乳果糖联合莫沙必利治疗糖尿病便秘的临床研究

目的观察乳果糖联合莫沙必利治疗糖尿病患者便秘的临床效果与安全性。方法86例糖尿病合并便秘患者按随机数字表法随机分为观察组（30例）、莫沙必利组（27例）和乳果糖组（29例）。观察组患者给予乳果糖30ml／次，1次／d，待起效后改为10～20ml／（次·d），以及莫沙必利5mg，3次／d，餐前30min服用；莫沙必利组患者仪给予莫沙必利治疗，乳果糖组患者仅给予乳果糖治疗，给药途径及用药方法同观察组。分别比较3组患者治疗3d及2周时便秘及伴随症状改善情况、不良反应。结果86例患者全部进入结果分析，无失访或退出者。治疗3d、2周后，观察组总有效率达73．3％（22／30）、96．7％（29／30），均明显高于莫沙必利组37．0％（10／27）、63．0％（17／27）]和乳果糖组48．3％（14／29）、79．3％（23／29）]，差异均有统计学意义（均P〈0．05）。观察组不良反应有腹胀加重3例、腹泻1例、腹痛2例；莫沙必利组腹痛4例，腹泻1例；乳果糖组腹胀2例，腹痛2例，无严重不良反应。观察组、莫沙必利组与乳果糖组3组不良反应发生率分别为20．0％（6／30）、18．5％（5／27）、13．8％（4／29），组间比较差异无统计学意义（P〉0．05）。结论乳果糖联合莫沙比利治疗糖尿病患者便秘较单用乳果糖或者莫沙必利疗效好。

Clinical study of lactulose combined with mosapride in treatment of constipation in type 2 diabetes

Objective To evaluate the efficacy of lactulose combined with mosapride in treating patients of type 2 diabetes with constipation. Methods Totally 86 cases of type 2 diabetes with constipation were selected from department of gastroenterology, Anyang district hospital from January 2007 to March 2012. They were ran- domized into three groups ： observation group（ n = 30 ） , mosapride group （ n = 27 ） and lactulose group （ n = 27 ）. The treatment group was treated with lactulose and mosapride and other two groups were treated only with mosa- pride or lactulose, The improvement of constipation and simultaneous phenomenon of three groups after therapy were compared. Results Totally 86 cases of type 2 diabetes with constipation were involved. The total effective rate was 73.3 % （22/30）and 96.7 % （29/30） after three-day therapy and two-week therapy respectively in observation group; it was 37.0% （10/27） and 63.0% （ 17/27 ） in mosapride group; it was 48.3% （14/29） and 79.3% （23/29） in lactulose group. The total effective rate in observation group was significantly higher than that in other two groups （P 〈 0.05 ）. The major adverse reactions were bellyache, abdominal distention and diarrhea. No serious adverse reaction occurred. There were no significant differences among three groups regarding the incidence of adverse reactions t 20.0% （ 6/30）, 18. 5% （ 5/27 ）, 13. 8% （4/29）, respectively, P 〉 0. 05 ]. Conclusion Lactulose combined with mosapride show a higher effectiveness than single medication in treating patients of type 2 diabetes with constipation.