Klinika Gastroenterologii Onkologicznej, Narodowy Instytut Onkologii im. Marii Skłodowskiej-Curie, Państwowy Instytut Badawczy w Warszawie.
Katedra i Klinika Chirurgii Ogólnej, Endokrynologicznej i Onkologii Gastroenterologicznej, Uniwersytet Medyczny w Poznaniu.
Pol Przegl Chir. 2020 Apr 7;92(2):22-28. doi: 10.5604/01.3001.0014.0946.
Background: Diverticulosis is the most common finding in the GI tract. Nearly half of the people with diverticula experience symptomatic uncomplicated diverticular disease (SUDD).
The primary endpoints of our study were to assess the effectiveness of combined therapy with rifaximin-α and arabinogalactan-lactoferrin in symptom reduction and normalization of bowel movements. The secondary endpoints were an assessment of efficacy in SUDD recurrence prevention and patients' compliance to the combined therapy.
A retrospective observational survey study was performed in 2019 among physicians experienced in diverticular disease (DD) treatment in Poland. Patients with previous episodes of recurrences treated with combined therapy (cyclic rifaximin-α at least 400 mg b.i.d/7 days/every month and continuous arabinogalactan-lactoferrin supplementation 1 sachet daily) were assessed after 3 and 6 months regarding symptoms' resolution in the three-point scale. The patients' SUDD history, diagnostic methods, treatment, and results, as well as patients' compliance were evaluated.
281 patients met inclusion criteria, and were further evaluated (67.6% women, median age 65 years). After 6 months of combined treatment, there was a statistically significant reduction in the total severity score (median from 1.7 [max 3 points] to 0.26; P < 0.0001; sum from 8.5 [max 15 points] to 1.28; P < 0.0001) and improvement in each symptom score. Stool frequency statistically normalized in every group. As many as 31.7% had complete symptom resolution. Patients' compliance with the therapy was very good and good in 92.9% of cases. C onclusions and discussion: Combination therapy with cyclic rifaximin-α and continuous arabinogalactan combined with lactoferrin are effective in SUDD treatment in terms of symptom resolution, bowel movement normalization, prevention of recurrences with very good patient's compliance.
背景：憩室病是胃肠道最常见的发现。近一半的憩室患者患有症状性单纯性憩室病（SUDD）。
本研究的主要终点是评估利福昔明-α和阿拉伯半乳糖甘露聚糖-乳铁蛋白联合治疗在减轻症状和改善排便方面的有效性。次要终点是评估预防 SUDD 复发的疗效和患者对联合治疗的依从性。
2019 年，在波兰经验丰富的憩室病（DD）治疗医生中进行了一项回顾性观察研究。评估了先前接受联合治疗（至少每 400 毫克 b.i.d/7 天/每月循环利福昔明-α和每日连续补充阿拉伯半乳糖甘露聚糖-乳铁蛋白 1 袋）治疗的复发性发作患者，在 3 个月和 6 个月后，根据三点量表评估症状缓解情况。评估了患者的 SUDD 病史、诊断方法、治疗和结果以及患者的依从性。
281 名患者符合纳入标准，并进一步评估（67.6%为女性，中位年龄 65 岁）。经过 6 个月的联合治疗，总严重程度评分（中位数从 1.7[最高分 3 分]降至 0.26；P < 0.0001；总分从 8.5[最高分 15 分]降至 1.28；P < 0.0001）和每个症状评分均有统计学显著降低。排便频率在每个组中均趋于正常。多达 31.7%的患者完全缓解症状。治疗的患者依从性非常好和良好占 92.9%。
利福昔明-α循环治疗联合连续阿拉伯半乳糖甘露聚糖与乳铁蛋白联合治疗在 SUDD 治疗方面是有效的，在缓解症状、排便正常化、预防复发方面效果显著，患者的依从性非常好。
