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一项随机对照试验,比较1升聚乙二醇溶液加抗坏血酸与普芦卡必利与2升聚乙二醇溶液加抗坏血酸用于肠道准备的疗效。

A randomized controlled trial comparing the efficacy of 1-L polyethylene glycol solution with ascorbic acid plus prucalopride versus 2-L polyethylene glycol solution with ascorbic acid for bowel preparation.

作者信息

Choi Seong Ji, Kim Eun Sun, Choi Byeong Kwang, Min Geeho, Kim Woojung, Lee Jung Min, Lee Jae Min, Kim Seung Han, Choi Hyuk Soon, Keum Bora, Jeen Yoon Tae, Lee Hong Sik, Chun Hoon Jai, Kim Chang Duck

机构信息

a Department of Internal Medicine, Division of Gastroenterology and Hepatology , Korea University College of Medicine , Seoul , South Korea.

出版信息

Scand J Gastroenterol. 2018 Dec;53(12):1619-1624. doi: 10.1080/00365521.2018.1543450. Epub 2019 Jan 8.

Abstract

OBJECTIVES

Bowel cleansing is a major patient complaint during colonoscopy. Adding laxatives to the bowel preparation is effective in replacing a portion of bowel preparation solution and reducing its volume. Prucalopride is a serotonin receptor agonist that stimulates gastrointestinal motility and provides propulsive force for defecation. This study aimed to compare 1 L polyethylene glycol (PEG) with ascorbic acid (Asc) plus 2 mg prucalopride (1LP/AP) and 2 L PEG with Asc (2LP/A) for colonoscopy preparation with respect to bowel-cleansing quality and side effects.

METHODS

A single-center, randomized, prospective study was conducted with 260 outpatients administered either 1LP/AP or 2LP/A. The primary endpoint was bowel preparation quality, which was evaluated using the Boston Bowel Preparation Scale and Aronchick Bowel Preparation Scale, and the secondary endpoints were patient tolerability and acceptability, assessed by a questionnaire-based survey.

RESULTS

The adequate bowel preparation rates were 88.5% and 83.1% in the 2LP/A and 1LP/AP groups, respectively, and the efficacy of 1LP/AP was equivalent to the control regimen (p=.216). Other colonoscopic variables including adenoma detection rate were similar in both groups. Patient tolerability and acceptability were not significantly different, but patients in the 1LP/AP group were more willing to repeat the same regimen (p=.039).

CONCLUSIONS

Bowel preparation quality with 1LP/AP was equivalent to that with 2LP/A, which did not increase the occurrence of side effects, but it reduced the volume of the solution ingested, and increased patient satisfaction.

摘要

目的

肠道准备是结肠镜检查期间患者的主要诉求。在肠道准备过程中添加泻药可有效补充部分肠道准备溶液并减少其用量。普芦卡必利是一种血清素受体激动剂,可刺激胃肠蠕动并为排便提供推进力。本研究旨在比较1升聚乙二醇(PEG)加抗坏血酸(Asc)加2毫克普芦卡必利(1LP/AP)与2升PEG加Asc(2LP/A)用于结肠镜检查准备时的肠道清洁质量和副作用。

方法

进行了一项单中心、随机、前瞻性研究,260名门诊患者分别接受1LP/AP或2LP/A治疗。主要终点是肠道准备质量,采用波士顿肠道准备量表和阿龙奇克肠道准备量表进行评估,次要终点是患者耐受性和可接受性,通过问卷调查进行评估。

结果

2LP/A组和1LP/AP组的充分肠道准备率分别为88.5%和83.1%,1LP/AP的疗效与对照方案相当(p = 0.216)。两组的其他结肠镜检查变量,包括腺瘤检出率,相似。患者耐受性和可接受性无显著差异,但1LP/AP组患者更愿意重复相同方案(p = 0.039)。

结论

1LP/AP的肠道准备质量与2LP/A相当,不会增加副作用的发生,但减少了摄入溶液的量,并提高了患者满意度。

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