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首页> 外文期刊>The American Journal of Gastroenterology >Interventions for treating microscopic colitis: a Cochrane Inflammatory Bowel Disease and Functional Bowel Disorders Review Group systematic review of randomized trials.
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Interventions for treating microscopic colitis: a Cochrane Inflammatory Bowel Disease and Functional Bowel Disorders Review Group systematic review of randomized trials.

机译：治疗微观结肠炎的干预措施：Cochrane炎症性肠病和功能性肠病审查小组对随机试验进行系统的审查。

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OBJECTIVES: To conduct a systematic review to determine effective treatments for patients with collagenous colitis or lymphocytic colitis, the two subtypes of microscopic colitis. METHODS: Relevant papers were identified via the MEDLINE, PUBMED, and Cochrane Collaboration databases, manual searches of the references of identified papers and review papers on microscopic colitis, as well as searches of abstracts from major gastroenterological meetings. RESULTS: All studies assessing treatment of microscopic colitis had relatively small sample sizes. A total of 10 randomized trials included patients with collagenous colitis. Budesonide was studied for induction of response in three trials and for maintenance of response in two trials. The pooled odds ratio for inducing clinical response with budesonide was 12.32 (95% confidence interval, CI 5.53-27.46), and for maintaining clinical response was 8.82 (95% CI 3.19-24.37), with a number needed to treat (NNT) of 2 patients for each outcome. Budesonide also induced and maintained histological response and was well tolerated. Bismuth subsalicylate, prednisolone, and mesalamine with or without cholestyramine may be effective, whereas Boswellia serrata extract and probiotics were ineffective for treating collagenous colitis. Three randomized trials included patients with lymphocytic colitis. Budesonide was shown in one study to be effective for inducing clinical response (OR 9.00; 95% CI 1.98-40.93), with an NNT of three patients. Budesonide also induced histological response and was well tolerated. Bismuth subsalicylate and mesalamine with or without cholestyramine may be effective for treating lymphocytic colitis. No trials assessed maintenance of response in patients with lymphocytic colitis. CONCLUSIONS: Budesonide is effective and well tolerated for inducing and maintaining clinical and histological responses in patients with collagenous colitis, and for inducing clinical and histological responses in patients with lymphocytic colitis. Determining the magnitude of benefit is limited by the small sample sizes of the studies. The evidence for other agents, including bismuth subsalicylate, prednisolone, B. serrata extract, probiotics, and mesalamine with or without cholestyramine is weaker. It is not clear that any of these agents induce or maintain actual remission of collagenous or lymphocytic colitis, as opposed to clinical or histological response.
机译：目的：进行系统的审查以确定对胶原性结肠炎或淋巴细胞性结肠炎（显微镜下结肠炎的两种亚型）患者的有效治疗方法。方法：通过MEDLINE，PUBMED和Cochrane协作数据库，相关文献的参考文献和微观结肠炎的综述论文的人工检索以及主要胃肠病学会议摘要的检索来鉴定相关论文。结果：所有评估微观结肠炎治疗的研究均具有相对较小的样本量。共有10项随机试验纳入了胶原性结肠炎患者。在三个试验中研究了布地奈德的诱导反应，在两个试验中研究了维持反应。布地奈德诱发临床反应的合并优势比为12.32（95％置信区间，CI 5.53-27.46），维持临床反应的综合优势比为8.82（95％CI 3.19-24.37），其中需要治疗（NNT）的数每个结局2例。布地奈德还诱导并维持组织学反应，并且耐受性良好。水杨酸铋，泼尼松龙和美沙拉敏加或不加胆甾胺可能有效，而乳香乳香提取物和益生菌对治疗胶原性结肠炎无效。三项随机试验包括淋巴细胞性结肠炎患者。在一项研究中显示布地奈德可有效诱导临床反应（OR 9.00; 95％CI 1.98-40.93），三名患者的NNT。布地奈德还诱导组织学反应，并且耐受性良好。水杨酸铋和美沙明胺加或不加胆甾胺均可有效治疗淋巴细胞性结肠炎。没有试验评估淋巴细胞性结肠炎患者反应的维持。结论：布地奈德对于诱导和维持胶原性结肠炎患者的临床和组织学反应，以及诱导淋巴细胞性结肠炎的临床和组织学反应均有效且耐受性良好。确定受益的幅度受到研究样本量的限制。其他药物的证据较弱，包括水杨酸铋，泼尼松龙，锯齿状芽孢杆菌提取物，益生菌和美沙明胺（含或不含胆固醇）。与临床或组织学反应相反，尚不清楚这些药物中的任何一种均能诱导或维持胶原或淋巴细胞性结肠炎的实际缓解。

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