聚乙二醇3350电解质散对氯氮平诱发便秘的影响

Effect of polyethylene glycol 3350 plus electrolytes on the constipation induced by clozapine

目的 探讨聚乙二醇3350电解质散治疗精神分裂症患者使用氯氮平诱发便秘的有效性和安全性.方法 使用氯氮平治疗后出现便秘的精神分裂症患者150例,随机进入聚乙二醇组、乳果糖组和按需导泻组,每组各50例,分别予以聚乙二醇3350电解质散13.7 g,2次/d;乳果糖口服液10 ml,3次/d;按需导泻组不予定期缓泻剂,只是按需予以导泻治疗;观察6周,包括2周的基线观察期、4周治疗期.评估标准：对便秘患者的全部症状进行总体评估,对患者的每个便秘参数及安全性进行评估.结果 治疗4周后聚乙二醇组、乳果糖组、按需导泻组总有效率分别为90.0%、68.0%、38.0%,差异均有统计学意义（均P＜0.05）;各组大便形态正常率分别为84.0%、60.0%、28.0%.聚乙二醇组在首次排便时间、每周平均排便次数等方面优于其它两组及基线期,同时在治疗前后大便伴随症状积分改善方面明显优于其它组.在安全性比较中,各组治疗前后的肝肾功能、电解质、血糖、心电图、精神分裂症症状潘氏评分等均无发生明显改变（P＞0.05）;各组无明显的不良反应发生.结论 聚乙二醇3350电解质散治疗精神分裂症患者氯氮平诱发的慢性便秘安全、有效.

Objective To explore the efficacy and safety of Polyethylene glycol 3350 plus electrolyte bulk on the schizophrenia patients with constipation induced by clozapine. Methods 150 cases of schizophrenia inpatient and outpatient with constipation induced by clozapine treatment were selected and randoly dirided into the group of polyethylene glycol,lactulose group and non-intervention group with 50 patients in each group and each patient or their families signed the informed consent. The treatment groups took orally with Polyethyle ne glycol 3350 plus electrolyte 13. 7grams,2 times per day and lactulose oral solution 10ml,3 times per day respectively. The non-intervention group was not given a regular basis laxatives, but with cathartic therapy in demand. The period of experiment was 6 weeks including 2 weeks baseline observation period and 4 weeks treatment. Assessment criteria： an overall assessment of all symptoms of patients and each patient＇s constipation and safety parameters were assessed. Results After treatment for 4 weeks,the total effective rate in three groups was 90.0% ,68.0% ,38.0% （all P ＜0.05）. The difference was statistically significant. The normal shape of stool rate was 84.0% ,60.0% ,28.0%. PEG group were better than the other 2 groups at baseline in the first defecation time,the average times of bowel movements per week,theutilization of laxatives during treatment, while symptom score improvement in the stool was significantly better than other groups after treatment. The safety parameters including liver and kidney function, lectrolytes, glucose, ECG, symptoms of schizophrenia such as PANSS score had no obvious change in each group after treatment. Conclusion PEG 3350 plus electrolytes was effective and safe in the treatment of clozapine-indueed constipation in chronic schizophrenia.