小麦纤维素治疗便秘型肠易激综合征30例的疗效观察

目的 观察小麦纤维素用于治疗便秘型IBS的疗效及其安全性.方法 于南方医院消化科选择30例便秘型IBS患者,采用前瞻性自身对照研究的方法,口服小麦纤维素治疗2周,观察服药前后IBS症状及大便性状情况,并进行量化评分比较.结果 小麦纤维素治疗便秘型IBS症状明显好转,大便性状得到改善,总有效率90.0%,用药前后对比临床排便症状非常显著改善(P<0.01),服药期间未发现明显不良反应.结论 小麦纤维素治疗便秘型IBS安全有效.     

小麦纤维素治疗老年功能性便秘的临床疗效分析

目的 研究小麦纤维素治疗老年功能性便秘的有效性和安全性.方法 选择80例老年功能性便秘患者,给予口服小麦纤维素治疗2 w,观察服药前后便秘症状及大便性状情况,并进行量化评分比较.结果 所有病人均获随访,服药期间无不良反应发生.治疗2 w,排便时间、排便不尽感、腹胀与治疗前相比有差异(P＜0.05);排便困难、粪便性状、排便频率与治疗前相比有显著差异(P＜0.01).治疗7 d总有效率为81.3%;14 d总有效率为93.8%.结论 小麦纤维素治疗老年功能性便秘安全有效.     

中西医结合治疗功能性便秘的疗效观察

目的探讨小麦纤维素颗粒联合乳果糖口服液治疗功能性便秘的疗效。方法研究对象为我院收治的109例功能性便秘患者并随机分为试验组55例和对照组54例。对照组给予乳果糖口服液治疗,试验组联合小麦纤维素颗粒治疗方法。比较两组的临床疗效。结果两组总有效率分别为96.36%、74.07%,试验组较对照组高,差异显著(P0.05)。结论小麦纤维素颗粒联合乳果糖口服液治疗功能性便秘的临床疗效显著,值得推广。     

苁蓉通便口服液联合莫沙必利对化疗所致便秘的疗效观察

[目的]观察口服苁蓉通便口服液联合莫沙必利对化疗所致便秘的疗效。[方法]采用随机对照的方法,化疗后便秘患者68例,随机分为两组,A组给予口服莫沙比利5rag／次,3次／d,苁蓉通便口服液10ml／次,2次／d;B组单用莫沙比利,剂量同A组;疗程均为1周。记录患者服药前后大便间隔天数、大便性状的改变、排便困难程度改变及不良反应。[结果]治疗1周后,两组总有效率分别为88．2％和61．8％,疗效差异有统计学意义（P〈O．05）。[结论]苁蓉通便口服液联合莫沙必利治疗化疗所致的便秘安全,使用方便,具有较好的疗效。     

小麦纤维素对功能性便秘儿童肛门直肠压力的影响

[目的]观察小麦纤维素对功能性便秘儿童肛门直肠压力的影响以及其临床疗效。[方法]选取我院2014年1月~2016年4月儿科治疗的功能性便秘患儿116例,患儿使用数字法随机分为对照组和观察组,每组58例。对照组使用枯草杆菌二联活菌颗粒,1.0g/次,2次/d;观察组在对照组基础上加用小麦纤维素颗粒,3.5g/次,2次/d。4周为一疗程。多通道胃肠功能监测仪直肠肛管测压。比较2组临床有效率。[结果]2组治疗前、后直肠静息压和肛管静息压变化比较差异无统计学意义。治疗后观察组肛管最大缩榨压、直肠最大容量感觉阈值、模拟排便时肛管压显著低于对照组(P0.05)。2组治疗前排便次数、排便不净感、排便困难、排便疼痛评分差异无统计学意义。治疗后上述指标均较治疗前显著减低(P0.05或P0.01),但观察组显著低于对照组(P0.05)。观察组临床治疗有效率为94.8%(55/58),显著高于对照组的82.8%(48/55)(P0.05)。[结论]小麦纤维素显著改善了功能性便秘患儿的肠道动力学异常,以及肠道对粪便刺激的感觉能力,临床疗效显著。     

非比麸治疗结直肠癌肠造口术后患者19例

目的:观察非比麸颗粒对结直肠癌肠造口术后患者的疗效及其安全性.方法:选取2010-01/2011-07在我科住院的结直肠癌行肠造口术后患者19例,连续口服非比麸颗粒治疗1wk,采用自身前后对照方法观察服药前后大便频率、大便性状、造口周围皮肤及医患双方满意度情况,并进行量化评分比较.结果:非比麸颗粒能明显改善结直肠癌肠造口术后大便频率、大便性状及造口周围皮肤刺激[(1.09±0.78)分vs(2.03±0.63)分,(4.32±0.49)分vs(6.01±0.66)分,(0.44±0.21)分vs(1.57±0.57)分,均P<0.05],服药期间未发现明显不良反应.结论:非比麸颗粒可以改善肠造口术后大便频率、大便性状及造口周围皮肤刺激,安全有效,满意度高.     

