| 特集名 | クローン病の治療 | |
|---|---|---|
| 題名 | 薬物療法の概論 | |
| 発刊年月 | 1998年 01月 | |
| 著者 | 佐竹 儀治 | 田坂記念クリニック |
| 【 要旨 】 | クローン病の薬物療法のメリットはその利便性にある．栄養療法は比較的確実な治療効果を有し，副作用も少ないが，長期間の入院，絶食を必要とするので患者の精神的負担は大きい． クローン病の治療は緩解導入療法と緩解維持療法に分かれるが，緩解導入に有効な薬剤は副腎皮質ホルモンがもっとも評価されている．大腸クローンでは副腎皮質ホルモンとサラゾピリンの併用も効果的である．免疫抑制剤については副作用に注意をしつつ使用すべきである．緩解維持療法では確実な有用性が証明された薬剤はないが，大腸クローンではサラゾピリン，小腸クローンでは5-ASAが使用可能と考えられる．薬物療法の問題点は薬物の効果の不確実さと副作用にある． |
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| Theme | Treatment of Crohn's Disease | |
|---|---|---|
| Title | Outline of Drug Therapy for Crohn's Disease | |
| Author | Yoshiharu Satake | Tasaka Memorial Clinic |
| [ Summary ] | Convenience is a merit of drug therapy in the treatment of Crohn's disease. Although enteral nutritional treatment has reliable efficacy for active and quiescent Crohn's disease, prolonged hospitalization and fasting are burdensome for patients with this disease. The treatment of Crohn's disease consists of therapy for the active symptomatic phase and maintenance therapy for the quiescent phase. Corticosteroids are evaluated as the most effective medicine for active Crohn's disease. Combined use of corticosteroids and sulfasalazine is effective for the colonic lesions of this disease. Antimetabolic agents should be prescribed after the risks and benefits have been carefully explained to the patient. There is no medicine with reliable efficacy for quiescent Crohn's disease. Sulfasalazine and 5-aminosalicylic acid might be beneficial for colonic lesions and small bowel involvement. The poor reliability and the adverse effects of drug therapy for Crohn's disease are problems that should be resolved in the near future. |
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