治療面からみた腸管Behçet病・単純性潰瘍の経過

Treatment of Enteral Behçet's Disease and Simple Ulcer

要旨　腸管Behçet病（EB）の治療では，下記の項目に着目して治療に当たる．発症からの経過・他臓器の併発症の状況（完全型・不完全型ならどの症候を併発した群か，活動期か寛解期か，併用免疫調節薬は何か，他に腸管に影響を及ぼす治療薬の有無），病変の部位・大きさ・深さ・形状，治療薬への反応性などである．浅い，小さな病変は5-ASA，典型像の大きな病変ではステロイド・IFXが有用な場合が多い．治療中はEBの治療への反応性のみならず，他臓器の併発病状についても，同時に経過観察すべきであるし，感染症や薬剤の副作用への注意も必須である．腸穿孔を起こさない治療が最低限の目標で，内科治療に窮する前に外科治療を相談することも重要である．

　In treatment of EB（enteral Behçet's disease）, we focus on the post-onset course, concurrent diseases in other organs（complete type or in cases of incomplete type, which group of concurrent syndromes is present, whether it is in the active or remission phase, what combined immunomodulatory agents are being used, and the presence or absence of other drugs that may affect the intestine）, site, size, depth, and form of the lesion, and response to drugs used in treatment. It is likely that 5-ASA（5-aminosalicylate）is useful for shallow and small lesions, and steroid/IFX（infliximab）is useful for typical large lesions. Concurrent pathological conditions in other organs as well as the response treatment of EB should be followed up at the same time. It is also essential to exercise caution to prevent infection and side effects of drugs. The minimum goal of treatment is to avoid causing intestinal perforation, and a consultation for surgical treatment is important before any internal treatment becomes ineffective.