稳心颗粒治疗快速性心律失常110例疗效观察

目的 观察稳心颗粒治疗冠心病快速性心律失常患者的疗效及安全性.方法 选取冠心病快速性心律失常患者110例,口服稳心颗粒1袋/次,3次/d,4周为1个疗程.观察治疗前后症状、心电图、24h动态心电图等指标的变化,同时监测药物不良反应.结果 110例患者临床总有效率为86.3%,心电图示心肌缺血总有效率为85.4%,24h动态心电图分析:治疗后心律失常次数显著减少(P＜0.01),未发现严重不良反应.结论 稳心颗粒治疗冠心病快速性心律失常安全有效,值得临床推广.     

稳心颗粒与美托洛尔联用治疗缺血性快速心房纤颤的临床观察

目的观察步长稳心颗粒与美托洛尔联用治疗缺血性心脏病合并快速心房纤颤(缺血性快速房颤)的临床疗效和不良反应。方法将61例缺血性快速房颤患者随机分成两组,治疗组30例,对照组31例。治疗组予步长稳心颗粒9g/次,3次/d,冲服;美托洛尔12.5mg/次,2次/d,口服。对照组予美托洛尔12.5mg/次,2次/d,口服。两组疗程均为4周。观察用药前后疗效与不良反应。结果症状疗效:治疗组总有效率96.67%,对照组总有效率77.42%,两组比较差异有统计学意义(P<0.05);快速房颤情况疗效比较:治疗组总有效率90.00%,对照组总有效率67.74%,两组比较差异有统计学意义(P<0.05);药物不良反应发生率:治疗组6.67%,对照组12.90%,两组比较差异无统计学意义(P>0.05),其中对照组发生2例致心律失常(1例房颤合并Ⅱ度Ⅱ型房室传导阻滞,1例房颤合并高度房室传导阻滞),治疗组未见此情况发生。两组治疗后实验室检查无明显变化。结论步长稳心颗粒与美托洛尔联用治疗缺血性快速房颤不但安全有效,而且步长稳心颗粒还能有效减少西药抗心律失常药物所引起的不良反应。     

中西医结合治疗慢性功能性便秘的疗效观察

目的探讨小麦纤维素颗粒联合盐酸伊托必利治疗功能性便秘的疗效。方法选取我院2013年11月~2015年11月收治的功能性便秘患者121例作为研究对象,并随机分为观察组61例和对照组60例。对照组采用盐酸伊托必利治疗方案,观察组联合小麦纤维素颗粒治疗方法。比较两组的临床疗效。结果观察组的总有效率95.08%较对照组的76.67%高,差异有统计学意义(P0.05))。结论小麦纤维素颗粒联合盐酸伊托必利治疗功能性便秘的疗效显著,值得推广。     

普芦卡必利联合小麦维素颗粒治疗老年功能性便秘的效果

目的探讨普芦卡必利联合小麦维素颗粒治疗老年功能性便秘的效果。方法选择90例老年功能性便秘患者,随机分为观察组和对照组各45例。观察组给予普芦卡必利联合小麦维素治疗,对照组给予普芦卡必利治疗。观察两组治疗后的总有效率、治疗前后便秘症状总评分和各项便秘症状评分、盆底表面肌电图改善情况及不良反应情况。结果观察组治疗后有效率明显高于对照组(P<0. 05);两组治疗后便秘症状总评分和生存质量自评量表(PAC-QOL)评分均显著下降,且观察组明显低于对照组(P<0. 05);两组治疗后排便不尽感、排便困难、排便频繁、粪便性状、直肠阻塞感、排便时间评分显著下降,且观察组显著低于对照组(P<0. 05);观察组治疗后盆底肌和腹肌矛盾运动消失率明显高于对照组(P<0. 05);两组不良反应发生率差异无统计学意义(P>0. 05)。结论普芦卡必利联合小麦维素颗粒治疗老年功能性便秘可显著提高治疗效果,改善患者便秘症状,且安全性高。     

Effects of a new, concentrated wheat fibre preparation on intestinal transit, deoxycholic acid metabolism and the composition of bile.

