培菲康联合拉克替醇对功能性便秘的疗效

目的探讨益生菌联合拉克替醇对不同类型功能性便秘患者的治疗效果。方法选取我院功能性便秘不伴结肠黑变病患者112例,随机分为拉克替醇A组(56例)和培菲康联合拉克替醇A组(联合A组)(56例)。选取我院功能性便秘伴结肠黑变病患者46例,随机分为拉克替醇B组(23例)和培菲康联合拉克替醇B组(联合B组)(23例)。4组患者均接受排便习惯训练、调整饮食和适当锻炼等基础治疗。拉克替醇A组和拉克替醇B组患者在此基础上给予拉克替醇治疗,起始剂量为20g/d,早餐时一次服用;第2天起改为10g/d,早餐时一次服用。联合A组和联合B组患者在拉克替醇组治疗方案的基础上联合培菲康治疗,2粒/次,3次/d,饭后半小时温水服用。4组患者均持续治疗14d,观察4组患者治疗后的效果、停药1个月和2个月后的复发率和治疗过程中出现的不良反应。结果 4组患者治疗后的临床效果存在显著差异(χ2=20.17,P0.01)。联合A组患者的总有效率高于其他3组。拉克替醇B组的总有效率低于其他3组。4组患者治疗后大便形态评分和Wexner评分均明显改善(P0.05),且联合A组患者治疗后的大便形态评分和Wexner评分显著低于其他3组。拉克替醇B组患者治疗后大便形态评分和Wexner评分显著高于其他3组(P0.05)。各组患者不良反应发生率差异无统计学意义(χ2=0.295,P=0.961)。4组患者停药1个月后的复发率差异无统计学意义(χ2=3.05,P=0.384);停药2个月后其复发率差异有统计学意义(χ2=9.506,P=0.023)。其中拉克替醇B组复发6例,占总有效例数的50.0%,复发率最高。联合A组复发7例,复发率13.2%,复发率最低。结论益生菌可提高拉克替醇对功能性便秘的疗效、降低患者复发率且不影响拉克替醇的安全性。同时,以上作用对于伴有结肠黑变病的功能性便秘患者同样有效。

Clinical efficacy of oral Bifico combined with Lactitol in treatment of functional constipation

Abstract: Objective To explore the effect of the probiotic combined with Lactitol in the treatment of different types of functional constipation. Methods 112 patients with functional constipation without melanosis coli were randomly divided into two groups: 56 patients in Lactitol group A while 56 patients in Combination group A. Forty-six patients with functional constipation with melanosis coli were randomly divided into two groups: 23 patients in the Lactitol group B and 23 patients in the Combination group B. All the four groups received the same basic treatments. The Lactitol groups A and B were treated with Lactitol at a starting dose of 20 g in the first day and then 10 g during the following days qd at breakfast. The Combination groups A and B were treated with Bifico on the basis of the treatment given to Lactitol groups, 2 capsules tid half an hour after meals. All the patients were treated for 14 days. The efficacy of treatment, recurrence rate after one month and two months of withdrawal, and the adverse reactions during the treatment were observed. Results The clinical effects were significantly different among the four groups (P<0.01). The total efficiency rate in the Combination group A was the highest, while that in the Lactitol group B was the lowest. The stool morphology score and Wexner score were significantly improved in the four groups after treatment (P<0.05); the scores in Combination group A were significantly lower than in the other three groups, while those in Lactitol group B were significantly higher than in the other three groups (P<0.05). There was no significant difference in the incidence of adverse reactions among the four groups (P>0.05). There was no significant difference in the recurrence rate among the four groups one month after withdrawl (P>0.05) but 2 months after the treatment (P<0.05). There were 6 cases (50.0%) of recurrence in lactitol group B, representing a highest recurrence rate. There were 7 cases (13.2%) of recurrence in Combination A, significantly lower than in the other groups. Conclusion Probiotic intervention can improve the efficacy of lactitol in the treatment of functional constipation and reduce the recurrence rate without compromising the safety of Lactitol, which is equally effective for patients with functional constipation with melanosis coli.