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目的评价普芦卡必利联合乳果糖对顽固性便秘患者的疗效。方法 2013年1月至2015年6月,对35例使用普芦卡必利(2 mg/天)单药连续4周治疗效果欠佳即平均每周完全自发排便(CSBMs)≤2次的顽固性便秘患者采用普芦卡必利(2 mg/天)联合乳果糖(15 ml×2次/天)连续8周方案进行治疗。观察指标为:服药后首次完全自发排便所需时间和每周平均CSBMs次数,并采用Bristol粪便评分量表、胃肠生活质量评分(GIQLI)、Wexner便秘评分和健康状况调查问卷(SF-36)比较联合治疗前后患者便秘症状和生活质量改善情况,并观察不良反应事件。结果患者联合治疗前后首次CSBMs所需时间为(6.7±3.2)天和(2.4±2.1)天(t=10.161,P<0.01);平均每周CSBMs为(0.86±0.77)次/周(单药治疗前4周)和(5.26±6.09)次/周(联合治疗后8周)(t=-4.363,P<0.01);患者总体便秘症状和生活质量各评分较联合治疗前明显改善(均P<0.01)。联合治疗8周后35例患者中有25例每周平均CSBMs≥3次,有效率达71.4%(25/35)。治疗期间不良反应为轻中度恶心、头痛、腹泻和腹胀,持续数天后即缓解。结论普芦卡必利联合乳果糖能进一步改善顽固性便秘患者的便秘症状和生活质量,值得临床推广应用。
Objective To evaluate the efficacy of propafar plus lactulose in refractory patients with constipation. Methods From January 2013 to June 2015, 35 patients treated with propafacapide (2 mg / day) for 4 consecutive weeks were given ineffective treatment with mean stubborn spontaneous bowel movements (CSBMs ≤2) Patients with constipation were treated with prophylactic (2 mg / day) and lactulose (15 ml × 2 times daily) for 8 weeks. Observations were the time required for the first spontaneous spontaneous bowel movements and the average weekly number of CSBMs after taking the medication, and the Bristol stool score, gastrointestinal quality of life score (GIQLI), Wexner constipation score and health status questionnaire (SF-36) Patients with constipation symptoms and quality of life before and after treatment were compared, and adverse events were observed. Results The mean duration of CSBMs was (6.7 ± 3.2) days and (2.4 ± 2.1) days before and after the combination therapy (t = 10.161, P <0.01) (T = -4.363, P <0.01). The scores of overall constipation and quality of life in all patients were significantly better than those before treatment (P <0.05) <0.01). After 8 weeks of combination therapy, 25 out of 35 patients had mean CSBMs ≥3 times per week, with an effective rate of 71.4% (25/35). Adverse reactions during treatment were mild to moderate nausea, headache, diarrhea and bloating, which eased after several days. Conclusions Pulucarbide combined with lactulose can further improve the constipation symptoms and quality of life of patients with refractory constipation, which is worthy of clinical application.