乳果糖预防口服吗啡所致便秘的临床观察

[Clinical observation of prophylactic lactulose for prevention of oral morphine-induced constipation].

作者信息

Wang Zhan, Qian Jian-Xin, Jiao Xiao-Dong, Yuan Ling-Yan, Xiao Ming, Gu Xiao-Qiang, Lou Cheng, Wang Miao-Miao, Lan Hai-Feng

机构信息

Department of Medical Oncology, Shanghai Changzheng Hospital, Shanghai, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2012 Nov 13;92(42):2968-71. doi: 10.3760/cma.j.issn.0376-2491.2012.42.005.

DOI:10.3760/cma.j.issn.0376-2491.2012.42.005

PMID:23328286

Abstract

OBJECTIVE

To evaluate the effects of different doses of lactulose on preventing oral morphine-induced constipation.

METHODS

From January 2011 to May 2012, a total of 112 patients received oral lactulose solution to prevent morphine-induced constipation at our hospital and their clinical data were retrospectively analyzed. The doses of morphine were adjusted according to the pain scores and lactulose was taken simultaneously. There were 52 males and 60 females. They were randomized into Group 30 ml/d (n = 40), Group 60 ml/d (n = 43) and Group 90 ml/d (n = 29). The incidences of constipation and adverse reactions were obtained at 1 week after the start of medicine. The measurement data were analyzed with analysis of variance. And the enumeration data were analyzed with χ(2), Kruskal-Wallis and Mann-Whitney U tests.

RESULTS

The incidence of constipation was 67.5% (27/40) in Group 30 ml/d, 46.5% (20/43) in Group 60 ml/d, and 37.9% (11/29) in Group 90 ml/d. And there were statistical differences (P = 0.036). The incidence of constipation in Group 30 ml was significantly higher than Group 90 ml/d (P = 0.015). No statistical difference existed in the incidence of constipation between Groups 30 ml/d and 60 ml/d (P = 0.054) or Groups 60 ml/d and 90 ml/d (P = 0.471). The incidence of vomiting was 34.5% (10/29) in Group 90 ml/d and it was significantly higher than 10.0% (4/40) in Group 30 ml/d (P = 0.013) and 9.3% (4/43) in Group 60 ml/d (P = 0.009). No statistical difference existed in the incidence of vomiting between Groups 30 ml/d and 60 ml/d (P = 0.915). The incidence of diarrhea was 17.2% (5/29) in Group 90 ml/d and it was significantly higher than 0 (0/40) in Group 30 ml/d (P = 0.007). No statistical difference existed in the incidence of diarrhea between Groups 30 ml/d and 60 ml/d (4.7% (2/43), P = 0.170) or Groups 60 ml/d and 90 ml/d (P = 0.072).

CONCLUSION

The correct dosage of lactulose for the prevention of oral morphine-induced constipation is 60 ml/d.

摘要

目的

评估不同剂量乳果糖预防口服吗啡所致便秘的效果。

方法

回顾性分析2011年1月至2012年5月在我院接受口服乳果糖溶液预防吗啡所致便秘的112例患者的临床资料。根据疼痛评分调整吗啡剂量，同时服用乳果糖。其中男性52例，女性60例。随机分为30 ml/d组（n = 40）、60 ml/d组（n = 43）和90 ml/d组（n = 29）。于用药1周后统计便秘及不良反应发生率。计量资料采用方差分析，计数资料采用χ(2)检验、Kruskal-Wallis检验和Mann-Whitney U检验。

结果

30 ml/d组便秘发生率为67.5%（27/40），60 ml/d组为46.5%（20/43），90 ml/d组为37.9%（11/29），差异有统计学意义（P = 0.036）。30 ml组便秘发生率显著高于90 ml/d组（P = 0.015）。30 ml/d组与60 ml/d组便秘发生率差异无统计学意义（P = 0.054），60 ml/d组与90 ml/d组便秘发生率差异无统计学意义（P = 0.471）。90 ml/d组呕吐发生率为34.5%（10/29），显著高于30 ml/d组的10.0%（4/40）（P = 0.013）和60 ml/d组的9.3%（4/43）（P = 0.009）。30 ml/d组与60 ml/d组呕吐发生率差异无统计学意义（P = 0.915）。90 ml/d组腹泻发生率为17.2%（5/29），显著高于30 ml/d组的0（0/40）（P = 0.007）。30 ml/d组与60 ml/d组腹泻发生率差异无统计学意义（4.7%（2/43），P = 0.170），60 ml/d组与90 ml/d组腹泻发生率差异无统计学意义（P = 0.072）。