乳果糖合用美常安治疗老年功能性便秘临床观察

目的联合应用乳果糖与美常安治疗老年功能性便秘,与单用乳果糖对照组比较,观察疗效及不良反应。方法采用随机、平行对照研究,将老年功能性便秘患者97例随机分为治疗组(49例)及对照组(48例)。入选患者年龄大于等于65周岁,患者或家属能准确完成治疗过程中大便改变及不良反应等记录。病例排除标准为对乳果糖与美常安等药物过敏,半乳糖血症。治疗组同时口服乳果糖溶液与美常安,对照组口服乳果糖溶液,乳果糖起始量为15ml bid,症状无改善可逐渐增量至30ml bid,起效后改为10ml bid,美常安剂量为500mg bid。疗程6周。患者或家属每日记录内容包括服药剂量,腹痛,腹胀或腹部不适感,是否排便或排便次数,大便性状(按Bristol粪便分级评分),其他不良反应等。服药后每周随诊1次。分别于治疗后1周、3周及6周评价疗效。疗效标准为:患者大便次数和性状均恢复正常为显效;患者大便次数和性状较前改善或其中之一较前改善,不影响正常生活为有效;治疗后大便次数和性状均改善不明显为无效。结果治疗组49例,显效30例,有效17例,无效2例,总有效率95.92%,对照组48例,显效26例,有效17例,无效5例,总有效率89.59%。治疗组有效率明显高于对照组有效率,两组有效率差异具统计学意义(P【0.05)。结论乳果糖合用美常安治疗老年功能性便秘较单用乳果糖有更高的有效率,能更好地改善排便困难及大便性状,美常安能增加乳果糖的疗效,减少副作用。

Objective Combined application of Lactulose and the Live Combined Bacillus Subtilis and Enterococcus Faecium of elderly functional constipation,compared with those on Lactulose alone,observe the effect and adverse reaction.Methods Applying a randomized,controlled study.The old 97 patients with functional constipation divided into the treatment group(49)and control group(48).In patients older than is equal to 65 years of age and patient or family member can accurately complete treatment process change and adverse reaction of shit and record.Cases exclusion standard is Drug allergy of the live Combined Bacillus Subtilis and Enterococcus Faecium and lactulose and half of lactose hematic disease.patients in the treatment group took oral live Combined Bacillus Subtilis and Enterococcus Faecium and lactulose,and patients in the control group took oral lactulose alone.Starting dose of lactulose is 15ml bid.Symptoms can be no improvement increment to 30 ml gradually bid,and After work instead 10 ml bid.the rose of live Combined Bacillus Subtilis and Enterococcus Faecium is 500mg bid.the Period of treatment is six weeks.Patient or family member daily record contents including dose,abdominal pain,abdominal distension or abdominal discomfort,whether defecate or stool frequency,defecate traits and other harmful response.After taking the follow-up once a week and After treatment were in 1 week,three weeks and 6 weeks therapeutic evaluation.The curative standard for:patient defecate number and traits are back to normal for powerfully;Patients were relatively stool and improve or one of them before the previous improve,do not affect the normal life for effective and After treatment and traits stool are not obvious improvement null and void.Results The treatment group in 49 cases,powerfully 30 cases,effective 17 cases effectiveness and 2 cases,the total effective rate was 95.92%,and the control group 48 cases,26 cases were markedly improved,effective 17 cases effectiveness and in 5 patients,and the total effective rate of 89.59%.The treatment group efficient obviously higher than those in the control group efficient,two groups of efficient with statistically significant difference(P< 0.05).Conclusion Lactulose and he Live Combined Bacillus Subtilis and Enterococcus Faecium treatment than those elderly functional constipation Lactulose have higher efficient,to better improve defecate is difficult and defecate traits,beauty ChangAn can increase the curative effect of milk fructose,reduce the side effects.