替加色罗联合微生态制剂对便秘型肠易激综合征的疗效

Efficacy of tegaserod combined with medilac-s on constipation-dominant irritable bowel syndrome

目的探讨替加色罗联合微生态制剂按需给药治疗便秘型肠易激综合征(constipation-dominant irritable bowel syndrome,IBS-C)的临床疗效和可行性。方法IBS-C患者40例,随机分为两组,分别以系统给药和按需给药的方式口服替加色罗6 mg,每天2次和微生态制剂(美常安)500 mg,每天3次。疗程均为8周,治疗前后分别评价患者的大便性状、肠道症状严重程度及生活质量。结果治疗8周后,按需治疗组与系统治疗组患者的Bristol评分均较治疗前明显提高(治疗前后变化差值:按需治疗组1.32±0.59,P<0.05;系统治疗组1.34±0.61,P<0.05),腹部症状评分较治疗前都有明显下降(治疗前后变化差值:按需治疗组9.3±1.42,P<0.05;系统治疗组9.6±1.61,P<0.05;组间比较P>0.05),SF-36生活质量评分在各维度较治疗前有不同程度改善,但两种给药方式之间的治疗效果比较没有明显差异(P>0.05)。结论替加色罗联合微生态制剂按需给药治疗IBS-C患者具有与系统给药治疗相同的疗效,并具有临床可行性。

Objective To evaluate the clinical efficacy on constipation-dominant irrtable bowel syndrome （IBS-C） treated on-demand with tegaserod combined with medilac-s in improving patients＇ stool description, clinical symptom and quality of life. Thus to evaluate the efficacy and feasibility of on-demand treatment, and to make sure how to choose a suitable method to treat the IBS-C. Method Forty patients diagnosed as IBS-C according to the Rome 1I criteria by a simple stool description were randomly divided into two groups and followed up for 8 weeks. One group was given ondemand treatment： tegaserod, 6 mg twice daily, and medilac-s 500 mg, three times daily when having symptoms, and patients discontinued the drug once symptoms abated. Systematical treatment： tegaserod,6 mg twice daily, and medilacs 500 mg, three times daily, and patients took the drug continually. Main outcomes assessment included the Bristol Stool Form Scale, the symptomatic scores and a Chinese version of the SF-36 Health Survey Scales at baseline and at the end of 8 weeks. Result Eight weeks later, the Bristol Stool Form Scale, the symptomatic scores and the SF-36 Scales at baseline have significant improvement in both groups compared with baseline. There was no significant difference of efficiency between on-demand treatment and systematical treatment. Conclusion Clinical efficacy on IBS-C treated on-demand with tegaserod combined with medilac-s in improving patients＇ stool description, clinical symptom and quality of life is as available as that of systematical treatment.