Daikenchuto, a traditional Japanese herbal medicine, for the maintenance of surgically induced remission in patients with Crohn's disease: a retrospective analysis of 258 patients
Daikenchuto, a traditional Japanese herbal medicine, for the maintenance of surgically induced remission in patients with Crohn's disease: a retrospective analysis of 258 patients
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DOI：
10.1007/s00595-013-0747-6
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发表时间：
2014-08-01
期刊：
影响因子：
2.5
通讯作者：
Sahara, Rikisaburo
中科院分区：
文献类型：
--
作者：
Kanazawa, Amane;Sako, Minako;Sahara, Rikisaburo
尽管有大量的研究，克罗恩病的最佳术后治疗仍不确定。我们回顾性评估了克罗恩病患者术后使用日本传统汉方药物大研中托维持治疗对3年后再手术率的影响。共有258例克罗恩病患者接受了手术。为了预防术后复发，患者被分层接受5-氨基水杨酸，硫唑嘌呤或daikenchuto，并在3年内防止再次手术的效果进行了评估。在258例患者中，44例需要再次手术与肠切除术在3年内，由于疾病复发。术后Daikenchuto组的3年再手术率显著低于非Daikenchuto组（11.3 vs. 24.5%，P = 0.01），术后5-氨基水杨酸组的3年再手术率同样显著低于非5-氨基水杨酸组（14.8 vs. 29.6%，P = 0.0049）。多变量考克斯分析显示，术后大研中托（P = 0.035）和术后5-氨基水杨酸（P = 0.022）与克罗恩病患者术后3年的再次手术率显著独立相关。我们认为，持续大研中托治疗是预防克罗恩病患者术后再次手术的临床有用且可行的维持治疗。疾病
Despite numerous studies, the best postoperative therapy for Crohn's disease is still undefined. We retrospectively evaluated the effects of postoperative maintenance therapy with daikenchuto, a traditional Japanese Kampo medicine, on the reoperation rate at 3 years in patients with Crohn's disease.A total of 258 patients who underwent surgery for Crohn's disease were identified for the study. For the prevention of postoperative recurrence, patients were stratified to receive 5-aminosalicylic acid, azathioprine or daikenchuto, and their effects on preventing reoperation at 3 years were evaluated.Of the 258 patients, 44 required reoperation with intestinal resection within 3 years due to disease recurrence. The 3-year reoperation rate was significantly lower in the postoperative daikenchuto group than in the non-daikenchuto group (11.3 vs. 24.5 %, P = 0.01), and was similarly significantly lower in the postoperative 5-aminosalicylic acid group than in the non-5-aminosalicylic acid group (14.8 vs. 29.6 %, P = 0.0049). A multivariate Cox analysis showed that postoperative daikenchuto (P = 0.035) and postoperative 5-aminosalicylic acid (P = 0.022) were significantly and independently associated with the rate of reoperation at 3 years in patients with Crohn's disease.We propose that continuous daikenchuto therapy is a clinically useful and feasible maintenance therapy for the prevention of postoperative reoperation in patients with Crohn's disease.