溃疡性结肠炎内科治疗的进展

Progress in medical treatment of ulcerative colitis

溃疡性结肠炎(ulcerative colitis,UC)是一种发病原因及发病机制尚未明确的慢性炎症性肠道疾病,有大量证据表明患者基因型、免疫系统和肠道微生物群之间的相互作用在UC发病机制中起着至关重要的作用.针对UC的病因治疗较为困难,目前治疗的主要目的是对疾病活动期的快速诱导缓解和缓解期的长期维持,同时预防并发症的发生;由于近20年UC的发病率不断升高,且一些患者对传统治疗手段不反应或反应不完全,所以对UC的治疗手段需进一步研究.目前对UC的内科治疗手段主要有5-氨基水杨酸、免疫抑制剂、生物制剂及辅助的中草药、抗生素、益生菌,近年新开展的干细胞移植、粪菌移植、CO灌肠等治疗手段成为研究的热点,本文就UC近年来内科治疗手段的进展作一总结.

Ulcerative colitis（UC） is a kind of chronic inflammatory disease and its etiology and pathogenesis are not clear.Accumulating evidence has indicated that the interactions among genotype,immune system and intestinal microbiota of patients play a significant role in the pathogenesis of UC.At present,it is difficult to cure UC.The main goals of UC treatment include inducing remission rapidly,maintaining the remission stage for a long time and preventing the occurrence of complications.As the incidence of UC keeps rising sharply in the recent 20 years,and a portion of patients have no response to the treatments or the effects are not satisfying,it is necessary to make further research for the treatment of UC.There are some main medical treatments for UC,such as 5-ASA,immune inhibitors,biological agents,Chinese herbal medicine,antibiotics and probiotics.In recent years,some new treatments such as stem cell transplantation,fecal bacteria transplantation and CO enema treatment are becoming the hot spot of research.This article will make a summary of the progress in medical treatment of UC in recent years.