上部胃肠道克罗恩病的药理管理:系统性审查
Mark Chatto1,2, Dimah Alaskar1, Christopher Ma3,4
1Department of Medicine, Division of Gastroenterology, Western University, London, Ontario, Canada.
Journal of Crohn's & colitis
|October 28, 2025
概括
对于上部胃肠道克罗恩病 (UGICD) 治疗的证据有限. 皮质类固醇和抗瘤坏死因子 (抗TNF) 疗法有前途,但需要更多的受控研究才能有效管理UGICD.
科学领域:
- 胃肠病学 胃肠病学
- 内部医学 内部医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 上部胃肠道克罗恩病 (UGICD) 是一种罕见的疾病,治疗指南不足.
- 进行了对UGICD药理干预现有证据的审查.
研究的目的:
- 系统地审查上部胃肠道克罗恩病的药理治疗的安全性和有效性.
- 确定UGICD管理的证据库中的差距.
主要方法:
- 从1990年到2025年,在主要数据库 (MEDLINE,Embase,Cochrane CENTRAL) 中进行了全面的文献搜索.
- 包括随机对照试验和比较观察性研究,评估UGICD的药理或饮食干预措施.
- 数据提取和偏差评估由两名独立审查员进行,结果因异质性而被描述性地总结.
主要成果:
- 该审查包括11项观察性研究和两项RCT的后期分析,涉及387名患者.
- 抗瘤坏死因子 (TNF) 药物和皮质类固醇在临床结果和内镜治疗方面显示出潜在的益处,尽管可控数据很少.
- 其他疗法显示有效性有限到中等,表明需要进一步研究.
结论:
- 显著缺乏高质量的证据来指导UGICD的治疗策略.
- 虽然皮质类固醇和抗TNF疗法有前途,但它们主要得到了小型,不受控制的研究的支持.
- 进一步的研究至关重要,以解决管理上部胃肠道克罗恩病的未满足需求.
相关概念视频
Inflammatory Bowel Disease IV: Pharmacological Management
427
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
427
Peptic Ulcer Disease IV: Management
394
Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
394
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
402
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
402
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
447
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
447
Inflammatory Bowel Disease V: Surgical Management
420
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
420
Drugs for Treatment of Constipation-Predominant IBS
664
Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
664


