Gastroenterology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy.
Digestive Endoscopy Unit, ULSS7 Alto Vicentino, Santorso, Italy.
J Investig Med. 2019 Apr;67(4):767-770. doi: 10.1136/jim-2018-000901. Epub 2018 Dec 27.
Although rifaximin is currently advised in managing symptomatic uncomplicated diverticular disease (SUDD) of the colon, no long-term data are available. This retrospective study assessed the outcome of a large cohort of patients with SUDD, treated with rifaximin, during an 8-year follow-up. The study group (group A) included 346 patients with SUDD (median age 64 years, IQR 58-69, 62.4% females), treated with rifaximin 800 mg/d for 7 days every month. The control group (group B) included 470 patients with SUDD (median age 65 years, IQR 59-74 years, 60.8% females), taking any other treatment on demand. Two symptoms (left lower abdominal pain and bloating) were assessed by a visual analog scale (VAS), graded from 0=no symptom to 10=the most severe symptom. Daily bowel movements were also reported. Median (IQR) VAS score for pain was 6 (5-7) in group A and 6 (6-7) in group B at baseline (p=0.109); at 8-year follow-up it was 3 (3-4) and 6 (5-7), respectively (p<0.000). Both bloating and daily bowel movements were significantly reduced in group A. Acute diverticulitis occurred in 9 (2.6%) patients in group A and in 21 (4.5%) patients in group B (p=0.155). Surgery occurred in 4 (1.2%) patients in group A and 9 (1.9%) in group B (p=0.432). Disease-related mortality occurred in no patient in group A and 2 (0.4%) patients in group B (p=0.239). No side effects were recorded during the entire study period. Rifaximin is effective to relieve symptoms and reduce the risk of disease-related complications in patients with SUDD.
虽然利福昔明目前被建议用于治疗症状性单纯性结肠憩室病（SUDD），但尚无长期数据。本回顾性研究评估了在 8 年随访期间接受利福昔明治疗的大量 SUDD 患者的结果。研究组（A 组）包括 346 例 SUDD 患者（中位年龄 64 岁，IQR58-69，62.4%为女性），接受利福昔明 800mg/d，每月连用 7 天。对照组（B 组）包括 470 例 SUDD 患者（中位年龄 65 岁，IQR59-74 岁，60.8%为女性），按需服用任何其他治疗药物。通过视觉模拟量表（VAS）评估 2 个症状（左下腹疼痛和腹胀），评分范围为 0（无症状）至 10（最严重症状）。还报告了每日排便次数。A 组和 B 组基线时疼痛 VAS 评分中位数（IQR）分别为 6（5-7）和 6（6-7）（p=0.109）；8 年随访时分别为 3（3-4）和 6（5-7）（p<0.000）。A 组的腹胀和每日排便次数均显著减少。A 组有 9 例（2.6%）患者发生急性憩室炎，B 组有 21 例（4.5%）患者发生急性憩室炎（p=0.155）。A 组有 4 例（1.2%）患者接受手术，B 组有 9 例（1.9%）患者接受手术（p=0.432）。A 组无疾病相关死亡，B 组有 2 例（0.4%）患者死亡（p=0.239）。整个研究期间未记录到任何副作用。利福昔明可有效缓解症状，降低 SUDD 患者发生疾病相关并发症的风险。
