雷公藤多甙在维持术后克罗恩病临床缓解中的作用

Maintenance effect of polyglycosides of Tripterygium wilfordii on remission in postoperative Crohn disease

目的 观察雷公藤多甙对克罗恩病术后患者的维持临床缓解作用。方法将2005年至2007年间收治的克罗恩病术后患者45例随机分为2组，分别接受雷公藤多甙和美沙拉嗪治疗；术后3个月、半年和1年或出现临床症状时进行疾病活动度指数（CDAI）评价，并在术后1年或复发时行肠镜检查和行Rutgeert术后内镜复发评分。结果雷公藤多甙组与美沙拉嗪组比较，3个月内两组均无复发．半年内累计复发率分别为18．2％与21．7％（P=0．530）；1年内累计复发率分别为31．8％与39．1％（P=0．421），差异均无统计学意义；1年内内镜下累计复发率分别为45．5％和60．9％（P=0．231）．差异也无统计学意义。结论雷公藤多甙对维持术后克罗恩病缓解的作用与美沙拉嗪相似。

Objective To observe the maintenance effect of polyglycosides of Tripterygium wilfordii （GTW） on remission in postoperative Crohn disease（CD）. Methods From 2005 to 2007, 45 adult cases of postoperative Crohn disease were randomly divided into two groups, GTW group and mesalazine group, which received GTW and mesalazine treatment respectively. CD activity index（CDAI） and clinical markers were collected at 0, 3, 6, 12 months or at the onset of symptoms, lleocolonoscopy was performed at the end of the trial（ 1 year after operation） or at the onset of symptoms, and recurrence score were recorded. Results No clinical recurrence was ascertained in both groups at 3 months. Four patients （18.2%） in GTW group relapsed and 5 （21.7%） in mesalazine group relapsed at 6 months （P= 0.530）. Seven patients（31.8%） in GTW group and 9（39.1%） in mesalazine group relapsed at one year （P=0.421）. Ten patients （45.5%） in GTW group had endoscopic recurrence compared with 14 （60.9%） in mesalazine group at one year（P=0.231）. There were no significant differences between two groups. Conclusion GTW is similar to mesalazine in maintenance of remission of postoperative Crohn disease.