一项关于低剂量抗生素对接受高纤维饮食的慢性便秘患者治疗效果的对照性初步研究。
A controlled pilot study on the efficacy of a low dose antibiotic for the treatment of chronic constipation in patients receiving a high fiber diet.
作者信息
Bustos Fernández Luis Maria, Prizont Robert, Soifer Luis Oscar
机构信息
Instituto de Gastroenterología Dr Bustos Fernández Ciudad Autónoma de Buenos Aires, Argentina.
Gastrointestinal Drugs and Pharmaceuticals, Miami Beach, Florida, USA.
出版信息
Acta Gastroenterol Latinoam. 2013 Dec;43(4):275-8.
BACKGROUND AND AIMS
In a previous uncontrolled experiment, oral vancomycin improved the symptoms (S) of chronic constipation (CC). The aim of this 21 day controlled pilot study was to determine if a low lincomycin dose improved the S of CC patients unresponsive to a high fiber diet.
METHODS
On days 0-to-10, patients were randomized to 500 mg oral lincomycin + high fiber (L + F) or to placebo + high fiber (P + F). Participants and patients were blinded. From days 10-to-21, patients were continued solely on the high fiber diet. The primary efficacy endpoint was the difference in S between L + F and P + F from days 0-to-21 using a visual analog scale (VAS) calibrated from 0 = severe S to 10 = asymptomatic.
RESULTS
The means of all S were significantly improved by L + F but not by P + F. A significant higher proportion of L + F patients increased the VAS > or = 3 points.
CONCLUSIONS
The initial course of L facilitated the effect of F probably by its effect on the colon flora. This sequence of flora-altering biologics + F may serve as model to replace chronic use of drugs.
背景与目的
在之前的一项非对照实验中，口服万古霉素改善了慢性便秘（CC）的症状（S）。这项为期21天的对照试验性研究的目的是确定低剂量林可霉素是否能改善对高纤维饮食无反应的CC患者的症状。
方法
在第0至10天，患者被随机分为口服500毫克林可霉素+高纤维组（L+F）或安慰剂+高纤维组（P+F）。参与者和患者均为盲法。从第10至21天，患者仅继续采用高纤维饮食。主要疗效终点是使用视觉模拟量表（VAS）（0=严重症状至10=无症状）评估第0至21天L+F组与P+F组之间症状的差异。
结果
L+F组所有症状的平均值显著改善，而P+F组未改善。L+F组中VAS增加≥3分的患者比例显著更高。
结论
L的初始疗程可能通过其对结肠菌群的作用促进了F的效果。这种改变菌群的生物制剂+F的顺序可作为替代长期用药的模式。
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