普芦卡必利对慢性便秘患者结肠动力影响的研究  

Efficacy of prucalopride in treatment of chronic constipation

作　　者：王诗怡[1] 范一宏[1] 吕宾[1] 姚芳[1] 袁媛[1] 

机构地区：[1]浙江中医药大学附属第一医院消化科,杭州310006

出　　处：《浙江医学》2015年第7期582-585,共4页Zhejiang Medical Journal

基　　金：浙江省自然科学基金(LY13H030011);浙江省中医药管理局基金(2013ZB050)

摘　　要：目的评价普芦卡必利治疗慢性便秘(CC)患者的疗效及安全性。方法按罗马Ⅲ诊断标准对25例CC患者给予普芦卡必利2mg/d口服,疗程2周。治疗前后分别评定排便障碍情况(便意、排便频率、排便时间、大便性状、排便费力、未完全排空、排空后有便意、梗阻感、肛门痛和坠胀感)、结肠传输时间(CTT)、钡条排出率、合并症状及不良反应,比较治疗前后差异。结果 25例患者全部完成研究;与治疗前相比,治疗后排便费力、未完全排空、梗阻感、坠胀感症状均有明显改善(均P<0.01),肛门痛症状也有所缓解(P<0.05),而对排空后有便意症状无明显改善(P>0.05);大便性状分型评分、排便频率、便意天数和排便时间均有很大改善(均P<0.01);钡条排出率显著提高(P<0.01),CTT明显缩短(P<0.01);同时改善了部分患者合并的胃食管反流病、肠易激综合征、功能性消化不良及其他便秘相关合并症状。整体疗效方面,慢传输型、混合型及正常传输型便秘的症状及全结肠传输时间均有不同程度的改善,而排便障碍型效果欠佳。有1例患者发生头痛不良反应。结论普芦卡必利在促进结肠运动,改善CC患者症状方面均体现了良好的疗效。Objective To evaluate the therapeutic effect and safety of prucalopride in treatment of chronic constipa- tion. Methods Twenty five patients with chronic constipation according to Rome III diagnostic criteria were involved in the study. Patients received prucalopride 2 mg/d for 2 weeks. The bowl evacuation habit （including desire to defecate, defecation frequen- cy, defecation time, stool property, laborious defecation, incomplete evacuation, desire to defecate after evacuation, sense of ob- struction, pain in anus and tenesmus）, colonic transit time （CTT）, barium discharge rate, symptoms of comorbidities and adverse effect were compared before and after treatment. Results All 25 patients completed the study. Compared with the pre-treat- ment status, laborious defecation, incomplete evacuation, sense of obstruction and tenesmus were significantly improved （P〈 0.01） ; pain in anus was also improved （P〈0.05）; desire to defecate after evacuation still remained （P〉0.05）; score of stool prop- erty, defecation frequency, days of desire to defecate and defecation time were also substantially improved （P〈0.01）. After the treatment, barium discharge rate enhanced （P〈0.01） and C-IT was substantially shortened （P〈0.01）. The symptoms of comor- bidities, including gastroesophageal reflux disease （GERD）, irritable bowel syndrome （IBS）, functional dyspepsia （FD） and other constipation related disease were improved in some patients. The symptoms and whole colonic transit time were improved in pa- tients with slow transit constipation, normal transit constipation or mixed transit constipation in various degrees. However, patients with dysporia showed less effect. One patient had adverse reaction of headache. Conclusion Prucalopride shows satisfactory efficacy in promoting colonic movement and improving symptoms of patients with chronic constipation.

关 键 词：慢性便秘 普芦卡必利 结肠传输时间 疗效观察 

分 类 号：R574.62[医药卫生—消化系统]