Rutgeerts P
Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium.
Mediators Inflamm. 1998;7(3):137-40. doi: 10.1080/09629359891036.
Glucocorticosteroids are the mainstay of treatment of active Crohn's disease and ulcerative colitis. These drugs however carry important cosmetic short-term side effects and when used long-term they induce severe irreversible complications. Topically acting glucocorticosteroids, especially budesonide, have been designed to achieve local effect at the site of inflammation without systemic effects of the drug. The first results of clinical trials are promising and budesonide has been shown to have an improved safety with almost comparable efficacy in comparison with prednisolone. The optimal enema dose seems to be 2 mg/100 ml at night whereas 9 mg o.m. is the optimal dose to treat ileal or right ileocolonic Crohn's disease. Topically acting GCS, like standard GCS are not effective for maintenance of remission of Crohn's disease or recurrence prevention after resection of the involved Crohn's segment.
糖皮质激素是治疗活动期克罗恩病和溃疡性结肠炎的主要药物。然而，这些药物有重要的短期美容方面的副作用，长期使用会引发严重的不可逆并发症。局部作用的糖皮质激素，尤其是布地奈德，旨在在炎症部位实现局部作用而无药物的全身效应。临床试验的初步结果令人鼓舞，与泼尼松龙相比，布地奈德已显示出安全性提高且疗效几乎相当。灌肠的最佳剂量似乎是每晚2毫克/100毫升，而口服9毫克是治疗回肠或右回结肠克罗恩病的最佳剂量。与标准糖皮质激素一样，局部作用的糖皮质激素对维持克罗恩病缓解或预防受累克罗恩段切除术后复发无效。