When the cholesterol saturation index of bile is reduced by wheat bran there is generally a fall in the deoxycholic acid content of bile. As the same effects occur with senna, bran might act on bile simply via its accelerating effect on colonic transit. We have studied the effects of a new, concentrated, wheat fibre preparation (Testa Triticum Tricum, Trifyba, which is 80% dietary fibre) upon bile composition, deoxycholic acid metabolism and intestinal transit time, and have assessed whether these effects are related. Twenty constipated volunteers were prescribed Testa Triticum Tricum in doses (10-32 g/day) sufficient to relieve their symptoms for at least six weeks. Before and at the end of this period, duodenal bile was sampled to enable measurement of deoxycholic acid pool (by isotope dilution), total bile acid pool, bile acid composition and cholesterol saturation index. Whole gut transit time fell from 120 +/- SD35 to 68 +/- 35 hours. At the same time, biliary % deoxycholic acid fell from 26.6 +/- 12.0 to 23.0 +/- 11.8 (p = 0.002), the total bile acid pool expanded from 2.36 +/- 0.88 to 2.75 +/- 0.90 g (p = 0.008) and cholesterol saturation index fell from 1.13 +/- 0.32 to 1.07 +/- 0.29 (p = 0.04). In subjects with initial cholesterol saturation index over 1.0 (n = 12), it fell from 1.33 +/- 0.25 to 1.22 +/- 0.21 (p = 0.008). There was no significant correlation between change in saturation index and change in % deoxycholic acid or deoxycholic acid pool, nor between any of these parameters and change in transit time. Testa Triticum Tricum reduces the cholesterol saturation index of supersaturated bile but this action appears to be independent of its effect on colonic transit and of changes in deoxycholic acid metabolism.     

复方碳酸氢钠栓治疗功能性便秘的多中心、随机、双盲、安慰剂对照临床试验

背景：功能性便秘是一种常见慢性肠道功能性疾病，目前其治疗药物虽较多，但疗效不尽如人意。目的：观察复方碳酸氢钠栓治疗功能性便秘的临床疗效和安全性。方法：2006年5月-2007年5月由6家医院进行多中心、随机、双盲、安慰剂对照临床试验。1周筛选期后，218例功能性便秘患者随机分为试验组和对照组，每组109例，分别给予复方碳酸氢钠栓和安慰剂纳肛，1粒／d，连续7d。治疗第1d，用药1次后若无排便，可重复用药1次。治疗第2d起每日用药1次。受试者每日记录排便次数、大便性状以及排便费力、排便不尽感、服用缓泻剂天数和药物用量。结果：治疗1周后，与治疗前和对照组相比，试验组周排便次数、周大便性状、周排便不尽感天数均显著改善（P〈0．05），但两组周排便费力天数、周服用缓泻剂天数和周药物用量相比差异均无统计学意义。两组均未出现严重不良事件。结论：复方碳酸氢钠栓治疗功能性便秘有效而安全。     

莫沙必利联合氟哌噻吨美利曲辛治疗便秘型肠易激综合征的临床观察

背景:肠易激综合征(IBS)是一种临床常见的功能性肠病,目前治疗方法虽较多,但疗效不甚理想。目的:观察莫沙必利联合抗焦虑抑郁药氟哌噻吨美利曲辛治疗便秘型IBS(IBS-C)的疗效和安全性。方法:68例IBS-C患者随机分入联合治疗组(35例)和对照组(33例),对照组口服枸橼酸莫沙必利胶囊5 mg tid,联合治疗组在对照组的基础上加用氟哌噻吨美利曲辛片0.5 mg+10 mg qn,疗程4周。治疗前后行IBS-C症状评分和精神心理量表HAMA、HAMD、SCL-90评分,根据治疗后症状总评分改善情况评价临床疗效,观察治疗过程中不良事件发生情况。结果:4周疗程结束后,两组腹痛/不适、排便频率、粪便性状评分和症状总评分以及各精神心理量表评分均较治疗前显著降低(P0.05),联合治疗组降低更为明显,总有效率显著高于对照组(88.6%对75.8%,P0.05)。治疗过程中未发生严重不良事件。结论:莫沙必利联合氟哌噻吨美利曲辛能有效缓解IBS-C患者的临床症状、改善精神心理状态且无明显不良反应,值得在临床上推广应用。     

