Department of Anesthesiology, Intensive Care Medicine, Pain Therapy, Palliative Medicine, CURA-Hospital, Schuelgenstrasse 15, Bad Honnef, Germany.
Eur J Cancer Care (Engl). 2012 Jan;21(1):131-40. doi: 10.1111/j.1365-2354.2011.01286.x. Epub 2011 Aug 31.
Constipation and the laxatives polyethylene glycol (PEG), sodium picosulphate (SPS) and lactulose (L) were investigated in outpatients with cancer and on opioid therapy. Randomly selected patients were enrolled in a prospective, controlled, open-label trial. Endpoints were number of patients taking laxatives >28 days, number of patients with a stool-free interval >72 h (sfi72), dosage, numerical rating scale (NRS) for constipation, and European Organization for Research and Treatment of Cancer (EORTC) Quality of Life (QoL) questionnaire scores. The 348 patients had comparable demographic and medical data. In this ambulatory population, mobility scores remained unaffected. Constipation incidence was 5.7%, with sfi72 42, mean NRS 2.3557 and mean QoL 2.1. A total of 53.2% discontinued their laxative medication. Laxative use correlated with higher opioid usage (morphine-equivalent mg/day: no laxative 98.2, SPS 128.2, PEG 139.9, L 154.5). PEG was the most frequently prescribed laxative (PEG 27.3%, SPS 10.3%, L 9.2%). PEG (sfi72 12.6%, NRS 2.2, QoL 2.1) and SPS (sfi72 11.1%, NRS 2.7, QoL 2.2) proved more effective than L (sfi72 15.5%, NRS 3.8, QoL 2.5). In spite of opioid therapy, the incidence of constipation was low in these ambulatory cancer pain patients at an early disease stage. For prevention of constipation, PEG or SPS is recommended instead of L.
便秘以及聚乙二醇（PEG）、匹可硫酸钠（SPS）和乳果糖（L）等缓泻剂在接受阿片类药物治疗的癌症门诊患者中得到了研究。随机选择的患者被纳入一项前瞻性、对照、开放标签试验。主要终点为接受缓泻剂治疗>28 天的患者比例、粪便嵌塞间隔>72 小时（sfi72）的患者比例、剂量、便秘数字评分量表（NRS）和欧洲癌症研究与治疗组织（EORTC）生活质量（QoL）问卷评分。共 348 例患者具有相似的人口统计学和医疗数据。在该门诊人群中，活动能力评分无显著变化。便秘发生率为 5.7%，sfi72 为 42，平均 NRS 为 2.3557，平均 QoL 为 2.1。共有 53.2%的患者停止使用缓泻剂。缓泻剂的使用与更高的阿片类药物使用相关（吗啡等效毫克/天：无缓泻剂 98.2、SPS 128.2、PEG 139.9、L 154.5）。PEG 是最常开的缓泻剂（PEG 27.3%、SPS 10.3%、L 9.2%）。PEG（sfi72 12.6%、NRS 2.2、QoL 2.1）和 SPS（sfi72 11.1%、NRS 2.7、QoL 2.2）比 L（sfi72 15.5%、NRS 3.8、QoL 2.5）更有效。尽管接受阿片类药物治疗，在这些处于早期疾病阶段的门诊癌症疼痛患者中，便秘的发生率仍然较低。对于便秘的预防，建议使用 PEG 或 SPS 而非 L。
