聚乙二醇4000治疗老年人慢性功能性便秘

目的 :评价聚乙二醇 40 0 0对老年人慢性功能性便秘的疗效和安全性。方法 :60例年龄在(81±s 5)a的老年功能性便秘病人 ,分为 2组 ,共有 59例病人完成治疗 ,聚乙二醇组 2 9例给予聚乙二醇 40 0 0 ,1 0g,po,bid ;乳果糖组 30例 ,给以乳果糖 ,1 5mL ,po,bid ,疗程均为 2 1d。治疗后观察病人大便次数和大便形状 ,并观察腹胀、食欲不振、大便困难等症状缓解率。结果 :聚乙二醇组经治疗后排便困难发生率由 86 %下降至 34 % ,较治疗前有显著性下降 (P <0 .0 1 ) ,与乳果糖组比较 ,无统计学差异 (P >0 .0 5) ;且在有效病人中服药量小于乳果糖组 ,但 2组相比无统计学差异 ;聚乙二醇组治疗便秘的显效率和有效率分别为 52 %和 1 7% ,与乳果糖组相似 (P >0 .0 5) ;而不良反应发生率为 6 .9% ,与乳果糖组相近 (P >0 .0 5)。结论 :聚乙二醇 40 0 0能安全有效地治疗老年人慢性功能性便秘     

复方聚乙二醇电解质散治疗慢性功能性便秘的临床观察

目的：评价复方聚乙二醇电解质散治疗慢性功能性便秘的临床效果。方法：83例慢性功能性便秘患者随机分为试验组43例和对照组40例,分别口服复方聚乙二醇电解质散和乳果糖,bid,早晚餐前服用,治疗4周。结果：两组治疗后排便次教均明显增加,大便性状及伴随症状明显改善,均未出现明显不良反应。试验组总有效率及症状改善情况明显较优（P〈0．05）。结论：复方聚乙二醇电解质散治疗慢性功能性便秘疗效较为理想。     

复方聚乙二醇电解质散与芒硝清洁肠道的效果

良好的肠道清洁状况是电子结肠镜检查和治疗顺利进行的重要前提,同时也有利于减少术后并发症,有利于电子结肠镜的保养.我院历年常用的口服芒硝法在电子结肠镜的准备工作中起到了很好的作用,但随着人们对医疗舒适度的要求越来越高,部分患者由于不适应芒硝的口感,出现恶心、呕吐,从而抗拒应用芒硝.我院从2008年2月开始应用复方聚乙二醇电解质散来进行部分患者的肠道准备工作.本研究将复方聚乙二醇电解质散与芒硝清洁肠道的效果做一比较,现报告如下.     

复方聚乙二醇电解质散与芒硝清洁肠道的效果

良好的肠道清洁状况是电子结肠镜检查和治疗顺利进行的重要前提,同时也有利于减少术后并发症,有利于电子结肠镜的保养.我院历年常用的口服芒硝法在电子结肠镜的准备工作中起到了很好的作用,但随着人们对医疗舒适度的要求越来越高,部分患者由于不适应芒硝的口感,出现恶心、呕吐,从而抗拒应用芒硝.我院从2008年2月开始应用复方聚乙二醇电解质散来进行部分患者的肠道准备工作.本研究将复方聚乙二醇电解质散与芒硝清洁肠道的效果做一比较,现报告如下.     

理气通便方联合复方聚乙二醇电解质散治疗儿童慢传输型便秘的临床疗效观察

目的探讨理气通便方联合复方聚乙二醇电解质散治疗儿童慢传输型便秘(STC)的临床疗效。方法回顾性选取2020年6月至2021年9月浙江大学医学院附属第二医院建德分院收治的STC患儿92例作为研究对象, 按照治疗方法不同分为对照组和观察组, 每组46例。对照组给予复方聚乙二醇电解质散(儿童型)治疗, 观察组在对照组的基础上联合理气通便方治疗。比较两组患儿治疗前后血清P物质(SP)、生长抑素(SS)以及一氧化氮(NO)水平, 比较两组不良反应发生率、治疗后临床症状以及临床治疗效果。结果治疗前, 两组患儿SP、SS以及NO水平差异均无统计学意义(均P > 0.05)。治疗后, 观察组SP水平[(45.79±7.36)ng/L]高于对照组[(37.98±6.25)ng/L](P < 0.05), SS水平[(9.08±1.89)ng/L]和NO水平[(53.62±12.13)mmol/L]与对照组[(13.25±2.25)ng/L、(68.14±10.52)mmol/L]比较均降低(均P < 0.05);观察组不良反应发生率[4.35%(2/46)]低于对照组[21.74%(1...     

