Thomas G A, Swift G L, Green J T, Newcombe R G, Braniff-Mathews C, Rhodes J, Wilkinson S, Strohmeyer G, Kreuzpainter G
Department of Gastroenterology, University Hospital of Wales, Heath Park, Cardiff, UK.
Gut. 1998 Apr;42(4):497-500. doi: 10.1136/gut.42.4.497.
It has been suggested that Mycobacterium paratuberculosis is the cause of Crohn's disease. In a previous report the immediate effect of two years treatment with antituberculous chemotherapy showed no clinical benefit.
To assess both the immediate and longer term effect of treatment on the disease.
Patients were followed for five years from their date of entry to the study. One hundred and thirty patients entered the initial study, and of these 111 (81%) were followed regularly.
Overall, there was no evidence of consistent benefit or disadvantage from antituberculous chemotherapy in any of the assessments made, including the number of acute relapses, surgical episodes, hospital admissions, disease activity, blood tests, or medication required for Crohn's disease during the follow up period.
The absence of any benefit at the end of the initial two year trial period, and during the three year subsequent follow up, fails to support the hypothesis that mycobacteria play an important part in the pathogenesis of Crohn's disease, or that antituberculous chemotherapy may be of benefit.
有人提出副结核分枝杆菌是克罗恩病的病因。在之前的一份报告中,抗结核化疗两年的即时效果显示并无临床益处。
评估治疗对该疾病的即时和长期效果。
从患者进入研究之日起对其进行为期五年的随访。130名患者进入初始研究,其中111名(81%)接受了定期随访。
总体而言,在包括急性复发次数、手术次数、住院次数、疾病活动度、血液检查或随访期间克罗恩病所需药物治疗等任何评估中,均没有证据表明抗结核化疗会带来持续的益处或不利影响。
在最初两年的试验期结束时以及随后三年的随访期间均未发现任何益处,这无法支持分枝杆菌在克罗恩病发病机制中起重要作用或抗结核化疗可能有益的假设。