乳果糖在溃疡性结肠炎患者肠道准备中的应用  

Application of lactulose in the bowel cleaning preparation of ulcerative colitis patients

作　　者：张俊美[1] 张秀[1] 孙滨滨[1] ZHANG Junmei;ZHANG Xiu;SUN Binbin(Department of Gastroenterology,Beijing Rectum Hospital,Beijing 100120,China)

机构地区：[1]北京市肛肠医院消化内科,北京100120

出　　处：《安徽医药》2018年第7期1373-1376,共4页Anhui Medical and Pharmaceutical Journal

基　　金：北京中医药科技发展资金项目(JJ2016-05)

摘　　要：目的评估乳果糖在溃疡性结肠炎患者中的清肠效果及安全性。方法将明确诊断为溃疡性结肠炎,缓解期或轻中度活动期需行肠镜检查的患者,采用随机数字表法分成两组,分别给予乳果糖、聚乙二醇电解质散行肠道准备。观察两组清肠效果、不良反应、接受程度以及肠镜检查前后临床症状、炎症指标的变化。结果两组的肠道清洁度、清肠满意率差异无统计学意义(P值分别为0.856、1.000);清肠过程中不良反应评分、患者清肠药物接受程度乳果糖组均优于聚乙二醇电解质散组(P值分别为0.019、0.037)。乳果糖组在肠镜检查前后临床症状评分分别为(3.90±1.83)分、(4.70±2.45)分,差异无统计学意义(P=0.771);ESR均值分别为(13.75±6.12)mm·h^(-1)、(16.80±7.65)mm·h^(-1),差异无统计学意义(P=0.883);CRP均值分别为(18.70±8.75)mg·L^(-1)、(23.27±2.90)mg·L^(-1),差异无统计学意义(P=0.494)。聚乙二醇电解质散组在肠镜检查前后临床症状评分分别为(3.73±2.07)分、(5.32±2.85)分,ESR均值分别为(13.45±6.36)mm·h^(-1)、(18.68±8.75)mm·h^(-1),CRP均值分别为(16.51±0.02)mg·L^(-1)、(26.01±16.59)mg·L^(-1),均差异有统计学意义(P值分别为0.040、0.022、0.027)。结论在溃疡性结肠炎患者的肠道准备中,乳果糖优于聚乙二醇电解质散,值得临床推广使用。Objective To evaluate the cleaning effect and safety of lactulose in ulcerative colitis patients. Methods The patients in the stable or mild or moderate stage of ulcerative colitis were randomly divided into lactulose and polyethylene glycol-electrolyte group,which were treated with lactulose orpolyethylene glycol-electrolyte powder for bowel cleaning preparation respectively. The cleaning effect,adverse reactions,acceptance level,symptoms and the change of inflammatory indexes in two groups were observed. Results There was no significant difference in intestinal cleanliness and satisfaction rate between the two groups（ P = 0. 856,1. 000）,and the score of adverse reactions in the intestinal tract and the level of lactulose in the patients were superior topolyethylene glycol-electrolytegroup,and the two groups had statistical significance（ P = 0. 019,0. 037）. The clinical symptom scores of lactulose group were 3. 90 ±1. 83 and 4. 70 ± 2. 45 respectively before and after colonoscopy,and the difference was not statistically significant（ P = 0. 771）. The mean value of ESR was（ 13. 75 ± 6. 12） mm·h^-1 and（ 16. 80 ± 7. 65） mm·h^-1 respectively（ P = 0. 883）,and the mean value of CRP was（ 18. 70 ± 8. 75） mg·L^-1 and（ 23. 27 ± 2. 90） mg·L^-1,respectively,with no statistical significance（ P = 0. 494）. The clinical symptom scores of the polyethylene glycol-electrolytegroupbefore and after colonoscopy were 3. 73 ± 2. 07 and 5. 32 ± 2. 85 respectively,and the ESR mean was（ 13. 45 ± 6. 36） mm · h^-1 and（ 18. 68 ± 8. 75） mm · h^-1 respectively. The mean CRP was（ 16. 51 ± 0. 02） mg·L^-1 and（ 26. 01 ± 16. 59） mg · L^-1,respectively. The difference was statistically significant（ P = 0. 040,0. 022,0. 027）. Conclusion the lactulose is better than the polyethylene glycol-electrolyte powder in the bowel cleaning preparation of ulcerative colitis patients,so the lactulose is worthy of promotion.

关 键 词：肠炎 溃疡性 乳果糖 聚乙烯二醇类 灌肠 结肠镜检查 

分 类 号：R574.62[医药卫生—消化系统]