ANTIBIOTIC-THERAPY FOR TREATMENT IN RELAPSE OF INTESTINAL CROHNS-DISEASE - A PROSPECTIVE RANDOMIZED STUDY
ANTIBIOTIC-THERAPY FOR TREATMENT IN RELAPSE OF INTESTINAL CROHNS-DISEASE - A PROSPECTIVE RANDOMIZED STUDY
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DOI：
10.1007/bf02552649
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发表时间：
1985-01-01
影响因子：
3.9
通讯作者：
LENNARDJONES, JE
中科院分区：
文献类型：
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作者：
AMBROSE, NS;ALLAN, RN;LENNARDJONES, JE
对有症状的克罗恩病复发患者进行了一项1毫克抗生素治疗的前瞻性随机试验。入院标准包括2个主要症状：发热、腹痛、腹泻、体重减轻、腹部肿块或并发症（不包括肛周疾病）；2种血液学异常：血红蛋白、红细胞沉降率、白蛋白、c反应蛋白（CRP）、铁或总铁结合能力。在6周内监测患者的上述临床和血液学（Hb，白蛋白，CRP）参数以及粪便菌群的变化。随机分为4组：单用甲硝唑(M)、单用复方新诺明(C)、单用甲硝唑和复方新诺明（C + M）或双安慰剂(P)。72例患者进入研究（18例= M， 16例= C， 21例= C + M， 17例= P）。2周后改善情况：M = 67%, C = 17%, C + M = 71%, P = 35%。在M组中，2例患者需要手术，1例出现了令人烦恼的副作用。C组2例出现副作用。在C + M组中，有4例出现了麻烦的副作用，安慰剂组中有2例需要手术治疗。4周时，两组疗效无差异：（M = 44%, C = 62%, C + M = 57%, P = 41%）。抗菌药物对粪便菌群和血液学参数没有影响。这些结果表明，抗菌药物对肠克罗恩病复发的治疗潜力很小。
A prospective randomized trial of 1 mo. antimicrobial therapy was undertaken for patients with symptomatic relapse of Crohn''s disease. Criteria for entry included 2 major symptoms: fever, abdominal pain, diarrhea, weight loss, abdominal mass or complications (excluding perianal disease); and 2 hematologic abnormalities: Hb, erythrocyte sedimentation rate, albumin, C-reactive protein (CRP), Fe, or total Fe-binding capacity. Patients were monitored for the aforementioned clinical and hematologic (Hb, albumin, CRP)parameters over 6 wk and for changes in fecal flora. Randomization was to 4 groups: metronidazole alone (M), co-trimoxazole alone (C), metronidazole and cotrimoxazole (C plus M), or double placebo (P). Seventy-two patients entered the study (18 = M, 16 = C, 21 = C plus M, 17 = P). After 2 wk, improvement was reported as follows: M = 67%, C = 17%, C plus M = 71%, P = 35%. In the M group, 2 patients required surgery and 1 had troublesome side effects. In the C group, 2 had side effects. In the C plus M group, 4 had troublesome side effects and 2 of the placebo group (P) required operation. By 4 wk, there was no difference in response among the groups: (M = 44%, C = 62%, C plus M = 57%, P = 41%). Antimicrobials had no effect on fecal flora or hematologic parameters. These results indicate that antimicrobials have little therapeutic potential for relapse of intestinal Crohn''s disease.