Preel J L, Eugene C, Mignon M, Weissman A, Hardouin J P, Debray C
Sem Hop. 1979;55(1112):567-73.
Medical management of Crohn's disease is above all symptomatic. According to the severeness of the case, treatment varies and may be simple (regimen, antidiarrheic agents and sulfamid drugs) or more sophisticated (continous parenteral alimentation). Sulfamids and antibiotics have a definite although temporary action. Pathogenic medication includes: 1) steroid therapy who is active, but its effects are not long stand; 2) immunosuppressors who allow for the reduction of steroid therapy dosages; 3) immunostimulants as proposed by Geffroy. Among those presently studied are Calmette-Guérin vaccine, either given orally or by scarification, and two anti-parasitic drugs, metronidazole and levamisole. Short term results are good but they worsen with time. The main problem is to know when to discuss surgery. As need be, resection although mutilating, should be timely indicated.
克罗恩病的药物治疗首先是对症治疗。根据病情的严重程度,治疗方法各异,可能较为简单(饮食疗法、止泻剂和磺胺类药物),也可能更为复杂(持续胃肠外营养)。磺胺类药物和抗生素有确切疗效,但只是暂时的。特效药物包括:1)类固醇疗法,效果显著,但持续时间不长;2)免疫抑制剂,可减少类固醇疗法的剂量;3)如杰弗鲁瓦提议的免疫刺激剂。目前正在研究的有卡介苗,可口服或划痕接种,还有两种抗寄生虫药物,甲硝唑和左旋咪唑。短期效果良好,但随着时间推移会变差。主要问题是要知道何时考虑手术。如有必要,尽管切除手术会造成损害,但仍应及时进行。