乳果糖治疗产后便秘的疗效及安全性

Efficacy and safety of lactulose on the treatment of puerperal constipation

目的 探讨乳果糖口服溶液防治产后便秘的疗效及安全性.方法 从2013年1至10月在第三军医大学附属西南医院产科门诊建档产检并住院分娩的孕妇中选择产后发生单纯排便困难、无其他病理因素的产妇200例,采用随机数字表分成对照组（100例,不进行药物治疗,仅训练排便习惯、合理调整饮食、保证充足饮水等）和乳果糖治疗组（100例,在对照组治疗基础上给予乳果糖口服液20 ml/次,2次/d,疗程4周）.观察患者治疗前、治疗中及治疗后1周周排便次数、疗效及复发情况,并观察患者治疗过程中的不良反应.结果 口服乳果糖第1周,治疗组周排便次数较对照组增加（t =2.178,P=0.869）,第4周患者的周排便次数明显增加（t=8.390,P=0.000）.口服乳果糖4周后,乳果糖治疗组产妇改善便秘总体有效率明显高于对照组（92％比21％,x2=112.530,P=0.000）.随访120 d患者的便秘复发情况,结果发现乳果糖治疗组的总体复发率明显低于对照组（4％比18％,x2=10.010,P=0.001）.结论 乳果糖口服溶液治疗产后便秘的疗效确切,而且便秘复发率低,是一种有效且安全的方法.

Objective To observe the therapeutic effects and security of oral lactulose solution on treatment of puerperal constipation.Methods A total of 200 patients with puerperal constipation who received regular antenatal cares from early pregnancy in our department and delivered in our hospital from January 2013 to October 2013,were randomly divided into two groups.The patients in control group （n =100）received defecation habits training,diet management and drinking adequate water etc.The patients in therapy group（n =100）received 20 ml oral lactulose solution,twice a day and constantly treatment for 4 weeks.The frequency of defecation per week were recorded （including before treatment,period during the treatment,and the first week after finish the whole treatment）.The adverse reactions and recurrence of constipation after treatment were analyzed.Results The frequency of defecation per week in the therapy group was higher than that in the control group at the first week after treatment （t =2.178,P =0.869）,and significantly increase in the fourth week （t =8.390,P =0.000）.The efficiency of the lactulose groups was 92％,and the control group was 21％ （x2 =112.530,P =0.000）.The total recurrence of constipation in lactulose group was lower than that in the control group by follow up 120 days （4％ vs 18％,x2 ＝ 10.010,P =0.001）.Conclusion Oral lactulose solution is effective and safe for puerperal consipation.