Jung Camille, Kalach Nicolas, Degas Vanessa, Jeridi Yasmine, Bertrand Valérie, Bellaiche Marc
Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, Créteil, France.
Department of Pediatrics, Groupement des Hôpitaux de L'Institut Catholique de Lille, Lille, France.
Front Pediatr. 2022 Oct 26;10:997104. doi: 10.3389/fped.2022.997104. eCollection 2022.
Chronic constipation is common in children and often requires prolonged laxative treatment. Preliminary studies suggest that the probiotic () may be useful in treating constipation in children, but these preliminary results need to be replicated. The objective of this study was to assess the efficacy of in infants and young children with chronic functional constipation.
A prospective double-blind randomized placebo-controlled trial was conducted in 5 pediatric departments in France between June 2017 and June 2021. In all, 49 patients-ages 6 months to 4 years, and suffering from chronic constipation per Rome IV criteria-were randomly allocated to the test and control groups. For 4 weeks, all were orally administered 5 daily drops of the test ( DSM 17938 at 10 colony-forming units per day) or control (placebo) treatment, respectively. Participants were clinically assessed at 4 and 8 weeks. Parents were asked to daily record the number of spontaneous bowel movements (SBMs), stool consistency, and the use of any additional laxatives. Informed consent was obtained from parents of all recruited patients, and the study was approved by both an ethics committee and the French National Agency for Medicines and Health Products Safety (ANSM). The study is registered on ClinicalTrials.gov (NCT03030664).
The change in SBMs relative to baseline was greater in the control group at week 4 (control: 0.27 ± 0.5; test: 0.23 ± 0.5; = 0.01) and in the test group at week 8 (control: 0.26 ± 0.4; test: 0.22 ± 0.5; = 0.03). At week 4, the groups did not differ in number of responders (≥3 stools per week, with no non-retentive fecal incontinence), use of rescue medication, scoring of pain during defecation (Faces Pain Scale-Revised), or stool consistency (Bristol Stool Form Scale).
This double-blind randomized controlled trial did not confirm the efficacy of for treatment of chronic functional constipation in young children.
慢性便秘在儿童中很常见,通常需要长期使用泻药治疗。初步研究表明,益生菌()可能对治疗儿童便秘有用,但这些初步结果需要重复验证。本研究的目的是评估在婴幼儿慢性功能性便秘中的疗效。
2017年6月至2021年6月期间,在法国的5个儿科部门进行了一项前瞻性双盲随机安慰剂对照试验。共有49例年龄在6个月至4岁、符合罗马IV标准的慢性便秘患儿被随机分配到试验组和对照组。为期4周,所有患儿分别口服5滴试验药物(DSM 17938,每天10个菌落形成单位)或对照药物(安慰剂)。在第4周和第8周对参与者进行临床评估。要求家长每天记录自主排便次数(SBMs)、大便稠度以及是否使用其他泻药。获得了所有招募患儿家长的知情同意,该研究得到了伦理委员会和法国国家药品与健康产品安全局(ANSM)的批准。该研究已在ClinicalTrials.gov上注册(NCT03030664)。
在第4周时,对照组相对于基线的SBMs变化更大(对照组:0.27±0.5;试验组:0.23±0.5;=0.01),在第8周时试验组的变化更大(对照组:0.26±0.4;试验组:0.22±0.5;=0.03)。在第4周时,两组在缓解者数量(每周≥3次大便,无大便失禁)、使用急救药物、排便时疼痛评分(面部疼痛量表修订版)或大便稠度(布里斯托大便形态量表)方面没有差异。
这项双盲随机对照试验未证实对幼儿慢性功能性便秘的治疗效果。