Métodos diagnósticos e terapêuticos das doenças inflamatórias intestinais: revisão sistemática
Diagnostic and therapeutic methods of inflammatory bowel disease: systematic review
Gabriel Veríssimo Neves de Barros, Thaís Sant’Ana Soares Silva, Ana Paula de Santos Oliveira Brito, Hamilton Cezar Rocha Garcia, Rodrigo Bona Maneschy
Resumo
Objetivo: Realizar uma revisão sistemática de artigos publicados na última década, visando a pesquisa sobre métodos diagnósticos e terapêuticos das doenças inflamatórias intestinais. Método: Foram selecionados estudos publicados de 2014 a 2019. Os descritores utilizados foram de “Colite Ulcerativa”, “Doença de Crohn”, “Diagnóstico” e “Terapêutica”. As bases de dados consultadas foram MedLine, SciELO e Science Direct. Resultados: Foram selecionados 102 artigos, nos quais 92 destes se encontraram dentro dos critérios de exclusão, restando dez artigos dentro dos critérios de inclusão, onde três artigos foram retirados do MedLine, três do SciELO e quatro do Science Direct, nos idiomas espanhol (1), português (1) e inglês (8). Foram encontrados sete artigos sobre ambas as DII (Colite Ulcerativa e Doença de Chron), um artigo somente sobre Colite Ulcerativa e dois artigos somente sobre Doença de Chron, sendo que seis artigos citaram métodos diagnósticos da Colite Ulcerativa e oito relataram as alternativas terapêuticas, enquanto sete artigos analisaram métodos diagnósticos da Doença de Chron e nove relataram as opções terapêuticas. Conclusão: A análise da literatura demonstra que para o diagnóstico de doença inflamatória intestinal é necessário que este seja baseado em anamnese e exame físico de forma impecável, dificultando a identificação de casos positivos da doença em seus estágios iniciais para um melhor prognóstico do enfermo. Existe atualmente uma quantidade aceitável de medicamentos, o tratamento é feito somente para remissão dos sintomas haja vista que não existe cura atualmente para doença inflamatória intestinal e é baseada em vários tipos de agentes como aminossalicilatos, imunomoduladores e agentes biológicos. Ainda não é possível alcançar uma cura, pois não se tem entendimento completo da fisiopatologia a até mesmo do funcionamento de alguns medicamentos utilizados atualmente.
Palavras-chave
Abstract
Objective: To carry out a systematic review of articles published in the last decade, aiming at research on diagnostic and therapeutic methods of inflammatory bowel diseases. Method: Studies published from 2014 to 2019 were selected. The keywords used were “Ulcerative Colitis”, “Crohn’s Disease”, “Diagnosis” and “Therapeutics”. The databases consulted were MedLine, SciELO and Science Direct. Results: 102 articles were selected, in which 92 of them met the exclusion criteria, leaving ten articles within the inclusion criteria, where three articles were taken from MedLine, three from SciELO and four from Science Direct, in Spanish (1), Portuguese (1) and English (8). Seven articles were found on both IBD (Ulcerative Colitis and Chron’s Disease), one article only on Ulcerative Colitis and two articles only on Chron’s Disease, with six articles citing diagnostic methods of Ulcerative Colitis and eight reported therapeutic alternatives, while seven articles analyzed diagnostic methods for Chron’s Disease and nine reported therapeutic options. Conclusion: Analysis of the literature shows that for the diagnosis of inflammatory bowel disease it is necessary that it be based on anamnesis and physical examination in an impeccable way, making it difficult to identify positive cases of the disease in its initial stages for a better prognosis of the patient. There is currently an acceptable amount of medication, the treatment is done only for remission of symptoms since there is currently no cure for inflammatory bowel disease and is based on various types of agents such as aminosalicylates, immunomodulators and biological agents. It is not yet possible to achieve a cure, as there is no complete understanding of the pathophysiology or even the functioning of some drugs currently used.
Keywords
Referências
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Submetido em:
15/05/2020
Aceito em:
22/07/2020
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