Postoperative maintenance therapy for inflammatory bowel disease
Postoperative maintenance therapy for inflammatory bowel disease
复制标题
DOI：
10.1097/01.mog.0000231811.95525.7c
复制
发表时间：
2006-07-01
影响因子：
2.5
通讯作者：
Modesto, Irene
中科院分区：
文献类型：
--
作者：
Cottone, Mario;Orlando, Arnbrogio;Modesto, Irene
审查的目的这篇评论将突出的知识，从2005年发表的研究中获得的维持治疗手术后炎症性肠病。最近的研究结果在克罗恩病的作用，吸烟在增加复发和复发的风险手术后得到证实。奥硝唑似乎有效地减少内镜下复发和手术后的临床复发。益生菌似乎不能有效预防内镜下复发和临床复发：一项对照安慰剂试验表明，约氏乳杆菌不能有效预防内镜下复发，一项回顾性研究表明，术后肠内营养可能会减少临床复发。病理生理学研究强调了益生菌在结肠袋炎中的价值。总结在克罗恩病术后维持治疗是令人失望的，戒烟仍然是唯一有效的措施。美沙拉嗪仍然是一种通过大型试验和荟萃分析进行广泛研究的药物。令人鼓舞的结果来自抗生素的小型试验。硫唑嘌呤和6-巯基嘌呤必须在设计更好的对照试验中进行评估。没有证据支持益生菌作为预防复发的有效疗法。术后肠内营养是一种新的治疗方法，但还需要进一步的对照试验。病理生理学研究证实了益生菌在结肠袋炎中的有益作用。
Purpose of review This review will highlight the knowledge gained from studies published in the year 2005 on maintenance treatment after surgery for inflammatory bowel diseases.Recent findings In Crohn's disease the role of smoking in increasing the risk of relapse and recurrence after surgery is confirmed. Ornidazole seems effective in reducing endoscopic recurrence and clinical relapse after surgery. Probiotics do not appear to be effective in preventing endoscopic recurrence and clinical relapse: a controlled placebo trial showed that Lactobacillus johnsonii is not effective in preventing endoscopic recurrence, A retrospective study suggested that enteral nutrition after surgery may reduce the clinical relapse. Pathophysiological studies underlined the value of probiotics in pouchitis.Summary In Crohn's disease postoperative maintenance treatment is disappointing, Giving up smoking is still the only effective measure. Mesalamine remains the drug that has been widely studied with large trials and meta-analysis. Encouraging results come from small trials on antibiotics. Azathioprine and 6-mercaptopurine must be evaluated in better designed controlled trials. There is no evidence in favour of probiotics as an effective therapy to prevent recurrence. Enteral nutrition after surgery is a candidate new therapy, but further controlled trials are needed. Pathophysiological studies confirm the beneficial role of probiotics in pouchitis.