两种药物联合对慢性功能性便秘患者结肠传输功能的影响及疗效观察

陆永海　陈建丰

[摘要] 目的 探讨双歧杆菌三联活菌胶囊联合乳果糖对慢性功能性便秘（CFC）患者结肠传输功能的影响及疗效。方法 78例CFC患者随机分为研究组和对照组。两组均予以调整饮食结构、多饮水和排便锻炼等基础治疗。研究组加用双歧杆菌三联活菌胶囊联合乳果糖治疗，其中双歧杆菌三联活菌肠溶胶囊420 mg/次，3次/d，温水口服；乳果糖口服液10 mL/次，3次/d，餐前30 min口服，连用6周。对照组予以单用乳果糖治疗，用法用量及疗程同研究组。观察两组治疗前后全结肠通过时间（TCTT）变化，并比较其效果、药物不良反应及随访1年复发率。 结果 治疗6周后，两组TCTT时间较前明显下降（P<0.05或P<0.01），且研究组下降值明显大于对照组（P<0.05）；研究组总有效率明显高于对照组（χ2=5.19，P<0.05）；两组治疗期间出现不良反应6例，其中对照组4例和研究组2例，症状均较轻，两组比较差异无统计学意义（χ2=0.18，P>0.05）；随访1年，研究组复发率明显低于对照组（χ2=5.19，P<0.05）。结论 双歧杆菌三联活菌胶囊联合乳果糖治疗CFC疗效优于单纯乳果糖治疗，安全性较好，可提高其结肠传输功能，缩短TCTT时间，改善其便秘症状，且能明显降低其复发率。

[关键词] 功能性便秘；双歧杆菌三联活菌胶囊；乳果糖；复发

[中图分类号] R574.6 [文献标识码] B [文章编号] 1673-9701（2015）13-0059-03

[Abstract] Objective To discuss influence and curative effect of bifid triple viable capsules combined with lactulose on colonic transit function of patients with chronic functional constipation（CFC）. Methods A total of 78 cases with CFC were divided into research group and control group randomly. The patients in two groups were given basic medical treatment， such as diet structure adjustment， plenty of water， defecation training and etc. The patients in research group were additionally bifid triple viable capsules combined with lactulose oral fluid， with 420 mg bifid triple viable capsules， three times a day with warm boiled water， and 10 mL lactulose oral fluid， three times a day， 30 minutes before dinner for 6 weeks. The patients in control group were only given lactulose oral fluid with the same method， dose and course of treatment were same as in research group. The changes of total colonic transit time （TCTT） in two groups before and after medical treatment were observed， and the clinical curative effect， adverse drug reactions（ADR） and reoccurrence rate of one-year following-up were compared as well. Results After 6 weekstreatment， TCTT in two groups were obviously declined than before（P<0.05 or P<0.01）， and the declining rate in research group was much higher than that in control group （P<0.05）. The total clinical efficiency of patients in research group was much higher than that in control group（χ2=5.19， P<0.05）. 6 cases of ADR were appeared in two groups during the medical treatment， with 4 and 2 cases in control group and research group respectively with light symptom， and after comparing the occurrence rates in two groups， no statistical differences were appeared （χ2=0.18， P>0.05）. According to one-year following-up， the reoccurrence in research group was much lower than that in control group （χ2=5.19， P<0.05）. Conclusion Compare with pure lactulose oral fluid， bifid triple viable capsules combined with lactulose oral fluid have better curative effect and with favorable security on CFC， which can obviously improve the colonic transit function， shorten TCTT， improve constipation symptom and reduce the reoccurrence rate.

[Key words] Chronic functional constipation（CFC）； Bifid triple viable capsules； Lactulose； Reoccurrence

慢性功能性便秘（chronic functional constipation，CFC）是肛肠科较多见的下消化道功能紊乱性疾病，其发病率约4%～16%，其便秘症状持续存在或反复发作，对患者的日常工作生活影响较明显，且易诱发心脑血管意外等严重的并发症[1，2]。CFC的发病机制较复杂，大多数学者认为其主要是由于各种原因引起的结肠传输减慢引起，以排便频率减少、大便干结、大便费力等为主要临床表现[3，4]。目前临床上尚无统一治疗CFC的方案，传统的泻药以往较常用，虽然其临床起效较迅速，短期效果较显著，但长期使用可导致结肠变黑并损害肠壁神经及发生药物依赖，引起治疗效果下降，加重其病情[5-8]。本研究观察了双歧杆菌三联活菌胶囊联合乳果糖对CFC患者结肠传输功能的影响，并分析其临床效果，现报道如下。……