Colecchia Antonio, Vestito Amanda, Pasqui Francesca, Mazzella Giuseppe, Roda Enrico, Pistoia Francesca, Brandimarte Giovanni, Festi Davide
Department of Internal Medicine and Gastroenterology, University of Bologna, Cristo Re Hospital, Rome, Italy.
World J Gastroenterol. 2007 Jan 14;13(2):264-9. doi: 10.3748/wjg.v13.i2.264.
To comparatively evaluate the long term efficacy of Rifaximin and dietary fibers in reducing symptoms and/or complication frequency in symptomatic, uncomplicated diverticular disease.
307 patients (118 males, 189 females, age range: 40-80 years) were enrolled in the study and randomly assigned to: Rifaximin (400 mg bid for 7 d every month) plus dietary fiber supplementation (at least 20 gr/d) or dietary fiber supplementation alone. The study duration was 24 mo; both clinical examination and symptoms' questionnaire were performed every two months.
Both treatments reduced symptom frequency, but Rifaximin at a greater extent, when compared to basal values. Symptomatic score declined during both treatments, but a greater reduction was evident in the Rifaximin group (6.4 +/- 2.8 and 6.2 +/- 2.6 at enrollment, P = NS, 1.0 +/- 0.7 and 2.4 +/- 1.7 after 24 mo, P < 0.001, respectively). Probability of symptom reduction was higher and complication frequency lower (Kaplan-Meyer method) in the Rifaximin group (P < 0.0001 and 0.028, respectively).
In patients with symptomatic, uncomplicated diverticular disease, cyclic administration of Rifaximin plus dietary fiber supplementation is more effective in reducing both symptom and complication frequency than simple dietary fiber supplementation. Long term administration of the poorly absorbed antibiotic Rifaximin is safe and well tolerated by the patients, confirming the usefulness of this therapeutic strategy in the overall management of diverticular disease.
比较评价利福昔明和膳食纤维在减轻有症状、无并发症憩室病的症状和/或降低并发症发生率方面的长期疗效。
307例患者（男性118例，女性189例，年龄范围：40 - 80岁）纳入本研究，并随机分为：利福昔明（每月400 mg，每日2次，共7天）加膳食纤维补充剂（至少20克/天）或仅补充膳食纤维。研究持续时间为24个月；每两个月进行一次临床检查和症状问卷调查。
与基线值相比，两种治疗方法均降低了症状发生频率，但利福昔明的效果更显著。两种治疗期间症状评分均下降，但利福昔明组下降更明显（入组时分别为6.4±2.8和6.2±2.6，P =无显著性差异，24个月后分别为1.0±0.7和2.4±1.7，P < 0.001）。利福昔明组症状减轻的概率更高，并发症发生率更低（Kaplan-Meyer法）（分别为P < 0.0001和0.028）。
对于有症状、无并发症的憩室病患者，与单纯补充膳食纤维相比，周期性给予利福昔明加膳食纤维补充剂在减轻症状和降低并发症发生率方面更有效。长期给予吸收不良的抗生素利福昔明是安全的，患者耐受性良好，证实了这种治疗策略在憩室病整体管理中的有效性。
