沙利度胺及其类似物治疗炎症性肠病的系统性回顾

目的 评价沙利度胺及其类似物在炎症性肠病（IBD）治疗中的有效性以及安全性。方法 检索PubMed、Cochrane Center Register of Controlled Trails、Embase、Web of Science、中国期刊全文数据库、万方数据库、维普数据库，系统性评价沙利度胺及其类似物治疗IBD的有效性及安全性，就诱导缓解率、维持缓解率、不良反应事件进行总结分析。结果 共纳入16篇文献（3篇RCT，13篇病例系列研究），333例IBD患者。2篇RCT显示在克罗恩病（Crohn’s disease，CD）和溃疡性结肠炎（ulcerative colitis，UC）患者中，沙利度胺均能够显著提高诱导缓解率（46.4% vs 11.5%，P=0.010；83.3% vs 18.8%，P=0.005）。病例系列研究显示沙利度胺能够诱导CD缓解，合并缓解率为50%（95%CI＝36%~65%）。沙利度胺不良反应中神经系统不良反应最为常见（207/316，65.5%），周围神经病变是患者停药的最常见原因。结论 沙利度胺治疗IBD疗效理想，在CD诱导缓解治疗中效果尤为显著。

Systematic review of thalidomide and thalidomide analogues for treatment of inflammatory bowel disease

Objective To evaluate the efficacy and safety of thalidomide and thalidomide analogues for treatment of inflammatory bowel disease. Methods To review the efficacy and safety of thalidomide and thalidomide analogues for the treatment of IBD systematically, a systematic research was performed　on PubMed, Cochrane Center Register of Controlled Trails, Embase, Web of Science, CNKI, Wan Fang, CQVIP and other data bases. And analysis was made on its induced remission rate, sustaining remission rate and adverse events. Results Sixteen studies (3 RCTs and 13 case series) met the inclusion criteria and 333 patients were included. Two RCTs showed that thalidomide can effectively increase induced remission rate in patients with CD and UC(46.4% vs 11.5%, P=0.010; 83.3% vs 18.8%,P=0.005). And a series of case studies revealed that the thalidomide was conducive to the remission of CD, with the induced remission rate was 50.0% (95%CI=36.0% 65.0%). Neurologic disturbances accounted for 65.5% of the adverse events(207/316), being the most common adverse event. Peripheral neuropathy was the most frequent cause of drug withdrawal.Conclusion Thalidomide is effective for treating IBD, especially for inducing remission in CD patients.