Yang Luoyao, Zong Ye, Meng Fandong, Wu Yongdong, Zhang Shutian
Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
J Gastroenterol Hepatol. 2025 Feb;40(2):387-397. doi: 10.1111/jgh.16844. Epub 2024 Dec 11.
The objective of this study is to compare the efficacy and safety of lubiprostone (Lub) with osmotic laxatives in the treatment of chronic idiopathic constipation (CIC).
A comprehensive literature search was conducted using PubMed, EMBASE, and the Cochrane Library in May 2024. Studies that met the inclusion criteria were manually searched by two independent reviewers. The efficacy was assessed by the proportion of patients with spontaneous bowel movements (SBMs) within 24 h after the first administration of the medication and SBMs in Weeks 1 and 4. Safety was evaluated based on adverse events including nausea, diarrhea, and abdominal distension. Optimal probability values and the surface under the cumulative ranking area (SUCRA) were also calculated for all interventions. Higher SUCRA values indicate better efficacy and safety of the intervention.
Following a thorough search and screening process, 25 articles were included. Among the selected trials, 8 compared Lub to placebo, 10 compared polyethylene glycol (PEG) to placebo, 4 compared lactulose (Lac) to placebo, and 3 compared PEG to Lac. The meta-analysis results indicated that Lub and osmotic laxatives were significantly more effective than placebo. According to the SUCRA results, the highest rank probabilities were for Lub in increasing the SBMs and reducing abdominal distension.
Lubiprostone is more effective than PEG and Lactulose for treating CIC, with comparable safety profiles. However, this conclusion requires further validation through large-scale, high-quality studies.
本研究旨在比较鲁比前列酮（Lub）与渗透性泻药治疗慢性特发性便秘（CIC）的疗效和安全性。
2024年5月使用PubMed、EMBASE和Cochrane图书馆进行了全面的文献检索。符合纳入标准的研究由两名独立评审员进行人工检索。疗效通过首次给药后24小时内自发排便（SBM）的患者比例以及第1周和第4周的SBM来评估。安全性基于包括恶心、腹泻和腹胀在内的不良事件进行评估。还计算了所有干预措施的最佳概率值和累积排序曲线下面积（SUCRA）。较高的SUCRA值表明干预措施的疗效和安全性更好。
经过全面的检索和筛选过程，纳入了25篇文章。在选定的试验中，8项将Lub与安慰剂进行比较，10项将聚乙二醇（PEG）与安慰剂进行比较，4项将乳果糖（Lac）与安慰剂进行比较，3项将PEG与Lac进行比较。荟萃分析结果表明，Lub和渗透性泻药比安慰剂显著更有效。根据SUCRA结果，Lub在增加SBM和减轻腹胀方面的排序概率最高。
鲁比前列酮在治疗CIC方面比PEG和乳果糖更有效且安全性相当。然而，这一结论需要通过大规模、高质量的研究进一步验证。
