Jouët P, Sabate J-M, Flourie B, Cuillerier E, Gambini D, Lemann M, Jian R, Coffin B
AP-HP, Hôpital Louis Mourier, Department of Hepato-Gastroenterology, Colombes CEDEX, France.
Aliment Pharmacol Ther. 2008 May;27(10):988-93. doi: 10.1111/j.1365-2036.2008.03654.x. Epub 2008 Feb 18.
Lactulose and polyethylene glycol are osmotic agents used to treat idiopathic chronic constipation.
To compare the effects of low doses of lactulose and PEG 4000 on transit time measured by scintigraphy in normal subjects.
For 5 days, 10 healthy subjects received either 10 g b.d. of lactulose or PEG 4000 in a randomized, double-blind, crossover study. On the evening of day 4, they took a capsule containing Amberlite resin pellets labelled with (111)In. On day 5, after a 1000 kcal test meal labelled with 99 Tcm, gastric, small bowel and colonic transits were measured.
Gastric emptying and small bowel transit time were not different. Ascending colon emptying curve was significantly accelerated with lactulose in comparison with polyethylene glycol (P = 0.001) and, respectively, 50 +/- 18% vs. 35 +/- 18% of the radioactivity had left the ascending colon at the end of the study (P < 0.05). The descending colon filling curves, variations in the geometric centre and numbers of scintigraphic movements were not different.
In healthy subjects, in comparison to PEG 4000, usual therapeutic doses of lactulose significantly accelerate ascending colon emptying. This result supports a stimulating motor effect of colonic fermentation of lactulose.
乳果糖和聚乙二醇是用于治疗特发性慢性便秘的渗透性药物。
比较低剂量乳果糖和聚乙二醇4000对正常受试者通过闪烁扫描法测量的转运时间的影响。
在一项随机、双盲、交叉研究中，10名健康受试者连续5天每日两次接受10 g乳果糖或聚乙二醇4000。在第4天晚上，他们服用一粒含有用铟 - 111标记的Amberlite树脂颗粒的胶囊。在第5天，进食一顿用锝 - 99m标记的1000千卡试验餐之后，测量胃、小肠和结肠的转运情况。
胃排空和小肠转运时间没有差异。与聚乙二醇相比，乳果糖使升结肠排空曲线显著加快（P = 0.001），在研究结束时，分别有50±18%和35±18%的放射性物质离开升结肠（P < 0.05）。降结肠充盈曲线、几何中心的变化以及闪烁扫描运动的次数没有差异。
在健康受试者中，与聚乙二醇4000相比，常规治疗剂量的乳果糖能显著加快升结肠排空。这一结果支持了乳果糖结肠发酵的刺激运动效应。
