Translational Research Center for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium.
Best Pract Res Clin Gastroenterol. 2011 Feb;25(1):151-8. doi: 10.1016/j.bpg.2011.01.005.
In this article, traditional and novel therapies for chronic constipation are reviewed. Traditional laxatives are effective at inducing bowel movements, but efficacy in long-term management and efficacy on constipation-associated abdominal symptoms are less well established, with the exception of polyethylene glycol, for which long-term studies confirm sustained efficacy. Recently approved drugs include the colonic secretagogue lubiprostone and the 5-HT4 agonist prucalopride. In controlled trials in chronic constipation, these drugs were shown to significantly improve constipation and its associated symptoms, with a favourable safety record. Methylnaltrexone, a subcutaneously administered peripherally acting mu opioid receptor antagonist, has recently been approved for opioid-induced constipation in terminally ill patients. New agents under evaluation include the 5-HT4 agonists velusetrag and naronapride, the guanylate cyclase-C receptor agonist linaclotide and the peripherally acting mu opioid receptor antagonist alvimopan.
本文综述了慢性便秘的传统和新型治疗方法。传统的泻药可有效促进排便，但在长期管理和缓解便秘相关腹部症状方面的疗效尚不确定，除了聚乙二醇，其长期研究证实了持续疗效。最近批准的药物包括结肠分泌性药物鲁比前列酮和 5-HT4 激动剂普芦卡必利。在慢性便秘的对照试验中，这些药物显著改善了便秘及其相关症状，且安全性良好。皮下给予的外周作用型μ阿片受体拮抗剂美沙酮最近被批准用于治疗终末期患者的阿片类药物引起的便秘。正在评估的新药包括 5-HT4 激动剂维鲁司他和那洛普肽、鸟苷酸环化酶-C 受体激动剂利那洛肽和外周作用型μ阿片受体拮抗剂阿立哌唑。
