潰瘍性大腸炎に対する内科的治療の最近の動向―ステロイドの初回量，動注

Medical Treatment of Ulcerative Colitis: Recent Advances

　厚生省の潰瘍性大腸炎調査研究班（班長：土屋周二，1973～75）により“潰瘍性大腸炎の薬物療法指針（案）（代表：井上幹夫）”が発表されてから37年を経過し，そろそろその改正が問題となりつつある．一方，昨年は奈良で“炎症性腸管障害の成因と治療に関する国際シンポジウム”が開催され，これを機会に潰瘍性大腸炎の内科的治療についても幾つかの情報が得られつつある．ここでは，これらや厚生省の炎症性腸管障害調査研究班（班長：白鳥常男，内科治療分科会長：渡辺晃，1979～　）（以下厚生省研究班と略す）の調査成績を中心に，内科的治療の最近の動向について解説する．

　Symposium on long-term management of ulcerative colitis and work-shop on update management of acute severe colitis were held at the world congress of Stockholm last year. International symposium on etiopathogenesis and treatment of IBD was also held in Nara Japan, last year and furthermore, work-shop on management of refractory ulcerative colitis was held at Yamagata Japan, during the 24th Autumn meeting of the Japanese Society of Gastroenterology.

　On the other hand, the Investigation and Research Committee for IBD, organized by the Ministry of Health and Welfare, had conducted investigation on its treatment and new therapeutic advances have been achieved.

　Analyzing such results and reviewing recent literature, I discussed recent advances of medical treatment on ulcerative colitis here.

　At the Nara symposium, Dr. Jewell, Oxford England, commented on our drug therapy of ulcerative colitis, so I asked him to send us their therapeutic guideline and I introduced it here for the first time.

　I also discussed management of acute severe or fluminant type of ulcerative colitis, indication for immune-suppresive agents, maintenance therapy of Salazopyrin, management during pregnancy and longterm prognosis of medical treatment.

　Significant advances on medical treatment of ulcerative colitis have been achieved recently, therefore ulcerative colitis can be safely controlled by medical management unless we misjudge the timing for surgical intervention.