Scott Frank I, Osterman Mark T
Division of Gastroenterology, Department of Medicine, University of Pennsylvania, Penn Presbyterian Medical Center, Philadelphia, Pennsylvania.
Clin Colon Rectal Surg. 2013 Jun;26(2):67-74. doi: 10.1055/s-0033-1348043.
Crohn disease (CD) is one of the major subtypes of inflammatory bowel disease and can occur in any segment of the alimentary tract. There have been significant advances in the medical therapy of CD over the past several decades. For mild CD, the oral corticosteroid derivative budesonide has demonstrated superior efficacy compared with traditional therapies such as 5-aminosalicylic acid, and can be used concurrently with these agents. For the management of moderate to severe disease, the immunomodulators azathioprine, 6-mercaptopurine, and methotrexate, as well as the antitumor necrosis factor-alpha (TNF-α) agents infliximab, adalimumab, and certolizumab pegol, have become the mainstay of therapy, with growing interest in combining these agents for maximal effect. Immunomodulators and anti-TNF-α agents have also demonstrated benefit in fistulizing CD. There has been growing evidence suggesting that both of these agents, along with the antibiotics metronidazole and ornidazole, are also effective in preventing postoperative recurrence of CD.
克罗恩病（CD）是炎症性肠病的主要亚型之一，可发生于消化道的任何部位。在过去几十年中，CD的药物治疗取得了显著进展。对于轻度CD，口服皮质类固醇衍生物布地奈德与传统疗法如5-氨基水杨酸相比，已显示出更高的疗效，并且可以与这些药物联合使用。对于中重度疾病的管理，免疫调节剂硫唑嘌呤、6-巯基嘌呤和甲氨蝶呤，以及抗肿瘤坏死因子-α（TNF-α）药物英夫利昔单抗、阿达木单抗和赛妥珠单抗已成为治疗的主要手段，人们越来越关注将这些药物联合使用以达到最大效果。免疫调节剂和抗TNF-α药物在瘘管性CD中也显示出益处。越来越多的证据表明，这些药物以及抗生素甲硝唑和奥硝唑在预防CD术后复发方面也有效。
