普芦卡必利联合乳果糖在顽固性便秘中的应用研究  

Application of the combination of prucalopride and lactulose in the refractory constipation

作　　者：汤东 王杰 黄玉琴 周怀成 史友权 田滢[2] 陆永蝶 邹胜男[2] 陈宇吉 孙晓明[2] 徐梦月[2] 孙鹏翔[2] 王道荣 李宁 

机构地区：[1]扬州大学临床医学院(江苏省苏北人民医院)普外科,普通外科研究所,225001 [2]扬州大学医学院临床医学系,225001 [3]南京大学医学院临床学院(南京军区南京总医院全军普通外科研究所)普通外科研究所,210002

出　　处：《中华结直肠疾病电子杂志》2017年第3期207-211,共5页Chinese Journal of Colorectal Diseases(Electronic Edition)

基　　金：2013年第一批省资助招收博士后科研项目

摘　　要：目的评价普芦卡必利联合乳果糖对顽固性便秘患者的疗效。方法 2013年1月至2015年6月,对35例使用普芦卡必利(2 mg/天)单药连续4周治疗效果欠佳即平均每周完全自发排便(CSBMs)≤2次的顽固性便秘患者采用普芦卡必利(2 mg/天)联合乳果糖(15 ml×2次/天)连续8周方案进行治疗。观察指标为:服药后首次完全自发排便所需时间和每周平均CSBMs次数,并采用Bristol粪便评分量表、胃肠生活质量评分(GIQLI)、Wexner便秘评分和健康状况调查问卷(SF-36)比较联合治疗前后患者便秘症状和生活质量改善情况,并观察不良反应事件。结果患者联合治疗前后首次CSBMs所需时间为(6.7±3.2)天和(2.4±2.1)天(t=10.161,P<0.01);平均每周CSBMs为(0.86±0.77)次/周(单药治疗前4周)和(5.26±6.09)次/周(联合治疗后8周)(t=-4.363,P<0.01);患者总体便秘症状和生活质量各评分较联合治疗前明显改善(均P<0.01)。联合治疗8周后35例患者中有25例每周平均CSBMs≥3次,有效率达71.4%(25/35)。治疗期间不良反应为轻中度恶心、头痛、腹泻和腹胀,持续数天后即缓解。结论普芦卡必利联合乳果糖能进一步改善顽固性便秘患者的便秘症状和生活质量,值得临床推广应用。Objective To evaluation of the efficacy of the combination of prucalopride and lactulose in the patients with refractory constipation. Methods From January 2013 to June 2015, thirty-five cases of patients with refractory constipation whom were not benefited from single drug treatment （prucalopride, 2 rag/day, for 4 weeks, and the average weekly complete spontaneous bowel movements 〈 3 times） were treated by the combination ofprucalopride （2 rag/day） and lactulose （15 ml×2 times/day） for 8 weeks. The time and number of complete spontaneous bowel movements （CSBMs） was observed. The bristol stool scale, gastrointestinal quality of life score （GIQLI）, Wexner constipation score and a 36-item short-form （SF-36） were compared before and after combined treatment of prucalopride and lactulose in patients with refractory constipation to observe the improvement of constipation and quality of life, and the adverse reaction events. Results The first time of CSBM is （6.7±3.2） d and （2.4±2.1） d h （t=10.161, P 〈 0.01） in the study group before and after combined medication. The average number of CSBMs is （0.86 ± 0.77） times/week （4 weeks before combined medication） and （5.26±6.09） times/week （8 weeks after combined medication）, respectively （t=-4.363, P 〈 0.01）. Compared to the single drug medication, the constipation symptoms and quality of life of the patients were significantly improved after combined medication （all P 〈 0.01）. 25 cases in 35 patients with refractory constipation has CSBMs more than 3 times a week after 8 weeks of combination of prucalopride and lactulose, with the effective rate 71.4% （25/35）. Only little mild and moderate adverse reactions such as nausea, headache and abdominal distension were observed and were natural disappeared several days after medication. Conclusion The combination of prucalopride and lactulose can be effectively improved the related symptoms and quality of life of the patients with refractory constipation, w

关 键 词：便秘 治疗 普芦卡必利 乳果糖 联合用药 效果 

分 类 号：R574.62[医药卫生—消化系统]