Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan.
Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan.
Pediatr Int. 2022 Jan;64(1):e15113. doi: 10.1111/ped.15113.
Pediatric ulcerative colitis (UC) is more challenging to treat than adult UC. Qing-Dai therapy is effective in adults but reports of its efficacy in children are unavailable. We conducted a questionnaire survey on Qing-Dai use among pediatric patients with UC in Japan to determine its efficacy and safety.
Questionnaires were sent to 31 high-volume centers treating pediatric patients with inflammatory bowel disease. The number of patients using Qing-Dai, short-term and long-term effects, and adverse events were assessed. A systematic review of studies on the efficacy and safety of Qing-Dai usage for UC was also performed.
Overall, 29/31 facilities (93.5%) responded, Qing-Dai was used in 107 patients with UC, and 84/107 patients (78.5%) initiated treatment. Within 6 months, 81/101 (80.2%) patients had clinical remission, while 59/92 (64.1%) patients had no relapse and 29/92 (31.5%) experienced only one to two relapses yearly. Eighty-seven percent of the patients underwent regular follow ups for adverse events, among whom one patient was diagnosed with pulmonary arterial hypertension (PAH), five with enteritis, and one with headache. In the systematic review, the clinical remission rate was 50-80%, and PAH was observed in 14 of 1,158 patients (1.2%).
Qing-Dai is highly effective in treating pediatric UC. However, Qing-Dai should be administered with caution as it may cause adverse events such as PAH.
小儿溃疡性结肠炎（UC）的治疗难度大于成人 UC。清黛疗法对成人有效，但尚无其在儿童中的疗效报告。我们对日本小儿 UC 患者使用清黛的情况进行了问卷调查，以确定其疗效和安全性。
向 31 家治疗炎症性肠病的儿科患者的大容量中心发送了问卷。评估了使用清黛的患者人数、短期和长期疗效以及不良反应。还对清黛治疗 UC 的疗效和安全性进行了系统评价。
31 家机构中的 29 家（93.5%）做出了回应，107 例 UC 患者使用了清黛，84 例（78.5%）患者开始治疗。在 6 个月内，101 例患者中的 81 例（80.2%）临床缓解，92 例患者中 59 例（64.1%）无复发，29 例（31.5%）每年仅复发一到两次。87%的患者定期随访不良反应，其中 1 例患者被诊断为肺动脉高压（PAH），5 例患者患肠炎，1 例患者头痛。在系统评价中，临床缓解率为 50-80%，1158 例患者中有 14 例（1.2%）出现 PAH。
清黛治疗小儿 UC 非常有效。然而，由于清黛可能会引起不良反应，如 PAH，因此应谨慎使用。
