聚乙二醇4000治疗出口梗阻型便秘的临床疗效观察

Clinical efficacy of polyethylene glycol 4000 in the treatment of outlet obstruction constipation

目的 评价聚乙二醇 4 0 0 0 (PEG 4 0 0 0 )治疗出口梗阻型便秘 (OOC)的临床疗效。方法 采用随机对照试验方法 ,选择OOC 6 9例 ,随机分为治疗组 (36例 )和对照组 (33例 ) ,分别接受PEG 4 0 0 0和乳果糖治疗 ,疗程 4周并评估其疗效。总体疗效评估采用模拟视觉梯度的评分方法 (1 0 0mmVAS)。结果 治疗 2周和 4周后 ,二组每周排便次数较治疗前均显著增加 ,大便性状、排便困难和直肠排空感均也比治疗前明显改善 (P <0 .0 1 ) ,但二组间差异无显著性 (P <0 .0 5 ) ,其中大便性状改善PEG 4 0 0 0明显优于乳果糖 (P <0 .0 5 )。大便性状恢复正常比例治疗组大于对照组 (治疗 2周和 4周后 ,分别为 75 .0 %和 83.3%比 5 1 .5 %和 6 0 .6 % ,P <0 .0 5 )。PEG 4 0 0 0组 1 0 0mmVAS评分为75 .3,显著高于乳果糖组的 5 4 .8(P <0 .0 5 )。结论 聚乙二醇 4 0 0

Objective To evaluate the efficacy of polyethylene glycol 4000 in the treatment of outlet obstruction constipation (OOC). Methods A total of 69 patients with OOC were enrolled in this randomized controlled trial. Patients were divided into two groups treated by polyethylene glycol 4000 as a treating group (n=36) and lactulose as a control (n=33) for 4 weeks. The efficacy was evaluated. Global impression of efficacy was assessed [using a visual analogue scale (VAS) 0～100 mm].Results Weekly stool frequency significantly increased compared with baseline in the two groups, and stool consistency, straining on defecation and rectal evaluation were all significantly improved compared with baseline in the two groups at weeks 2 and 4 (P< 0.01 ), and there was no significant difference between the two groups (P>0.05).Stool consistency in treated group was significantly more liquid compared with controlled group (P<0.05). The percentage of patients with normal stool was significantly higher in treated group at week 2 (75.0%) and 4 (83.3%) compared with controlled group at week 2 (51.5%, P<0.05) and 4 ( 60.6% ,P<0.05). The VAS score was significantly higher in treated group (75.3) than in controlled group (54.8, P<0.05). Conclusion Administration of polyethylene glycol 4000 was an effective and safe treatment for outlet obstruction constipation.