Pistoia M A, Lombardi L, Rossi M, Vittorini C, Cavaliere G F, Pistoia F
Department of Surgery, Chair of Surgical Endoscopy, University of L'Aquila, Italy.
Eur Rev Med Pharmacol Sci. 2004 Nov-Dec;8(6):283-7.
While the treatment of complicated diverticular disease (DD) is standardized, the approach to the symptomatic DD and prevention of relapsing complicated DD is still debated. An open question is whether nonabsorbable antibiotics may reduce the incidence of major complications of DD. We wanted to retrospectively analyze the prevalence of this disease in a large population of patients undergoing colonoscopy in our center in the last 10 years. Patients with symptomatic or complicated DD were treated with rifaximin 1,200 mg/die for 10-12 days during the acute phase in addition to the appropriate systemic antibiotics, followed by a prophylactic regimen with 800 mg/die for 7 days every month. The patients were followed up to December 2003, and the incidence of new complications and the relapses of symptomatology were determined. A total of 11,344 patients were screened. Of them, 2,287 showed an anatomical diverticulosis, and 408 had a diagnosis of complicated DD. The results indicate that the prevalence of DD--either in the uncomplicated or complicated form--in our area (Abruzzo, Italy) is identical to that of European countries, whose diet is characterized by a low amount of fiber and a high content of calories and refined sugars. Along a period of 10 years, a relapsing symptomatology of DD was observed in 112 patients treated with rifaximin (4.89%), while new complications of the DD were observed in 27 patients (1.18%). The comparison of these data with those of larger published series suggests a possible role of rifaximin in the prevention of DD main complications.
虽然复杂性憩室病（DD）的治疗已标准化，但对于症状性DD的治疗方法以及复发性复杂性DD的预防仍存在争议。一个悬而未决的问题是非吸收性抗生素是否可以降低DD主要并发症的发生率。我们想回顾性分析过去10年在我们中心接受结肠镜检查的大量患者中这种疾病的患病率。有症状或复杂性DD的患者在急性期除使用适当的全身抗生素外，还接受利福昔明1200mg/天治疗10 - 12天，随后每月接受800mg/天治疗7天的预防性方案。对患者随访至2003年12月，确定新并发症的发生率和症状复发情况。共筛查了11344例患者。其中，2287例显示有解剖学上的憩室病，408例诊断为复杂性DD。结果表明，我们地区（意大利阿布鲁佐）DD的患病率——无论是非复杂性还是复杂性形式——与欧洲国家相同，这些国家的饮食特点是纤维含量低、热量和精制糖含量高。在10年期间，接受利福昔明治疗的112例患者（4.89%）出现了DD的复发性症状，而27例患者（1.18%）出现了DD的新并发症。将这些数据与已发表的更大系列的数据进行比较表明，利福昔明在预防DD主要并发症方面可能发挥作用。