Efficacy of tegaserod in chronic constipation in men

OBJECTIVES: Chronic constipation/idiopathic constipation is highly prevalent in western countries and traditional treatments are suboptimal. This multicenter study evaluated the efficacy and safety of tegaserod, a selective 5-HT(4) agonist and promotility agent, in men with chronic constipation. METHODS: After screening and baseline phases, men with chronic constipation were randomized to receive either tegaserod 6 mg twice daily or placebo in a double-blind manner for 12 wk. Patients recorded symptoms using a diary. Primary efficacy variable was the response rate for an increase in complete spontaneous bowel movements (CSBMs) during the first 4 wk of double-blind treatment. Other efficacy measures included patient assessment of symptoms and satisfaction with symptom relief. Safety and tolerability were also evaluated. RESULTS: In total, 322 patients were randomized to tegaserod (N = 158) or placebo (N = 164). Increases of at least one CSBM per wk during the first 4 wk of treatment observed for tegaserod compared with placebo (40.5%vs 29.3%, P= 0.03) were sustained throughout the 12-wk treatment period. Response rate for CSBM was also superior for tegaserod (P= 0.04 vs placebo) over the treatment period. Benefits for tegaserod over placebo were also observed for some secondary efficacy variables, however, statistical significance was not achieved at all weeks. Frequency of adverse events was similar with tegaserod and placebo. CONCLUSIONS: Tegaserod 6 mg twice daily was effective and well tolerated in the treatment of chronic constipation in men. Tegaserod provided rapid relief of constipation within 1 wk and the effects were sustained for up to 12 wk.     

Increasing dietary fiber intake in terms of kiwifruit improves constipation in Chinese patients

AIM To investigate if increased dietary fiber, in terms of kiwifruit, is effective in Chinese constipated patients.METHODS 33 constipated patients and 20 healthy volunteers were recruited for a 4-wk treatment of kiwi fruit twice daily. Response during wk 1-4 was defined as an increase in complete spontaneous bowl, motion (CSBM)≥ 1/wk. Secondary efficacy included response during wk 1-4, individual symptoms and scores of bowel habits and constipation. Responses were compared with the baseline run-in period. Colonic transit time and anorectal manometry were performed before and after treatment.RESULTS Responder rate was 54.5% in the constipated group. The mean CSBM increased after treatment (2.2 ± 2.6 vs 4.4 ± 4.6, P = 0.013). There was also improvement in the scores for bothersomeness of constipation (P = 0.02), and satisfaction of bowel habit (P = 0.001), and decreased in days of laxative used (P =0.003). There was also improvement in transit time (P =0.003) and rectal sensation (P ＜ 0.05). However, there was no change in the bowel symptoms or anorectal physiology in the healthy subjects.CONCLUSION Increasing dietary fiber intake is effective in relieving chronic constipation in Chinese population.     

Side effects of oral iron prophylaxis in pregnancy--myth or reality?

BACKGROUND: It is a common belief among women that iron compounds have unpleasant gastrointestinal side effects. OBJECTIVE: To assess the gastrointestinal side effects of iron prophylaxis in pregnancy. METHODS: A randomized, double-blind study comprising 404 healthy pregnant women allocated to four groups taking ferrous iron supplement (as fumarate) in doses of 20 (n = 99), 40 (n = 100), 60 (n = 102) and 80 mg (n = 103) daily from 18 weeks of gestation to delivery. Iron supplement was predominantly taken at bedtime. Gastrointestinal symptoms (nausea, vomiting, epigastric pain, eructation, pyrosis, meteorism, borborygmi, colic pain, flatulence, constipation, thin feces, diarrhea), black feces, and use of laxatives were recorded by interview at 18, 32 and 39 weeks of gestation. RESULTS: The frequencies of gastrointestinal symptoms were not significantly different in the four iron supplement groups either at inclusion or at 32 and 39 weeks of gestation and thus not related to the iron dose. CONCLUSION: This study shows that a supplement of 20-80 mg ferrous iron (as fumarate), taken between meals, has no clinically significant gastrointestinal side effects. The implementation of iron prophylaxis to pregnant women should not be compromised by undue concern of non-existing side effects.     

