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姜黄素在溃疡性结肠炎达到临床和内镜缓解中的应用:系统评价和荟萃分析。

Use of Curcumin in Achieving Clinical and Endoscopic Remission in Ulcerative Colitis: A Systematic Review and Meta-analysis.

机构信息

Internal Medicine, Bassett Medical Center, Cooperstown, New York.

Jinnah Sindh Medical University, Karachi, Pakistan.

出版信息

Am J Med Sci. 2018 Oct;356(4):350-356. doi: 10.1016/j.amjms.2018.06.023.

Abstract

BACKGROUND

Ulcerative Colitis (UC) is characterized by chronic inflammation of the mucosal layers of the colon. Treatment of refractory UC is challenging and has a huge healthcare burden. Although there have been advancements in immunomodulatory therapies, these require a step-up financially, and these medications are also associated with significant adverse events. Curcumin, an active ingredient of turmeric, has been studied in the past and found to be useful in the treatment of UC when used as an adjuvant along with mesalamine. We did a systematic review and meta-analysis to explore the role curcumin plays in clinical and endoscopic remission in patients with UC.

MATERIALS AND METHODS

A comprehensive literature review was conducted by first searching the MEDLINE, Pubmed, and Embase databases through December 2017 to identify all studies that compared the use of curcumin when used along with mesalamine with placebo for clinical and endoscopic improvement and remission.

RESULTS

Three randomized controlled trials including 142 patients were included in the study. Use of curcumin along with mesalamine was associated with increased odds of clinical remission (pooled odds ratio of 6.78, 95% CI: 2.39-19.23, P = 0.042). Clinical improvement, endoscopic remission and improvement rate also trended higher in the curcumin group compared to placebo.

CONCLUSIONS

This study demonstrates higher clinical remission rates when curcumin was used in combination with mesalamine to achieve remission in patients with UC. Curcumin, due to its cost effectiveness and safer side effect profile, can decrease the healthcare burden and morbidity associated with this relapsing and remitting disease.

摘要

背景

溃疡性结肠炎(UC)的特征是结肠黏膜层的慢性炎症。难治性 UC 的治疗具有挑战性,并且给医疗保健带来了巨大的负担。尽管免疫调节疗法已经取得了进展,但这些疗法在经济上需要逐步升级,而且这些药物也与重大不良事件有关。姜黄素是姜黄的一种活性成分,过去曾对其进行过研究,发现当与美沙拉嗪一起用作辅助药物治疗 UC 时,它是有用的。我们进行了系统评价和荟萃分析,以探讨姜黄素在 UC 患者的临床和内镜缓解中的作用。

材料和方法

首先通过搜索 MEDLINE、Pubmed 和 Embase 数据库,对截至 2017 年 12 月的所有比较姜黄素与安慰剂联合美沙拉嗪用于临床和内镜改善和缓解的研究进行了全面的文献综述。

结果

纳入了三项随机对照试验,共 142 例患者。姜黄素联合美沙拉嗪使用与临床缓解的可能性增加相关(合并优势比为 6.78,95%CI:2.39-19.23,P=0.042)。与安慰剂相比,姜黄素组的临床改善、内镜缓解和改善率也更高。

结论

这项研究表明,在 UC 患者中,姜黄素与美沙拉嗪联合使用可提高临床缓解率。姜黄素由于其成本效益和更安全的副作用谱,可以降低与这种复发性和缓解性疾病相关的医疗保健负担和发病率。

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