Simadibrata Marcellus, Halimkesuma Christopher Christian, Suwita Benedicta Mutiara
Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Acta Med Indones. 2017 Oct;49(4):363-368.
treatment guidelines for ulcerative colitis (UC) not yet established. Currently, mesalazine, corticosteroids, and immunomodulators are treatment options for UC. However, they are known to have unpleaseant side effects such as nausea, vomiting, headaches, hepatitis, and male infertility. Curcumin is found in Turmeric plants (Curcuma longa L.), which possesses both anti-inflammatory and antioxidant properties. This study aimed to determine whether curcumin as adjuvant therapy can induce or maintain remission in UC patients.
structured search in three database (Cochrane, PubMed, Proquest) using "Curcumin", "remission" and "Ulcerative Colitis" as keywords. Inclusion criteria is randomized controlled trials (RCTs), meta-analysis, or systematic review using curcumin as adjuvant therapy in adult UC patients.
we found 49 articles. After exclusion, three RCTs were reviewed; two examined curcumin efficacy to induce remission and one for remision maintenance in UC. Curcumin was significantly more effective than placebo in all RCTs. The efficacy of curcumin could be explained by its anti-inflammatory properties, which inhibit NF-kB pathway. Regulation of oxidant/anti-oxidant balance can modify the release of cytokines. However, methods varied between RCTs. Therefore, they cannot be compared objectively. Futhermore, the sample size were small (n= 50, 45, 89) therefore the statistical power was not enough to generate representative results in all UC patients.
Available evidence showed that curcumin has the potential to induce and maintain remission in UC patients with no serious side effects. However, further studies with larger sample size are needed to recommend it as adjuvant therapy of ulcerative colitis.
溃疡性结肠炎（UC）的治疗指南尚未确立。目前，美沙拉嗪、皮质类固醇和免疫调节剂是UC的治疗选择。然而，已知它们会产生诸如恶心、呕吐、头痛、肝炎和男性不育等不良副作用。姜黄素存在于姜黄植物（姜黄属植物）中，具有抗炎和抗氧化特性。本研究旨在确定姜黄素作为辅助治疗是否能诱导或维持UC患者的缓解。
在三个数据库（Cochrane、PubMed、Proquest）中进行结构化检索，使用“姜黄素”、“缓解”和“溃疡性结肠炎”作为关键词。纳入标准为在成年UC患者中使用姜黄素作为辅助治疗的随机对照试验（RCT）、荟萃分析或系统评价。
我们找到了49篇文章。排除后，对三项RCT进行了综述；两项研究了姜黄素诱导缓解的疗效，一项研究了其在UC中维持缓解的疗效。在所有RCT中，姜黄素比安慰剂显著更有效。姜黄素的疗效可以用其抗炎特性来解释，它能抑制NF-κB通路。氧化剂/抗氧化剂平衡的调节可以改变细胞因子的释放。然而，RCT之间的方法各不相同。因此，它们无法进行客观比较。此外，样本量较小（n = 50、45、89），因此统计效力不足以在所有UC患者中产生具有代表性的结果。
现有证据表明，姜黄素有可能诱导和维持UC患者的缓解，且无严重副作用。然而，需要进一步进行更大样本量的研究，以推荐其作为溃疡性结肠炎的辅助治疗。