氯氮平对白细胞的影响观察

调查了349例服用氯氮平患者治疗期间血象报告及有关病史,发现氯氮平对白细胞的影响具有双相性.白细胞减少发生率7.44%(男2.74%,女11.39%),出现时间为用药后7-57天,平均(37.23±23.04)天;白细胞增高发生率为15.75%(男4.46%,女26.58%),发生于用药后第2一12周.白细胞增多对机体无明显不良影响,能自行恢复正常.白细胞减少在治疗过程的各时期均有可能发生,但通常是可逆的,很少进展到粒细胞减少或或粒细胞缺乏的程度.提示氯氮平是一种安全有效的抗精神病药物.     

番泻叶治疗氯氮平所致便秘60例

氯氮平是二苯二氮平类广谱抗精神医药,适用于急、慢性精神分裂症.在临床使用中,便秘是其最常见的副作用之一.笔者运用单味番泻叶开水泡服治疗60例,取得良好疗效,现总结如下.     

番泻叶治疗氯氮平所致便秘60例

氯氮平是二苯二氮平类广谱抗精神医药,适用于急、慢性精神分裂症。在临床使用中,便秘是其最常见的副作用之一。笔者运用单味番泻叶开水泡服治疗60例,取得良好疗效,现总结如下。 1 临床资料 60例均为2001-2002年我科收住院的精神分裂症病人,年     

聚乙二醇治疗慢性便秘优于乳果糖

根据Cochrane数据库7月7日报道的系统评价的结果,对于治疗慢性便秘,PEG（聚乙二醇）优于乳果糖。英国谢菲尔德北总医院的Heather Lee-Robichaud写道,便秘是一种常见的临床疾病,乳果糖和HPEG均为常用的治疗慢性便秘的安全有效的渗透性泻药。然而,之前并没有可靠数据显示二者之中谁的效果更好。     

复方聚乙二醇电解质散治疗功能性便秘的疗效观察

目的 评价复方聚乙二醇电解质散治疗功能性便秘的有效性和安全性。方法 222例便秘患者随机分为试验组(112例)和安慰剂组(110例),试验组使用复方聚乙二醇电解质散治疗,对照组使用安慰剂治疗,比较两组的治疗效果。结果 试验组每周排便次数、首次排便时间、大便性状、治疗前后变化情况及伴随症状疗效方面均优于对照组(P<0.05)。两组不良反应比较差异无统计学意义(P>0.05)。结论 复方聚乙二醇电解质散在治疗功能性便秘时,比安慰剂有更好的疗效。     

Long-term efficacy and cost-effectiveness of polyethylene glycol 3350 plus electrolytes in chronic constipation: a retrospective study in a disabled population

ABSTRACT

Objectives: The efficacy and safety of treatments for constipation in severely intellectually disabled patients and their associated cost-effectiveness are an underinvestigated area of clinical practice. Aiming to address this, the objectives of the study were to evaluate the efficacy and tolerability of polyethylene glycol 3350 plus electrolytes (Movicol; PEG+E) by comparing clinical data collected before and after its introduction to a stable population of residents of a mental health care, long-stay institution. The study also attempted an economic evaluation of the use of PEG+E in this setting.

Research design and methods: This was a retrospective study of 54/66 severely intellectually and physically disabled residents of a specialist unit at La Milétrie University Hospital, Poitiers, France, who suffered regularly from constipation. A total of 54 residents were treated with PEG+E (1–3 sachets a day) for 24 months. The number of stools, episodes of diarrhoea (defined as frequent stools, not necessarily watery), body weights and blood biochemistry were recorded. Data were compared with those recorded during the 21 months preceding the introduction of PEG+E for 16/54 residents who had been treated regularly with a range of other interventions for the relief of constipation. The monthly use and costs of laxatives, enemas and suppositories was obtained from hospital pharmacy records, and the total hospital costs before and after the introduction of PEG+E treatment was calculated.

