Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Digestion. 2013;88(2):110-8. doi: 10.1159/000353244. Epub 2013 Aug 15.
BACKGROUND/AIMS: Split-dose polyethylene glycol (PEG) is a standard bowel preparation regimen for colonoscopy, but the large volume is burdensome to ingest and the night dose causes sleep disturbance. This study was performed to evaluate the efficacy and tolerability of a bowel preparation protocol using low-volume morning-only PEG with specially designed low-residue test meals (LV-PEG with TM) compared to a standard-volume split-dose PEG bowel preparation with a standard diet (SV-PEG with SD).
This was a single-center, prospective, randomized, investigator-blinded, noninferiority study. The primary end point was bowel preparation quality according to the Ottawa scale. Tolerability, compliance, adverse events, sleep quality and polyp/adenoma detection were also assessed.
Among 197 patients analyzed (mean age 54.6 years, 51.3% men), 97 received LV-PEG with TM and 100 received SV-PEG with SD. The Ottawa score for the total colon was 3.76 ± 2.07 in the LV-PEG with TM group and 3.67 ± 1.57 in the SV-PEG with SD group (p = 0.723; difference 0.09, 95% confidence interval -0.60 to 0.42). The compliance was high (more than 95%) in both groups (p = 0.621). PEG was easier to ingest for patients in the LV-PEG with TM group compared to the SV-PEG with SD group [visual analogue scale (VAS) for difficulty: 4.64 ± 2.46 vs. 5.97 ± 2.42, respectively; p < 0.001]. Diet instructions were also easier to comply with for patients in the LV-PEG with TM group compared to the SV-PEG with SD group (VAS for difficulty: 3.11 ± 2.25 vs. 4.00 ± 2.39, respectively; p = 0.008). Patients in the LV-PEG with TM group had a lower incidence of abdominal bloating (p = 0.012) and better sleep quality (p < 0.001). There was no difference between the groups regarding polyp and adenoma detection.
LV-PEG with TM and SV-PEG with SD have similar efficacy with regard to bowel preparation for colonoscopy. LV-PEG with TM provided easier PEG intake and diet compliance, less abdominal bloating and better sleep quality than SV-PEG with SD.
背景/目的：聚乙二醇（PEG）分剂量是结肠镜检查的标准肠道准备方案，但大量摄入很麻烦，且夜间剂量会导致睡眠障碍。本研究旨在评估与标准剂量 PEG 分剂量（SV-PEG 与 SD）相比，使用低容量晨服 PEG 联合特殊设计低残留试验餐（LV-PEG 与 TM）的肠道准备方案的疗效和耐受性。
这是一项单中心、前瞻性、随机、研究者设盲、非劣效性研究。主要终点是根据渥太华评分评估肠道准备质量。还评估了耐受性、依从性、不良事件、睡眠质量和息肉/腺瘤检出率。
在 197 例分析患者中（平均年龄 54.6 岁，51.3%为男性），97 例接受 LV-PEG 与 TM，100 例接受 SV-PEG 与 SD。LV-PEG 与 TM 组全结肠的渥太华评分（Ottawa score）为 3.76 ± 2.07，SV-PEG 与 SD 组为 3.67 ± 1.57（p = 0.723；差值 0.09，95%置信区间 -0.60 至 0.42）。两组的依从性均很高（均超过 95%）（p = 0.621）。与 SV-PEG 与 SD 组相比，LV-PEG 与 TM 组的患者更容易摄入 PEG[视觉模拟量表（VAS）评估难度：4.64 ± 2.46 对 5.97 ± 2.42，分别；p < 0.001]。与 SV-PEG 与 SD 组相比，LV-PEG 与 TM 组的患者更容易遵守饮食说明[VAS 评估难度：3.11 ± 2.25 对 4.00 ± 2.39，分别；p = 0.008]。LV-PEG 与 TM 组患者腹胀的发生率较低（p = 0.012），睡眠质量更好（p < 0.001）。两组在息肉和腺瘤检出率方面无差异。
LV-PEG 与 TM 和 SV-PEG 与 SD 在结肠镜检查的肠道准备方面具有相似的疗效。与 SV-PEG 与 SD 相比，LV-PEG 与 TM 具有更易摄入 PEG 和饮食依从性、腹胀发生率更低、睡眠质量更好的优点。
