Leeds Gastroenterology Institute, Leeds General Infirmary, Great George Street, Leeds, UK.
Aliment Pharmacol Ther. 2011 Apr;33(8):895-901. doi: 10.1111/j.1365-2036.2011.04602.x. Epub 2011 Feb 20.
Patients with chronic idiopathic constipation are often told to increase dietary fibre intake. Whether this is of any benefit remains unclear.
To conduct a systematic review of the efficacy of soluble and insoluble fibre supplementation in the management of chronic idiopathic constipation.
MEDLINE, EMBASE, and the Cochrane central register of controlled trials were searched to identify randomised controlled trials (RCTs) comparing fibre with placebo or no therapy in adult chronic idiopathic constipation patients. Studies had to report dichotomous data assessing response to therapy, or continuous data examining either effect of therapy on mean number of stools per week, or mean symptom scores. Adverse events data were extracted where reported.
Six RCTs were eligible. Four used soluble fibre and two used insoluble fibre. Formal meta-analysis was not undertaken due to concern about methodological quality of identified studies. Compared with placebo, soluble fibre led to improvements in global symptoms (86.5% vs. 47.4%), straining (55.6% vs. 28.6%), pain on defaecation, and stool consistency, an increase in the mean number of stools per week (3.8 stools per week after therapy compared with 2.9 stools per week at baseline), and a reduction in the number of days between stools. Evidence for any benefit of insoluble fibre was conflicting. Adverse events data were limited, with no RCT reporting total numbers.
Soluble fibre may be of benefit in chronic idiopathic constipation, but data for insoluble fibre are conflicting. More data from high quality RCTs are required before the true efficacy of either fibre type in the treatment of chronic idiopathic constipation is known.
患有慢性特发性便秘的患者常被告知增加膳食纤维摄入量。但这种方法是否有益尚不清楚。
系统评价可溶性和不溶性膳食纤维补充剂在慢性特发性便秘治疗中的疗效。
检索 MEDLINE、EMBASE 和 Cochrane 对照试验中心注册库，以确定比较纤维与安慰剂或无治疗在成人慢性特发性便秘患者中的随机对照试验（RCT）。研究必须报告评估治疗反应的二分类数据，或连续数据，以评估治疗对每周平均排便次数或平均症状评分的影响。在有报告的情况下提取不良事件数据。
有 6 项 RCT 符合条件。4 项使用可溶性纤维，2 项使用不溶性纤维。由于对确定研究的方法学质量的担忧，未进行正式的荟萃分析。与安慰剂相比，可溶性纤维可改善整体症状（86.5% vs. 47.4%）、用力排便（55.6% vs. 28.6%）、排便时疼痛和粪便稠度，每周平均排便次数增加（治疗后每周 3.8 次排便，而基线时每周 2.9 次排便），以及排便间隔天数减少。不溶性纤维获益的证据相互矛盾。不良事件数据有限，没有 RCT 报告总数量。
可溶性纤维可能对慢性特发性便秘有益，但不溶性纤维的数据相互矛盾。在确定任何纤维类型在慢性特发性便秘治疗中的真正疗效之前，需要更多来自高质量 RCT 的数据。
