4% in the steroid group (n = 3335) and 0.3% in the placebo group (n = 3267), the difference being non-significant. Although a weak cause-effect relationship cannot be definitely excluded, these data demonstrate that it is unnecessary in practice to prescribe preventive anti-ulcer treatments to all patients receiving corticosteroids.
与一种仍被广泛持有的观点相反,没有解释性或临床证据表明皮质类固醇疗法会对消化道产生不良影响,尤其是导致胃溃疡或十二指肠溃疡。对所有已发表的比较皮质类固醇与安慰剂的随机双盲试验进行的荟萃分析显示,类固醇组(n = 3335)消化性溃疡的患病率为0.4%,安慰剂组(n = 3267)为0.3%,差异无统计学意义。虽然不能绝对排除微弱的因果关系,但这些数据表明,在实践中没有必要给所有接受皮质类固醇治疗的患者开预防性抗溃疡药物。