1．Crohn病の内科治療
Crohn病は原因不明で，外科的な対処を行っても再燃を繰り返し進行していく疾患であることから，内科的管理が治療戦略の中心となる．本邦では依然として栄養療法が主流ではあるが，抗TNF-α抗体療法の導入以来，薬物療法も普及している．新たな生物学的製剤，白血球除去療法，内視鏡的拡張術などにも期待が寄せられている．従来からの栄養療法と新しい薬物療法を上手く組み合わせて患者のQOL（quality of life）向上に努めなければならない．...
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| Published in | 日本内科学会雑誌 Vol. 98; no. 1; pp. 82 - 87 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本内科学会
2009
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-5384 1883-2083 |
| DOI | 10.2169/naika.98.82 |
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| Abstract | Crohn病は原因不明で，外科的な対処を行っても再燃を繰り返し進行していく疾患であることから，内科的管理が治療戦略の中心となる．本邦では依然として栄養療法が主流ではあるが，抗TNF-α抗体療法の導入以来，薬物療法も普及している．新たな生物学的製剤，白血球除去療法，内視鏡的拡張術などにも期待が寄せられている．従来からの栄養療法と新しい薬物療法を上手く組み合わせて患者のQOL（quality of life）向上に努めなければならない． |
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| AbstractList | Crohn病は原因不明で，外科的な対処を行っても再燃を繰り返し進行していく疾患であることから，内科的管理が治療戦略の中心となる．本邦では依然として栄養療法が主流ではあるが，抗TNF-α抗体療法の導入以来，薬物療法も普及している．新たな生物学的製剤，白血球除去療法，内視鏡的拡張術などにも期待が寄せられている．従来からの栄養療法と新しい薬物療法を上手く組み合わせて患者のQOL（quality of life）向上に努めなければならない． |
| Author | 古賀, 秀樹 飯田, 三雄 松本, 主之 |
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| Copyright | 2009 一般社団法人 日本内科学会 |
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| DOI | 10.2169/naika.98.82 |
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| References | 2) Takagi S, et al: Effectiveness of an half elemental diet as maintenance therapy for Crohn's disease: a randomized-controlled trial. Aliment Pharmacol Ther 24: 1333-1340, 2006. 1) 飯田三雄, 松本主之: クローン病の治療指針. 臨牀消化器内科 23: 599-606, 2008. 10) Irving PM, et al: Review article: appropriate use of corticosteroids in Crohn's disease. Aliment Pharmacol Ther 26: 313-329, 2007. 6) D'Haens G, et al: Early combined immunosuppression or conventional management in patients with newly diagnosed Crohn's disease: an open randomised trial. Lancet 371: 660-667, 2008. 4) Matsumoto T, et al: Therapeutic efficacy of infliximab on active Crohn's disease under nutritional therapy. Scand J Gastroenterol 40: 1423-1430, 2005. 8) van Assche G, et al: Withdrawal of immunosuppression in Crohn's disease treated with scheduled infliximab maintenance: a randomized trial. Gastroenterology 134: 1861-1868, 2008. 7) Rosh JR, et al: Hepatosplenic T-cell lymphoma in adolescents and young adults with Crohn's disease: a cautionary tale? Inflamm Bowel Dis 13: 1024-1030, 2007. 5) Holtmann MH, et al: Long-term effectiveness of azathioprine in IBD beyond 4 years: a European multicenter study in 1176 patients. Dig Dis Sci 51: 1516-1524, 2006. 3) Esaki M, et al: Factors affecting recurrence in patients with Crohn's disease under nutritional therapy. Dis Colon Rectum 49: 568-574, 2006. 9) Colombel JF, et al: A controlled trial comparing ciprofloxacin with mesalazine for the treatment of active Crohn's disease. Am J Gastroenterol 94: 674-678, 1999. 11) Bergman R, Parkes M: Systematic review: the use of mesalazine in inflammatory bowel disease. Aliment Pharmacol Ther 23: 841-855, 2006. |
| References_xml | – reference: 2) Takagi S, et al: Effectiveness of an half elemental diet as maintenance therapy for Crohn's disease: a randomized-controlled trial. Aliment Pharmacol Ther 24: 1333-1340, 2006. – reference: 1) 飯田三雄, 松本主之: クローン病の治療指針. 臨牀消化器内科 23: 599-606, 2008. – reference: 9) Colombel JF, et al: A controlled trial comparing ciprofloxacin with mesalazine for the treatment of active Crohn's disease. Am J Gastroenterol 94: 674-678, 1999. – reference: 3) Esaki M, et al: Factors affecting recurrence in patients with Crohn's disease under nutritional therapy. Dis Colon Rectum 49: 568-574, 2006. – reference: 7) Rosh JR, et al: Hepatosplenic T-cell lymphoma in adolescents and young adults with Crohn's disease: a cautionary tale? Inflamm Bowel Dis 13: 1024-1030, 2007. – reference: 10) Irving PM, et al: Review article: appropriate use of corticosteroids in Crohn's disease. Aliment Pharmacol Ther 26: 313-329, 2007. – reference: 4) Matsumoto T, et al: Therapeutic efficacy of infliximab on active Crohn's disease under nutritional therapy. Scand J Gastroenterol 40: 1423-1430, 2005. – reference: 5) Holtmann MH, et al: Long-term effectiveness of azathioprine in IBD beyond 4 years: a European multicenter study in 1176 patients. Dig Dis Sci 51: 1516-1524, 2006. – reference: 11) Bergman R, Parkes M: Systematic review: the use of mesalazine in inflammatory bowel disease. Aliment Pharmacol Ther 23: 841-855, 2006. – reference: 6) D'Haens G, et al: Early combined immunosuppression or conventional management in patients with newly diagnosed Crohn's disease: an open randomised trial. Lancet 371: 660-667, 2008. – reference: 8) van Assche G, et al: Withdrawal of immunosuppression in Crohn's disease treated with scheduled infliximab maintenance: a randomized trial. Gastroenterology 134: 1861-1868, 2008. |
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| Snippet | Crohn病は原因不明で，外科的な対処を行っても再燃を繰り返し進行していく疾患であることから，内科的管理が治療戦略の中心となる．本邦では依然として栄養療法が主... |
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| SubjectTerms | Crohn病 Crohn病治療指針 栄養療法 薬物療法 |
| Title | 1．Crohn病の内科治療 |
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