克罗恩病的循证治疗

Evidence-Based Treatment for Crohn's Disease

目的针对1例常规治疗疗效不理想的克罗恩病患者,我们进行了证据检索和评价,以期找到更有效的治疗方法。方法计算机检索MEDLINE(1978-2006年)和Cochrane图书馆(2007年第4期)等,查找治疗克罗恩病及与病情缓解有关的系统评价、临床随机对照试验等,并对所获证据进行评价。结果纳入克罗恩病治疗的随机对照试验11篇,系统评价或Meta分析8篇,根据所获证据给患者制定治疗方案。结论以高质量证据、结合患者情况制定治疗方案,能明显提高克罗恩病患者的近期疗效,但远期预后尚需更长时间的随访观察。

Objective To find the most effective treatment for patients with Crohn＇s disease whose therapeutic effect was not ideal by EBM practice. Methods We attempted to get the evidence of method which was used to treat Crohn＇s disease and maintain remission by searching MEDLINE （1978-2006） and The Cochrane Library （Issue 4, 2007） and the critical appraised evidence. Results A total of 11 randomized controlled trials, 8 systematic reviews and meta-analyses were identified. The treatment plan was developed accordingly. Conclusions The individualized treatment plan based on the high quality evidence and patient＇s condition is optimal for the short-term treatment of Crohn＇s disease. However, the long-term prognostic benefits need to be confirmed by continuing follow-up.