Klauser A G, Mühldorfer B E, Voderholzer W A, Wenzel G, Müller-Lissner S A
Abteilung für Gastroenterologie, Universität Munich, Germany.
Z Gastroenterol. 1995 Jan;33(1):5-8.
Slow transit constipation is notoriously difficult to treat. We tested whether polyethylene glycole 4000 (PEG) improves slow transit constipation. Eight female outpatients with symptoms of constipation and a colonic marker transit of more than 60 h were included (age 46 +/- 4y, duration of complaints 17 +/- 3y) in a randomised controlled cross-over study. During a 6-week placebo and 6-week PEG-phase (60g PEG/d) the following parameters were measured: 1. subjective well-being with respect to defeacation on a visual analogue scale (-8 cm very bad, +8 cm very good), 2. in the first 5 weeks of each phase, average dose of sodium picosulfate (prescribed as only allowed laxans, dose adjusted and protocolled on a diary by patient) 3. stool frequency, 4. colonic transit of radiopague polythene pellets in the last week of each phase (the use of laxative was strictly prohibited in this last week). Both subjective and objective parameters of colonic function improved significantly. Visual analog scale ratings improved from -4.65, [-8; 0.5] to 4.65, [-8; 7.5]cm (median, range) (p = 0.028), the self-administered dose of sodium picosulfate decreased from 4, [0; 37] to 0, [0; 11] drops per day (p = 0.028), stool frequency increased from 3.1, [1; 30] to 11, [2; 33] defeacations per week (p = 0.017), and total colonic transit decreased from 91, [67; 116] to 43 h, [17; 76]h (p = 0.017). In conclusion, PEG improves colonic function in patients with slow transit constipation subjectively and objectively. PEG should be considered as an additional option in patients refractory to established forms of treatment.
慢传输型便秘 notoriously 难以治疗。我们测试了聚乙二醇4000（PEG）是否能改善慢传输型便秘。八名有便秘症状且结肠标志物传输时间超过60小时的女性门诊患者（年龄46±4岁，主诉持续时间17±3年）被纳入一项随机对照交叉研究。在为期6周的安慰剂期和6周的PEG期（60克PEG/天）内，测量了以下参数：1. 用视觉模拟量表评估排便方面的主观幸福感（-8厘米表示非常差，+8厘米表示非常好）；2. 在每个阶段的前5周，比沙可啶钠的平均剂量（作为唯一允许使用的泻药，剂量由患者在日记中调整并记录）；3. 排便频率；4. 在每个阶段的最后一周，不透X线聚乙烯颗粒的结肠传输时间（在这最后一周严格禁止使用泻药）。结肠功能的主观和客观参数均有显著改善。视觉模拟量表评分从-4.65，[-8；0.5]提高到4.65，[-8；7.5]厘米（中位数，范围）（p = 0.028），比沙可啶钠的自我给药剂量从每天4，[0；37]滴降至0，[0；11]滴（p = 0.028），排便频率从每周3.1，[1；30]次增加到11，[2；33]次（p = 0.017），总结肠传输时间从91，[67；116]小时降至43小时，[17；76]小时（p = 0.017）。总之，PEG在主观和客观上都能改善慢传输型便秘患者的结肠功能。对于难治性便秘患者，PEG应被视为一种额外的治疗选择。
