Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China.
J Gastroenterol Hepatol. 2020 May;35(5):722-729. doi: 10.1111/jgh.14911. Epub 2019 Nov 7.
Aminosalicylic acids are recognized to be the first-line treatment options for ulcerative colitis. Currently, the effectiveness of curcumin as an adjuvant treatment in ulcerative colitis has been investigated, which was still controversial. This study aimed to systematically review and meta-analyze the efficacy and safety of curcumin as an adjuvant treatment in ulcerative colitis.
The PubMed, EMBASE, and Cochrane Library databases were searched from original to July 2019, and relevant randomized controlled clinical trials were enrolled and analyzed. The primary outcomes were clinical and endoscopic remission; meanwhile, the secondary outcomes were clinical and endoscopic improvement. Subgroup analyses of doses, delivery way, form, and intervention time of curcumin were also conducted.
Six randomized controlled clinical trials with a total of 349 patients were included. Eligible trials suggested that adjuvant curcumin treatment in ulcerative colitis was effective in inducing clinical remission (odds ratio [OR] = 5.18, 95% confidence interval [CI]: 1.84-14.56, P = 0.002), endoscopic remission (OR = 5.69, 95% CI: 1.28-25.27, P = 0.02), and endoscopic improvement (OR = 17.05, 95% CI: 1.30-233.00, P = 0.03), but not in clinical improvement (OR = 4.79, 95% CI: 1.02-22.43, P = 0.05). We can see the potential advantages in large dosage, topical enema, special drug form, and longer duration from the enrolled studies. There were no severe side effects reported.
Curcumin, as an adjuvant treatment of mesalamine, was proved to be effective and safe in ulcerative colitis. Better efficacy can be achieved with suitable dose, delivery way, formation, and intervention time, which needs further study to verify.
氨基水杨酸被认为是溃疡性结肠炎的一线治疗选择。目前，姜黄素作为溃疡性结肠炎辅助治疗的有效性已被研究，但仍存在争议。本研究旨在系统评价和荟萃分析姜黄素作为溃疡性结肠炎辅助治疗的疗效和安全性。
从原始资料到 2019 年 7 月，检索了 PubMed、EMBASE 和 Cochrane 图书馆数据库，并纳入和分析了相关的随机对照临床试验。主要结局为临床和内镜缓解；同时，次要结局为临床和内镜改善。还进行了姜黄素剂量、给药途径、剂型和干预时间的亚组分析。
纳入了 6 项随机对照临床试验，共 349 例患者。合格试验表明，溃疡性结肠炎辅助姜黄素治疗在诱导临床缓解（比值比 [OR] = 5.18，95%置信区间 [CI]：1.84-14.56，P = 0.002）、内镜缓解（OR = 5.69，95%CI：1.28-25.27，P = 0.02）和内镜改善（OR = 17.05，95%CI：1.30-233.00，P = 0.03）方面有效，但在临床改善方面无效（OR = 4.79，95%CI：1.02-22.43，P = 0.05）。从纳入的研究中可以看出，大剂量、局部灌肠、特殊药物剂型和较长的治疗时间具有潜在的优势。未报告严重的副作用。
姜黄素作为美沙拉嗪的辅助治疗在溃疡性结肠炎中是有效且安全的。通过合适的剂量、给药途径、剂型和干预时间可以获得更好的疗效，这需要进一步的研究来验证。
