不同类型通便药物治疗老年功能性便秘疗效的临床研究

Effects of the Different Laxatives in the Treatment of Senile Functional Constipation

目的探讨不同类型通便药物治疗老年功能性便秘的临床疗效及复发情况。方法收集我院2007年1月—2013年4月收治的老年功能性便秘患者197例,所有患者均行肠镜检查排除结、直肠器质性病变。根据患者治疗期间服药不同分组:A组为莫沙比利治疗组;B组为莫沙比利+乳果糖治疗组;C组为非比麸+乳果糖治疗组;D组为莫沙比利+非比麸+乳果糖治疗组;疗程为4周,观察各组服药后自行排便频率、每次排便时间、粪便性质、腹胀、腹痛、排便不尽感相关情况以及停药4周和8周后复发情况。结果经Ridit分析,治疗后B、C、D组疗效均优于A组,差异有统计学意义(P=0.035)。在停药8周B、C、D组的复发率低于A组,差异有统计学意义(P<0.05)。结论不同类型通便药物联合治疗老年功能性便秘疗效和安全性优于单药使用效果,且复发率低,是治疗老年功能性便秘的理想方法。

Objective To investigate the clinical effects of different laxatives in the treatment of senile functional con- stipation. Methods A total of 197 patients with functional constipation admitted into our hospital between January 2007 and April 2013 underwent colonoscopy to exclude colon and rectal lesions. The subjects were divided into four groups according to their med- ication ： group A with mosapride, group B with mosapride and lactulose, group C with fiberform and lactulose, and group D with mosapride, fiberform and lactulose. The course of treatment was 4 weeks. Information about defecation frequency, defecation time, feces features, abdominal distention, abdominal pain, and non - complete defecation after treatment was collected among the patients. The recurrence rates at four weeks and eight weeks after withdrawal were also recorded. Results The Ridit analysis showed that the treatment effects in group B, C, and D were better than that in group A （ P = 0. 035 ） . The recurrence rates at 8 weeks after withdraw were lower in group B, C, and D than in group A （P 〈 0. 05 ） . Conclusion Combination therapy is more effective and safer, and had lower recurrence rate than mono -therapy in treating senile functional constipation.