Department of Gastroenterology, University of Health Sciences, Diskapı Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
Department of Gastroenterology, Ankara Yildirim Beyazit University, School of Medicine, Ankara, Turkey.
J Gastroenterol Hepatol. 2020 Nov;35(11):1923-1929. doi: 10.1111/jgh.15101. Epub 2020 Jun 8.
The aim of this study was to compare the quality and tolerability of bowel preparation using split high-doses of sennosides versus split-dose polyethylene glycol (PEG).
In this prospective, randomized, and endoscopist-blinded study, 474 outpatients were included and randomly assigned to two groups: Group 1 was comprised of 237 patients receiving split high-dose (1000 mg) sennoside solutions, and group 2 included 237 patients receiving 4 L of PEG. The efficacy of the preparations was evaluated on the Boston Bowel Preparation Scale (BBPS), and compliance and adverse effects were recorded.
The quality of colon cleansing and the ease of bowel preparation were significantly better in the senna group; the mean of total BBPS scores was 7.35 in the senna group and 6.57 in the PEG group, cleansing was adequate (BBPS score ≥ 6) in 89.9% of patients taking senna, and 73.8% in the PEG group (P = 0.001). The rates of vomiting in the senna and PEG groups were 12.7% and 29.5%, nausea rates were 28.7% and 43.9%, and abdominal pain rates were 70.9% and 43%, respectively (P < 0.001). Cecal intubation rates in the senna and PEG groups were 95.4% and 86.1% (P = 0.001), and the cecal intubation times were 6.73 ± 2.84 and 5.34 ± 5.98 min, respectively (P = 0.001).
Split high-dose senna is more effective than split-dose PEG in terms of bowel preparation quality and patient compliance. The patients who received senna had significantly less vomiting and nausea but significantly more abdominal pain. Thus, senna may be used as an alternative to PEG for bowel preparation.
本研究旨在比较番泻叶分剂量高剂量与聚乙二醇（PEG）分剂量在肠道准备方面的质量和耐受性。
在这项前瞻性、随机、内镜医师盲法研究中，纳入了 474 名门诊患者，并将其随机分为两组：第 1 组 237 例患者服用番泻叶分剂量高剂量（1000mg）溶液，第 2 组 237 例患者服用 4L 的 PEG。使用波士顿肠道准备量表（BBPS）评估准备效果，并记录患者的依从性和不良反应。
番泻叶组的结肠清洁质量和肠道准备的便利性明显更好；番泻叶组的总 BBPS 评分平均值为 7.35，PEG 组为 6.57，服用番泻叶的患者中 89.9%清洁效果充足（BBPS 评分≥6），PEG 组为 73.8%（P=0.001）。番泻叶组和 PEG 组呕吐的发生率分别为 12.7%和 29.5%，恶心发生率分别为 28.7%和 43.9%，腹痛发生率分别为 70.9%和 43%（P<0.001）。番泻叶组和 PEG 组盲肠插管率分别为 95.4%和 86.1%（P=0.001），盲肠插管时间分别为 6.73±2.84 和 5.34±5.98min（P=0.001）。
与 PEG 分剂量相比，番泻叶分剂量高剂量在肠道准备质量和患者依从性方面更有效。服用番泻叶的患者呕吐和恶心明显减少，但腹痛明显增多。因此，番泻叶可作为 PEG 肠道准备的替代药物。