Results: The mean (± standard deviation) number of stools per patient per month was significantly greater following the introduction of PEG+E (24.9 ± 6.3) compared to before its use (12.4 ± 3.4) (?p < 0.001). The mean (± standard deviation) monthly number of episodes of diarrhoea per patient before and after the introduction of PEG+E was 0.1 ± 0.1 and 6.3 ± 2.9, respectively (?p < 0.001). Treatment with PEG+E was not associated with adverse effects on body weight or blood biochemistry values. Introduction of PEG+E and its increasing use reduced the total hospital medical ward expenditure on laxatives from 3788 to 1767 Euros per month.

Conclusions: PEG+E is effective in the clinical management of constipation in an institutional setting. Furthermore, long-term intensive therapy with PEG+E was not associated with adverse effects on body weight or blood biochemistry values. Although the time periods over which the economic data and the efficacy and safety data were collected did not directly correspond, this study indicates that use of PEG+E in the management of constipation in people with severe intellectual disability may be cost-effective, reducing hospital laxative costs.     

Economic impact of low dose polyethylene glycol 3350 plus electrolytes compared with lactulose in the management of idiopathic constipation in the UK

OBJECTIVE: To estimate the economic impact of using low dose polyethyene glycol 3350 (PEG 3350) plus electrolytes (PEG+E) compared with lactulose in the treatment of idiopathic constipation in ambulant patients. DESIGN AND PERSPECTIVE: This was a decision analytic modelling study performed from the perspective of the UK's National Health Service (NHS). METHODS: The clinical outcomes from a previously reported single-blind, randomised, multicentre trial were used as the clinical basis for the analysis. These data were combined with resource utilisation estimates derived from a panel of six general practitioners (GPs) and four nurses enabling a decision model to be constructed depicting the management of idiopathic constipation with either PEG+E or lactulose over 3 months. The model was used to estimate the expected 3-monthly NHS cost of using either laxative to manage idiopathic constipation. MAIN OUTCOME MEASURES AND RESULTS: The expected 3-monthly NHS cost of using PEG+E or lactulose to manage idiopathic constipation was estimated to be 85 pound sterling and 96 pound sterling per patient, respectively (1999/2000 values). However, significantly more patients were successfully treated with PEG+E than lactulose (53% versus 24%; p < 0.001) at 3 months. GP visits were the primary cost driver for both PEG+E- and lactulose-treated patients, accounting for 56% (2.9 visits) and 73% (4.4 visits), respectively, of the expected NHS cost per patient at 3 months. Among PEG+E-treated patients, the acquisition cost of PEG+E was the secondary cost driver, accounting for 30% of the expected NHS cost per patient at 3 months, whereas the acquisition cost of lactulose accounted for only 11% of the expected NHS cost per lactulose-treated patient. District nurse domiciliary visits accounted for 4% and thyroid function tests for 2%. The costs of switched laxatives, concomitant laxatives, and gastroenterologist and colorectal surgeon visits collectively accounted for up to 9% of the total. CONCLUSIONS: The true cost of managing idiopathic constipation is impacted on by a broad range of resources and not only laxative acquisition costs. This study indicated that managing idiopathic constipation with PEG+E instead of lactulose reduces the expected 3-monthly NHS cost by 11 pound sterling per patient. Moreover, using PEG+E instead of lactulose is expected to double the percentage of patients successfully treated at 3 months. Hence, PEG+E is a dominant treatment compared with lactulose. This suggests that the decision to use either PEG+E or lactulose to treat idiopathic constipation should be based on efficacy, safety, patient preferences and total management costs, and not drug acquisition costs.     

利那洛肽联合聚乙二醇对比番泻叶联合聚乙二醇在便秘病人肠道准备中的应用

目的 对比利那洛肽联合聚乙二醇（PEG）与番泻叶联合聚乙二醇对便秘病人肠道准备的有效性及安全性。方法 选取2020年10月至2022年5月在蚌埠医学院附属阜阳医院行肠镜检查的便秘病人150例,按数字表法分为A、B、C三组,每组50例。肠镜检查前,A组病人服用利那洛肽+2L PEG、B组病人服用番泻叶颗粒+2L PEG、C组病人服用3L PEG,其中C组为对照。主要观察指标为肠道准备效果,该指标根据波士顿肠道准备量表（BBPS）进行评分,次要观察指标为息肉检出率、再次肠道准备意愿及不良反应发生率。结果 A组病人三段BBPS评分[（2.22±0.65）分、（2.12±0.66）分、（2.12±0.69）分]、B组病人三段BBPS评分[（2.08±0.75）分、（2.02±0.74）分、（1.86±0.76）分]均优于C组[1.70±0.54）分、（1.60±0.58）分、（1.46±0.50）分]（均P<0.05）。A、B组总BBPS评分[（6.46±1.05）分、（5.96±1.03）分]优于C组（5.00±0.99）分（均P<0.05）,A组病人总BBPS评分优于B组（6....     

