溃疡性结肠炎（UC）是一种炎症性肠病，主要影响大肠（结肠）的内壁。这种自身免疫性疾病的复发性病程，这意味着爆发的时期之后是缓解时期。
目前，UC还没有医疗治疗方法。当前的医疗治疗旨在增加爆发之间的时间，并使爆发不那么严重。这可能包括各种药物或手术。
Still, UC research continues to explore other methods to decrease the inflammation associated with this autoimmune disease. Learn more about the new UC treatments that have recently come out on the market, as well as emerging therapies that could be other options in the future.
近年来出现了两种新型UC药物：生物仿制药和Janus激酶（JAK）抑制剂。
生物仿制药
生物仿制药are a newer class of UC medications. These are copies of the antibodies used in a common type of UC medication called biologics.
生物制剂是基于蛋白质的疗法，可通过使用抗体来控制炎症过程来帮助中度至重度UC。
生物仿制药的工作方式与生物制剂相同。唯一的区别是生物仿制药是副本of the antibodies used in biologics, and not the originator drug.
Examples of biosimilars include:
- adalimumab-adbm（Cyltezo）
- adalimumab-atto（amjevita）
- 英夫利昔单抗-ABDA（renflexis）
- infliximab-dyyb (Inflectra)
- infliximab-qbtx (Ixifi)
JAK抑制剂
In 2018, the FDA approved a new type of JAK inhibitor for severe UC called tofacitinib (Xeljanz). Tofacitinib is the first oral medication used for the treatment of severe UC. It was previously approved for the treatment of rheumatoid and psoriatic arthritis.
Xeljanz works by blocking JAK enzymes to help control inflammation. Unlike other combination therapies, this medication isn’t intended to be used with immunosuppressants or biologics.
除药物外，研究人员还研究了采取其他治疗措施，以帮助预防和治疗UC引起的胃肠道炎症。
Clinical trials are also ongoing in the following emerging treatments:
- 干细胞疗法，这可能有助于免疫系统复位减轻炎症并导致组织修复
- 粪便移植（也称为粪便移植），涉及从供体中植入健康的凳子，以帮助恢复健康的肠道微生物组
- 大麻，可能有助于减少整体身体炎症 - 包括与UC相关的炎症
UC的当前治疗涉及药物或矫正手术的组合。与您的医生谈谈以下选择。
UC的药物
There are a number of medications used for the treatment of UC, each having the goal of controlling inflammation in the colon to stop tissue damage and manage your symptoms.
Established medications tend to be most helpful for mild to moderate UC. Your doctor may recommend one or a combination of the following:
- 皮质类固醇
- biologics
- aminosalicylates (5-ASA)
- 免疫调节剂
治疗手术
据估计up to one-thirdof people with UC will eventually need surgery. The symptoms typically associated with UC — such as cramping, bloody diarrhea, and inflammation of the bowel — can be stopped with surgery.
The removal of the entire large intestine (total colectomy) will stop the UC colon symptoms completely.
但是，总结肠切除术与其他不良反应有关。因此，有时会进行部分结肠切除术，而仅去除结肠的病态部分。
Of course, surgery isn’t for everyone. A partial or total colectomy is usually reserved for those who have severe UC.
对于那些对UC药物治疗不好的人来说，肠切除手术可能是一种选择。这通常是经过多年的医疗治疗后，在哪种药物控制疾病的副作用或能力下降导致生活质量差。
Partial or total colon resection
在总切除术中，整个大肠将被去除。虽然这是UC唯一真正的治疗方法，但它可以降低生活质量。
In a partial resection, colorectal surgeons remove the diseased region of the colon with a margin of healthy tissue on either side. When possible, the two remaining ends of the large intestine are surgically united, reconnecting the digestive system.
如果无法做到这一点，则将肠道路由到腹壁，废物在回肠造口术或结肠造口术袋中离开身体。
With modern surgical techniques, it’s potentially possible to reconnect the remaining bowel to the anus, either during the initial resection surgery or after a healing period.
急诊手术
虽然手术通常会延迟到UC变得严重或发生癌症点的发育不良变化，但有些人可能需要新兴的大肠切除手术，因为保持患病的肠子太大。
UC患者在经历的情况下可能需要紧急手术：
- toxic megacolon (life threatening dilation of the large intestine)
- 大肠中不受控制的出血
- 结肠穿孔
进行紧急手术会带来更多的风险和并发症。接受紧急手术的患者至少需要暂时需要回肠造口术或结肠造口术。
手术可能的并发症
Part of bowel surgery involves creating a pouch near the anus, which collects waste prior to defecation.
One of the complications of surgery is that the pouch can become inflamed, which causes diarrhea, cramps, and fever. This is called pouchitis, and it can be treated with an extended course of antibiotics.
The other main complication of bowel resection is small bowel obstruction. A small bowel obstruction is first treated with intravenous fluid and bowel rest (and possibly nasogastric tube suction for decompression). However, a severe small bowel obstruction may need to be treated with surgery.
尽管手术可以治愈UC的胃肠道症状，但可能并不总是治愈其他受影响的部位。有时，患有UC的人会发炎的眼睛，皮肤或关节。
即使肠完全切除，这些类型的炎症也可能会持续。尽管这并不常见，但在接受手术之前是要考虑的事情。
While there’s no medical cure for UC, new medications may help decrease the number of flare-ups while increasing your overall quality of life.
When UC is overly active, surgery may be required to help correct the underlying inflammation. This is the only way that UC may be “cured.”
At the same time, alternate facets of UC treatment are continually being studied for possible cures. This includes other types of surgery, as well as alternative therapies, like cannabis.
在医疗治疗之前，重要的是要防止爆炸，以防止组织损伤。与您的医生谈谈您的选择，以查看最适合您的选择。