MEDICAL-MANAGEMENT OF CHRONIC INFLAMMATORY BOWEL-DISEASE

被引:19
作者
MURCH, SH [1 ]
WALKERSMITH, JA [1 ]
机构
[1] ST BARTHOLOMEWS HOSP,LONDON EC1A 7BE,ENGLAND
来源
BAILLIERES CLINICAL GASTROENTEROLOGY | 1994年 / 8卷 / 01期
关键词
D O I
10.1016/S0950-3528(06)80023-0
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
In the absence of a definitive cure for Crohn's disease and ulcerative colitis,the aim of therapy must be to induce and maintain clinical remission at acceptable cost to the patient in terms of adverse effects. Despite the differences in their pathogenesis, the first-line treatments for Crohn's disease and ulcerative colitis are still based upon combinations of aminosalicylic acid derivatives and corticosteroids, although the use of enteral nutrition regimes is becoming increasingly widespread in Crohn's disease. In this chapter we attempt to provide reasonably didactic guidance for the management of most cases of chronic inflammatory bowel disease. However, we have tried to go beyond this brief, motivated by the recent explosion in knowledge of inflammatory mechanisms, to suggest a rational approach to the choice of newer and less well tested therapeutic approaches in the affected child who is not responding effectively. The relative failure of cyclosporine therapy in Crohn's disease has been particularly disappointing in view of its ideal theoretical suitability. However, the encouraging early reports of treatment with anti-CD4 and anti-TNFα monoclonals suggest that the shift from broad spectrum immunomodulation to the targeting of critical components of the inflammatory cascade may yet field important dividends. © 1994 Baillière Tindall. All rights reserved.
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收藏
页码:133 / 148
页数:16
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