Long-term efficacy and cost-effectiveness of polyethylene glycol 3350 plus electrolytes in chronic constipation: a retrospective study in a disabled population

OBJECTIVES: The efficacy and safety of treatments for constipation in severely intellectually disabled patients and their associated cost-effectiveness are an under-investigated area of clinical practice. Aiming to address this, the objectives of the study were to evaluate the efficacy and tolerability of polyethylene glycol 3350 plus electrolytes (Movicol; PEG+E) by comparing clinical data collected before and after its introduction to a stable population of residents of a mental health care, long-stay institution. The study also attempted an economic evaluation of the use of PEG+E in this setting. RESEARCH DESIGN AND METHODS: This was a retrospective study of 54/66 severely intellectually and physically disabled residents of a specialist unit at La Milétrie University Hospital, Poitiers, France, who suffered regularly from constipation. A total of 54 residents were treated with PEG+E (1-3 sachets a day) for 24 months. The number of stools, episodes of diarrhoea (defined as frequent stools, not necessarily watery), body weights and blood biochemistry were recorded. Data were compared with those recorded during the 21 months preceding the introduction of PEG+E for 16/54 residents who had been treated regularly with a range of other interventions for the relief of constipation. The monthly use and costs of laxatives, enemas and suppositories was obtained from hospital pharmacy records, and the total hospital costs before and after the introduction of PEG+E treatment was calculated. RESULTS: The mean (+/- standard deviation) number of stools per patient per month was significantly greater following the introduction of PEG+E (24.9 +/- 6.3) compared to before its use (12.4 +/- 3.4) (p < 0.001). The mean (+/- standard deviation) monthly number of episodes of diarrhoea per patient before and after the introduction of PEG+E was 0.1 +/- 0.1 and 6.3 +/- 2.9, respectively (p < 0.001). Treatment with PEG+E was not associated with adverse effects on body weight or blood biochemistry values. Introduction of PEG+E and its increasing use reduced the total hospital medical ward expenditure on laxatives from 3788 to 1767 Euros per month. CONCLUSIONS: PEG+E is effective in the clinical management of constipation in an institutional setting. Furthermore, long-term intensive therapy with PEG+E was not associated with adverse effects on body weight or blood biochemistry values. Although the time periods over which the economic data and the efficacy and safety data were collected did not directly correspond, this study indicates that use of PEG+E in the management of constipation in people with severe intellectual disability may be cost-effective, reducing hospital laxative costs.     

乳果糖联用莫沙比利治疗帕金森症便秘临床疗效观察

目的：观察比较莫沙比利联合乳果糖口服溶液治疗帕金森症便秘疗效及安全性。方法将64例患者按随机、双盲法分为治疗组和对照组各32例,对照组用乳果糖口服溶液15 ml／次,晨起1次口服,疗程2周。治疗组用乳果糖口服溶液15ml／次,晨起1次口服;同时口服莫沙比利5mg,3次／次,疗程2周。2周后观察患者治疗情况和药物不良反应。结果治疗组总有效率为81．3％明显高于对照组的56．3％,2组比较差异有统计学意义（ P＜0．05）。结论乳果糖口服溶液联合莫沙比利治疗帕金森患者便秘比单独使用乳果糖口服溶液疗效更确切。     

Evaluation of polyethylene glycol plus electrolytes in the treatment of severe constipation and faecal impaction in adults

