Hardikar Winita, Cranswick Noel, Heine Ralf G
Department of Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Parkville, Victoria, Australia.
J Paediatr Child Health. 2007 Jul-Aug;43(7-8):527-31. doi: 10.1111/j.1440-1754.2007.01116.x.
A Macrogol 3350-based, iso-osmotic laxative has become available for the treatment of chronic constipation in adults. This open-label, non-randomised study aimed to evaluate the safety and efficacy of this preparation in the treatment of chronic constipation in children.
Seventy-eight children, aged 2-11 years, with chronic constipation for greater than 3 months were enrolled. All children received Macrogol 3350 plus electrolytes for 12 weeks. The primary efficacy variable was the number of spontaneous defaecations per week. Secondary efficacy variables were faecal form, abdominal pain, rectal bleeding, pain on defaecation, straining, soiling, amount of stool, stool withholding and assessments of efficacy by the investigators and parents. Safety and compliance were also assessed.
The mean number of spontaneous defaecations per week increased from 1.4 +/- 0.55 (SD) at baseline to 6.8 +/- 3.45 after 14 days, and 7.1 +/- 3.45 at 12 weeks (P < 0.001). Similar improvements were found in the secondary efficacy variables. There was a significant reduction in reported abdominal pain from 53 (69%) children at baseline to 3 (4%) at the final visit (P < 0.0001). Similarly, 61 (79%) children had pain on defaecation at baseline, compared with 7 (9%) at the final visit (P < 0.0001). Treatment was well tolerated. Of 318 adverse events, 262 (82%) were considered mild, and 241 (76%) were deemed unrelated to treatment. Only 3 (4%) children were withdrawn because of poor compliance.
Macrogol 3350 plus electrolytes is a safe and effective treatment for constipation in children aged 2-11 years.
一种基于聚乙二醇3350的等渗泻药已可用于治疗成人慢性便秘。这项开放标签、非随机研究旨在评估该制剂治疗儿童慢性便秘的安全性和有效性。
纳入78名2至11岁、慢性便秘超过3个月的儿童。所有儿童接受聚乙二醇3350加电解质治疗12周。主要疗效变量是每周自主排便次数。次要疗效变量包括粪便形态、腹痛、直肠出血、排便疼痛、用力排便、大便失禁、粪便量、憋便以及研究者和家长对疗效的评估。同时评估安全性和依从性。
每周自主排便的平均次数从基线时的1.4±0.55(标准差)增加到14天后的6.8±3.45,12周时为7.1±3.45(P<0.001)。次要疗效变量也有类似改善。报告的腹痛从基线时的53名(69%)儿童显著减少至末次访视时的3名(4%)(P<0.0001)。同样,基线时有61名(79%)儿童排便时疼痛,而末次访视时为7名(9%)(P<0.0001)。治疗耐受性良好。在318例不良事件中,262例(82%)被认为是轻度的,241例(76%)被认为与治疗无关。只有3名(4%)儿童因依从性差而退出。
聚乙二醇3350加电解质是治疗2至11岁儿童便秘的安全有效方法。