Kumar A, Kumar N, Vij J C, Sarin S K, Anand B S
Gut. 1987 Feb;28(2):150-5. doi: 10.1136/gut.28.2.150.
To determine the optimum dose of ispaghula husk in patients with irritable bowel syndrome (IBS) and to assess the correlation, if any between the relief in patients' symptoms and the whole gut transit time, and the increase in stool weight, a two part study was carried out. In part 1, 14 male patients were given ispaghula husk in increasing doses of 10 g, 20 g, and 30 g a day for a duration of 17 days each (14 days of study period + three days of stool collection). Ten patients completed the trial. The symptom score improved significantly with all the three doses of ispaghula. Both 20 g and 30 g doses of ispaghula were superior to the 10 g dose but there was no significant difference between the 20 g and 30 g doses. There was a significant (p less than 0.001) increase in the daily stool weight with 10 g dose of fibre with further significant increases with the 20 g and 30 g doses. A positive correlation was seen between the improvement in the symptom score and the increase in stool weight with the 10 g dose of ispaghula but not with the 20 g and 30 g doses. Whole gut transit time remained fairly constant throughout the study period and there was no relationship with either the dose of ispaghula, the alteration in stool weight, or the improvement in the patients symptoms. Ten patients completed part 2 of the study in which ispaghula husk was given in the same dose (10 g, 20 g, and 30 g) but in a random order and with a "washout" period of one week between individual doses. Again all the three doses of ispaghula produced a significant improvement in the symptoms; 20 g and 30 g doses were equally effective and both were significantly superior to the 10 g dose. Assessed individually, all the three symptoms improved significantly; improvement in constipation and pain abdomen was more pronounced than diarrhoea. It is concluded that the optimum dose of ispaghula husk in irritable bowel syndrome is 20 g per day. There is some correlation between the increase in stool weight and the improvement in symptom score but the whole gut transit time remains unchanged despite alterations in stool weight and patients' symptoms.
为确定肠易激综合征（IBS）患者中卵叶车前草种子壳的最佳剂量，并评估患者症状缓解与全肠道转运时间及粪便重量增加之间是否存在相关性，开展了一项分为两部分的研究。在第1部分中，14名男性患者每天分别接受递增剂量的10克、20克和30克卵叶车前草种子壳，各持续17天（14天研究期+3天粪便收集期）。10名患者完成了试验。所有三种剂量的卵叶车前草种子壳均使症状评分显著改善。20克和30克剂量的卵叶车前草种子壳均优于10克剂量，但20克和30克剂量之间无显著差异。10克剂量的纤维使每日粪便重量显著增加（p<0.001），20克和30克剂量时粪便重量进一步显著增加。10克剂量的卵叶车前草种子壳使症状评分改善与粪便重量增加之间呈正相关，但20克和30克剂量时未观察到这种相关性。在整个研究期间，全肠道转运时间保持相当稳定，且与卵叶车前草种子壳剂量、粪便重量变化或患者症状改善均无关联。10名患者完成了研究的第2部分，其中给予卵叶车前草种子壳相同剂量（10克、20克和30克），但给药顺序随机，且各剂量之间有一周的“洗脱期”。同样，所有三种剂量的卵叶车前草种子壳均使症状显著改善；20克和30克剂量效果相同，且均显著优于10克剂量。单独评估时，所有三种症状均显著改善；便秘和腹痛的改善比腹泻更明显。结论是，肠易激综合征中卵叶车前草种子壳的最佳剂量为每日20克。粪便重量增加与症状评分改善之间存在一定相关性，但尽管粪便重量和患者症状发生改变，全肠道转运时间仍保持不变。
