Siegel Jonathan D, Di Palma Jack A
Division of Gastroenterology, University of South Alabama College of Medicine, Mobile, AL 36693, USA.
Clin Colon Rectal Surg. 2005 May;18(2):76-80. doi: 10.1055/s-2005-870887.
Various agents are used for the medical management of chronic constipation, but few of these have been adequately studied. This article specifically examines the medical treatment of chronic constipation and the available data concerning bulk agents, lubricating agents, stimulants, and osmotic laxatives, used alone and in combination. Most experts consider dietary fiber or medicinal bulk agents to be the initial therapeutic option for the treatment of chronic constipation. If fiber is not successful or poorly tolerated, subsequent treatments may include saline osmotic laxatives, lactulose, 5-hydroxytryptamine4 (5-HT(4)) agonists (tegaserod), or stimulants such as senna or bisacodyl. Recent data also demonstrate both polyethylene glycol laxative and tegaserod to be safe and effective as initial therapy for chronic constipation.
多种药物被用于慢性便秘的医学治疗，但其中很少有经过充分研究的。本文专门探讨慢性便秘的医学治疗以及关于容积性泻药、润滑性泻药、刺激性泻药和渗透性泻药单独使用及联合使用的现有数据。大多数专家认为膳食纤维或药用容积性泻药是治疗慢性便秘的初始治疗选择。如果膳食纤维治疗无效或耐受性差，后续治疗可能包括盐类渗透性泻药、乳果糖、5-羟色胺4（5-HT(4)）激动剂（替加色罗）或刺激性泻药如番泻叶或比沙可啶。近期数据还表明聚乙二醇泻药和替加色罗作为慢性便秘的初始治疗是安全有效的。