改善肠道微循环治疗慢传输型便秘42例临床观察

目的观察马来酸桂哌齐特注射液联合复方丹参注射液治疗结肠慢传输型便秘的临床疗效。 方法选取42例结肠慢传输型便秘患者作为研究对象,给予马来酸桂哌齐特注射液8 ml加入0.9%生理盐水500 ml静脉滴注,每天1次,疗程14 d;复方丹参注射液20 ml加入0.9%生理盐水250 ml静脉滴注,每天1次,疗程14 d。观察治疗前后的症状积分、肠内不透X线标记物残留情况及不良反应。 结果用药14 d后Bristol评分较治疗前有显著降低,差异有统计学意义(P<0.05),治疗后患者肠内残留标记物数较治疗前显著减少,差异有统计学意义(P<0.05),治疗总有效率78.25%,无明显不良反应。 结论马来酸桂哌齐特注射液联合复方丹参注射液治疗结肠慢传输型便秘临床疗效显著,可以改善肠道微循环,可能降低肠道血管阻力,增加血流量,促进肠蠕动,增强肠动力传输。     

Lubiprostone for chronic idiopathic constipation and irritable bowel syndrome with constipation

Lubiprostone, a locally acting highly selective type-2 chloride channel activator, has been US FDA approved since January 2006 for the treatment of adults with chronic idiopathic constipation and FDA approved since April 2008 for the treatment of woman aged 18 years or older suffering from irritable bowel syndrome (IBS) with constipation. Through activation of the type-2 chloride channels located on the luminal side of intestinal epithelial cells, it promotes fluid secretion, increasing the liquid content of stool and accelerating small bowel as well as colonic transit. Lubiprostone has demonstrated efficacy with respect to increasing weekly spontaneous bowel movements and improving stool consistency, straining and constipation severity, both in short- and long-term studies. It has also demonstrated efficacy in the treatment of IBS with constipation, with beneficial effects on global symptoms, abdominal pain, constipation-related symptoms and overall quality of life. There is no evidence of a rebound in constipation or IBS symptoms following cessation of lubiprostone. In general, lubiprostone is well tolerated, with the most common side effects including nausea, headache and diarrhea.     

中药验方APD-10治疗包虫病的临床观察

目的探讨中药验方APD-10治疗包虫病的疗效及机理。方法对确诊的120例包虫病患者经口服APD-10煎剂后，对治疗前后的各项临床指标与术后病理检查结果进行对比。结果服药后症状、体征减轻，62例服药90d临床治愈，42例服药120～150d临床治愈，16例有效。治疗后B超、肺部X线片及病理检查均显示囊壁变性皱缩，囊壁纤维层断裂，角质层厚薄不均，生发层细胞浊肿明显，囊腔内有大量坏死物质。结论用APD-10治疗包虫病可获得较为满意的效果。     

Prospective study of biofeedback retraining in patients with chronic idiopathic functional constipation

AIM: To determine the efficacy and long-term outcome of biofeedback treatment for chronic idiopathic constipation and to compare the efficacy of two modes of biofeedback(EMG-based and manometry-based biofeedback).METHODS: Fifty consecutive contactable patients included 8 cases of slow transit constipation, 36 cases of anorectic outlet obstruction and 6 cases of mixed constipation. Two modes of biofeedback were used for these 50 patients, 30 of whom had EMG-based biofeedback, and 20 had manometry-based biofeedback. Before treatment, a consultation and physical examination were done for all the patients, related information such as bowel function and gut transit time was documented, psychological test (symptom checklist 90, SCL90)and anorectic physiological test and defecography were applied. After biofeedback management, all the patients were followed up. The Student‘s t-test, chi-squared test and Logistic regression were used for statistical analysis.RESULTS: The period of following up ranged from 12 to 24 months (Median 18 months). 70 % of patients felt that biofeedback was helpful, and 62.5 % of patients with constipation were improved. Clinical manifestations induding straining, abdominal pain, bloating, were relieved, and less oral laxative was used. Spontaneous bowel frequency and psychological state were improved significantly after treatment. Patients with slow and normal transit, and those with and without paradoxical contraction of the anal sphincter on straining, benefited equally from the treatment. Thepsychological status rather than anorectal test could pre dictoutcome. The efficacy of the two modes of biofeedback was similar without side effects.CONCLUSION: This study suggests that biofeedback has a long-term effect with no side effects, for the majority of patients with chronic idiopathic constipation unresponsive to traditional treatment. Pelvic floor abnormalities and transit time should not be the selection criteria for treatment.