INTRODUCTION: Extreme and severe cases of constipation can lead to faecal impaction. Current therapies are often both ineffective and unpleasant. The objective of this trial was to evaluate the efficacy and safety of Movicol, a polyethylene glycol (PEG) + electrolyte solution (PEG+E), as treatment for severe constipation and faecal impaction. PATIENTS: 56 patients (aged 17 to 88 years) with a history of chronic constipation and presenting with no bowel movement for three to four days (severe constipation), or no bowel movement for at least five days (faecal impaction), were enrolled at three centres in Taiwan. Faecal loading was confirmed in all patients by abdominal and rectal examination or abdominal radiography. Patients were excluded from the study if they had a gastrointestinal obstruction, evidence of delayed gastric emptying, or if their constipation was secondary to severe inflammatory bowel disease. TREATMENT: All patients followed the same regimen: up to eight 13.8 g sachets of PEG+E (two at a time in 250 ml water; maximum of 1L/day) over a 4-6 h period each day, with 1-1.5 h between each dosing. Duration of treatment was for up to three days. EFFICACY ENDPOINTS AND RESULTS: Patients with either improvement (passage of a moderate to large volume of stool within four days of treatment initiation) or complete resolution (passage of moderate to large volumes of faecal matter plus the disappearance of palpable faecal masses in the abdomen and/or rectum) were considered responders. Based on bowel movement data recorded by the patients, an excellent response rate was obtained: 50/56 patients had a successful response to treatment (89.3%; 95% confidence intervals [CIs] 77.4% to 95.6%); there were 39 complete responders and 11 patients showed improvement. Investigator assessment of response was almost the same: 87.5% (95% CIs 75.3% to 94.4%). All bowel movement measurements (stool volume, number of evacuations, stool form and ease of evacuations) showed a positive improvement by Day 2. Median duration of treatment was two days. The incidence of adverse events was low, even for those side-effects such as abdominal pain and bloating, which are known undesirable consequences of PEG+E administration. No patient discontinued from the study because of an adverse event. CONCLUSION: PEG+E, administered orally at a dose equivalent to eight 13.8 g sachets (1 L) per day over three days, was a highly effective and well tolerated therapy for the treatment of severe constipation and faecal impaction.     

氯氮平剂量与心电图异常的关系探讨

目的 观察抗精神病药物氯氮平的剂量对心电图异常的影响.方法 对持续服用氯氮平治疗2年以上的81例精神分裂症患者服用不同剂量的氯氮平时的心电图检查结果进行回顾性分析.结果 氯氮平≥200 mg/d有35例患者,其中27例有心电图异常,占77.14％;＜200 mg/d有46例患者,其中24例有心电图异常,占52.17％,两组差异有统计学意义(x2=5.13,P＜0.05);两组心电图异常均以T波异常占首位,窦性心动过速居第二位.结论 患者心电图的异常改变和氯氮平的剂量存在着一定的关系,并随着用药剂量的增加而增多.     

聚乙二醇3350治疗成人慢性功能性便秘的多中心随机对照的临床研究

目的观察聚乙二醇3350(默维可,Movical)治疗成人慢性功能性便秘的疗效及安全性.方法采用多中心随机平行对照试验,按照试验中心分层,按入选标准选择成人便秘患者126例,随机进入试验组和对照组,2组均为63例.选择欧车前亲水胶(恺司尔,Konsyl)作为试验对照药.试验组服用聚乙二醇3350 13.7g*d-1,bid;对照组服用欧车前亲水胶 3.5g*d-1,bid;疗程2周.结果2组患者经治疗后便秘伴随症状如腹痛、腹胀、排便困难、排便疼痛等均得到缓解.均未造成服药后电解质丢失,2组结果近似,服药后试验组及对照组大便形状复常率为87.30%和66.67%,总有效率为92.07%和73.02%,大便性状恢复正常、总有效率及首次排便时间试验组均优于对照组(P<0.01).在安全性研究中,除对照组1例ALT升高外,其余均未发现明显不良反应.结论聚乙二醇3350治疗成人慢性功能性便秘安全、有效.     

氯氮平与阿立哌唑对精神分裂症患者代谢综合征的影响

目的研究氯氮平与阿立哌唑对精神分裂症患者代谢综合征的影响。方法将60例精神分裂症患者随机分为2组,分别给予氯氮平、阿利哌唑治疗,测量治疗前及治疗后2、4、8、16、24周体重指数(BMI)、腰围、血糖、血脂等指标的变化。结果治疗24周后,氯氮平组、阿立哌唑组的代谢综合征的发病率分别为43.33%、13.33%,两组比较差异有统计学意义(P<0.05);治疗8周后,两组BMI、腰围、FPG、HbA1c、TG均升高,治疗24周后达到高峰期;氯氮平组治疗8周后BMI、腰围、FPG、HbA1c、TG水平均高于阿立哌唑组,两组比较差异有统计学意义(P<0.05)。结论阿立哌唑对精神分裂症患者代谢指标的影响较氯氮平小,阿立哌唑是一种安全性更高的非经典抗精神病药物。