Nate-Anong Butsarin, Khorana Jiraporn, Chantakhow Sireekarn, Singhavejsakul Jesda, Tepmalai Kanokkan
Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Faculty of Medicine, Clinical Surgical Research Center, Chiang Mai University, Chiang Mai, Thailand.
Pediatr Surg Int. 2025 Aug 26;41(1):268. doi: 10.1007/s00383-025-06174-9.
To compare the efficacy and user preference of Sennosides, magnesium hydroxide (Mg(OH)), and polyethylene glycol (PEG) in treating constipation in ARM patients.
A randomized crossover trial was conducted from January 2018 to December 2019. Fifteen patients with surgically corrected ARM and diagnosed constipation were enrolled. Each patient received all three laxatives in a random order for 21-day periods, separated by washout periods. The primary outcome was post-treatment fecal loading assessed by Leech score on abdominal radiography. Secondary outcomes included the rate of clean fecal loading (Leech score ≤ 6) and user preference scores.
The mean post-treatment Leech scores were 6.67 ± 2.09 for Sennosides, 6.80 ± 2.37 for Mg(OH), and 5.80 ± 2.04 for PEG(p = 0.841). Clean fecal loading was achieved in 40% of cases with Sennosides, 46.67% with Mg(OH), and 60% with PEG(p = 0.655). User preference scores favored Sennosides (7.00 ± 2.36) over Mg(OH) (6.33 ± 2.94) and PEG (5.06 ± 2.28) with p = 0.582. No significant differences in treatment, period, or sequence effects were found, with the exception of a decrease in preference for Mg(OH) compared with Sennosides in the third treatment period (p = 0.045).
While PEG showed a trend towards better fecal clearance and Sennosides was preferred by users, no statistically significant differences in efficacy or user preference were found among the three laxatives.
比较番泻苷、氢氧化镁（Mg(OH)）和聚乙二醇（PEG）治疗肛门直肠畸形（ARM）患者便秘的疗效及患者偏好。
于2018年1月至2019年12月进行一项随机交叉试验。纳入15例经手术矫正的ARM且诊断为便秘的患者。每位患者按随机顺序接受所有三种泻药治疗，疗程均为21天，期间有洗脱期。主要结局是通过腹部X线片上的水蛭评分评估治疗后的粪便负荷。次要结局包括清洁粪便负荷率（水蛭评分≤6）和患者偏好评分。
番泻苷治疗后水蛭评分的平均值为6.67±2.09，氢氧化镁为6.80±2.37，聚乙二醇为5.80±2.04（p = 0.841）。番泻苷组40%的病例实现了清洁粪便负荷，氢氧化镁组为46.67%，聚乙二醇组为60%（p = 0.655）。患者偏好评分显示，番泻苷（7.00±2.36）优于氢氧化镁（6.33±2.94）和聚乙二醇（5.06±2.28），p = 0.582。除了在第三个治疗期与番泻苷相比对氢氧化镁的偏好有所下降（p = 0.045）外，未发现治疗、时期或顺序效应有显著差异。
虽然聚乙二醇显示出粪便清除效果更好的趋势，且患者更偏好番泻苷，但三种泻药在疗效或患者偏好方面未发现有统计学意义的差异。
