炎症性肠病:临床诊断与药物治疗》。

Medical Research Archives Pub Date : 2023-01-01 Epub Date: 2023-01-31 DOI:10.18103/mra.v11i1.3135
Amosy Ephreim M'Koma
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引用次数: 0

摘要

炎症性肠病对公共卫生、医疗系统、经济和社会状况产生了巨大影响。生物疗法改善了炎症性肠病患者的治疗和临床病程。目前可用疗法的疗效和安全性在许多方面仍不尽如人意,这凸显了对新治疗靶点的需求。针对炎症性肠病的一系列新药研究正在进行中,并取得了可喜的成果。这是一份关于炎症性肠病临床诊断和药物治疗的概要指南。该指南概述了现代理想实践原则的总体建议,以促进最佳实施和探索的采用,以及对炎症性肠病患者、胃肠病学家和其他医疗服务提供者的教育。炎症性肠病包括克罗恩病和溃疡性结肠炎,这是两种尚未治愈的医学炎症性肠病亚型。首次出现时的体征和症状与疾病的解剖定位和严重程度有关,而与由此产生的诊断关系不大,临床和组织学上无法明确解释和建立标准,特别是在结肠炎症性肠病方面,当建立标准不确定时,就被归类为不确定结肠炎。保守药物和可获得的途径并不取决于疾病的表型。一线治疗方法是控制症状,稳定活动性疾病;同时还需要进行维持治疗。营养和饮食并不是主要的治疗手段,但应作为支持性治疗。特别是在冠状病毒 SARS-CoV2 引起的 COVID-19 全球大流行期间,患者的心理功能和内镜检查服务都受到了影响。全球登记系统的建立和经验的积累促成了 COVID-19 大流行下炎症性肠病管理的共识。大流行对这些患者的医疗保健系统产生了深远的影响。笔者在此简要总结了大流行期间远程医疗的最新作用,以及炎症性肠病中心是如何管理患者并确保医疗质量的。总之:炎症性肠病已成为一种全球性的突发疾病。严重的医疗事故是发展中国家的公共卫生问题,即要区分炎症性肠病和传染病及寄生虫病。难治性炎症性肠病仍然是治疗克罗恩病和溃疡性结肠炎患者的重大挑战。对于最近新注册的药物,人们还存在知识空白和未来的研究方向。在 COVID-19 大流行期间,炎症性肠病的主要临床疗效得以保持。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Inflammatory Bowel Disease: Clinical Diagnosis and Pharmaceutical Management.

Inflammatory Bowel Disease: Clinical Diagnosis and Pharmaceutical Management.

Inflammatory bowel disease has an enormous impact on public health, medical systems, economies, and social conditions. Biologic therapy has ameliorated the treatment and clinical course of patients with inflammatory bowel disease. The efficacy and safety profiles of currently available therapies are still less that optimal in numerous ways, highlighting the requirement for new therapeutic targets. A bunch of new drug studies are underway in inflammatory bowel disease with promising results. This is an outlined guideline of clinical diagnosis and pharmaceutical therapy of inflammatory bowel disease. Outline delineates the overall recommendations on the modern principles of desirable practice to bolster the adoption of best implementations and exploration as well as inflammatory bowel disease patient, gastroenterologist, and other healthcare provider education. Inflammatory bowel disease encompasses Crohn's disease and ulcerative colitis, the two unsolved medical inflammatory bowel disease-subtypes condition with no drug for cure. The signs and symptoms on first presentation relate to the anatomical localization and severity of the disease and less with the resulting diagnosis that can clinically and histologically be non-definitive to interpret and establish criteria, specifically in colonic inflammatory bowel disease when the establishment is inconclusive is classified as indeterminate colitis. Conservative pharmaceuticals and accessible avenues do not depend on the disease phenotype. The first line management is to manage symptoms and stabilize active disease; at the same time maintenance therapy is indicated. Nutrition and diet do not play a primary therapeutic role but is warranted as supportive care. There is need of special guideline that explore solution of groundwork gap in terms of access limitations to inflammatory bowel disease care, particularly in developing countries and the irregular representation of socioeconomic stratification with a strategic plan, for the unanswered questions and perspective for the future, especially during the surfaced global COVID-19 pandemic caused by coronavirus SARS-CoV2 impacting on both the patient's psychological functioning and endoscopy services. Establishment of a global registry system and accumulated experiences have led to consensus for inflammatory bowel disease management under the COVID-19 pandemic. Painstakingly, the pandemic has influenced medical care systems for these patients. I briefly herein viewpoint summarize among other updates the telemedicine roles during the pandemic and how operationally inflammatory bowel disease centers managed patients and ensured quality of care. In conclusion: inflammatory bowel disease has become a global emergent disease. Serious medical errors are public health problem observed in developing nations i.e., to distinguish inflammatory bowel disease and infectious and parasitic diseases. Refractory inflammatory bowel disease is a still significant challenge in the management of patients with Crohn's disease and ulcerative colitis. There are gaps in knowledge and future research directions on the recent newly registered pharmaceuticals. The main clinical outcomes for inflammatory bowel disease were maintained during the COVID-19 pandemic period.

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