雷公藤多甙预防克罗恩病术后复发

Efficacy of polyglycosides of Tripterygium wilfordii in preventing postoperative recurrence of Crohn disease

目的观察雷公藤多甙预防克罗恩病（CD）术后复发的疗效。方法将2005年1月至2006年12月间接受病灶切除的静止期CD病患者随机分为两组，术后2周内分别接受雷公藤多甙（60mg／d，雷公藤组，21例）和柳氮磺胺吡啶（4g／d，柳氮磺胺吡啶组，18例）治疗。于服药后0、13、26、52周或出现临床症状时，测CDAI评分和红细胞沉降率（ESR）及C反应蛋白（CRP）；52周或出现临床症状时行肠镜检查，同时行Rutgeeert术后内镜复发评分。结果雷公藤组1例失访，2例因不规律服药而剔除，随访成功率为85．7％。柳氮磺胺吡啶组2例失访，随访成功率为88．9％。1年内出现临床症状复发者雷公藤组1例（5．6％），柳氮磺胺吡啶组4例（25．0％）；内镜复发者雷公藤组4例（22．2％），柳氮磺胺吡啶组9例（56．2％）；差异有统计学意义（P〈0．05）。结论雷公藤多甙预防CD术后复发的疗效较好，可以用来维持静止性CD缓解及预防术后复发。

Objective To observe the efficacy of polyglycoside of Tripterygium wilfordii（GTW） in preventing postoperative recurrence of Crohn disease （CD）. Methods Thirty-nine post-operative CD patients in whom all of the diseased gut had been removed from January 2005 to December 2006 were enrolled in a randomized, placebo-controlled trial. The patients took GTW（21 cases） or SASP（18 cases） in two weeks after operation. Crohn disease activity index （CDAI）, ESR and CRP were collected at week 0, 13, 26, 52 or at the onset of symptoms. Ileocolonoseopy was performed at the end of the trial or at the onset of symptoms. Results One patient in GTW group and 2 patients in SASP group were lost and 2 patients in GTW were excluded from the trial for non-compliance. Clinical recurrence was ascertained in one patient （5.6%） received GTW and in four （25.0%） received SASP. Four of eighteen patients in GTW （22.2%） had endoscopic recurrence compared with nine of sixteen （56.2%） in SASP. There were significant differences between the two groups （P〈0.05）. Conclusion Tripterygium wilfordii showed good efficacy in preventing recurrence of postoperative CD which can maintain remission and prevent recurrence.