Sugimura F, Ryoh H, Watanabe T, Kaneda N, Yonemitsu K, Aoki T, Motoki Y, Kawamura F, Ariga H, Matsuo Y
Third Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
Gastroenterol Jpn. 1990 Aug;25(4):437-50. doi: 10.1007/BF02779332.
Fifty of 100 persons who had undergone health screening received phosphate enema while the other 50 received glycerin enema prior to proctoscopy and barium enema, and their usefulness for preparation for colon examination was compared by a double-blind test. There was no significant difference in the degree of colonic cleansing achieved by proctoscopy and barium enema. In the subjects who received phosphate enema, the incidence of abdominal pain was less than that in those who received glycerin enema, while the effect of phosphate enema on defecation appeared later than that of glycerin enema, indicating prolonged stool retention in the subjects given phosphate enema. To study the safety of the two enemas, either phosphate enema, glycerin enema or physiological saline solution as a control was administered at 0.35 ml/animal in the rectum by 4-h closure of the anus in 10 male 7-week-old Wistar rats, and the rectal mucosa was observed for irritation macroscopically and histopathologically. Glycerin enema produced less irritation than phosphate enema diffusely in the entire area of the rectum, while phosphate enema produced more local irritation at the end of the rectum than glycerin enema. The differences in the extent of irritation and injury between phosphate and glycerin enemas were considered to be derived from differences in the pharmacologic actions of these drugs. If the extent of injury were included in the extent of irritation, the difference in irritation between phosphate and glycerin enemas would not be significant. As described above, no specific difference seem to exist in the usefulness of phosphate and glycerin enemas as preparation for colon examination.
100名接受健康筛查的人中有50人在直肠镜检查和钡灌肠前接受了磷酸盐灌肠,另外50人接受了甘油灌肠,通过双盲试验比较了它们在结肠检查准备中的效用。直肠镜检查和钡灌肠所达到的结肠清洁程度没有显著差异。接受磷酸盐灌肠的受试者腹痛发生率低于接受甘油灌肠的受试者,而磷酸盐灌肠对排便的作用比甘油灌肠出现得晚,这表明接受磷酸盐灌肠的受试者粪便潴留时间延长。为了研究两种灌肠剂的安全性,在10只7周龄雄性Wistar大鼠中,通过肛门封闭4小时,以0.35ml/动物的剂量将磷酸盐灌肠剂、甘油灌肠剂或生理盐水作为对照剂注入直肠,然后宏观和组织病理学观察直肠黏膜的刺激情况。甘油灌肠剂在直肠整个区域产生的刺激比磷酸盐灌肠剂少,而磷酸盐灌肠剂在直肠末端产生的局部刺激比甘油灌肠剂多。磷酸盐灌肠剂和甘油灌肠剂在刺激和损伤程度上的差异被认为源于这些药物药理作用的不同。如果将损伤程度纳入刺激程度,磷酸盐灌肠剂和甘油灌肠剂之间的刺激差异将不显著。如上所述,磷酸盐灌肠剂和甘油灌肠剂在结肠检查准备中的效用似乎没有具体差异。