Sykes N P
Palliative Medicine, University of Leeds, United Kingdom.
J Pain Symptom Manage. 1996 Jun;11(6):363-9. doi: 10.1016/0885-3924(96)00011-5.
Loperamide was used to provide a source of opioid-induced constipation in healthy volunteers. Each volunteer took a sequence of three dose levels of loperamide. One of three laxatives was used to counterbalance the effect of loperamide and restore bowel function to what the individual considered normal at each stage before the dose of loperamide was increased. Lactulose, senna, and codanthrusate were selected as examples of a softening, a stimulant, and a combination laxative, respectively. Outcome measures were the doses of laxative used, stool form and frequency, ease of defecation, a rating scale of subjective bowel function, and the occurrence of adverse effects. Each laxative was taken by ten volunteers, and all proved capable of maintaining normal bowel function. A combination of stimulant and softening laxatives was most likely to maintain normal bowel function at the lowest dose and least adverse effects. The mean final dose of lactulose was excessive for use in ill patients. Senna was associated with significantly more adverse effects than the other laxatives, mainly abdominal pain (P < 0.001). This model of constipation may provide a standardized means of assaying the clinical effectiveness of oral laxatives.
洛哌丁胺被用于在健康志愿者中引发阿片类药物所致便秘。每位志愿者服用了一系列三个剂量水平的洛哌丁胺。三种泻药中的一种被用于抵消洛哌丁胺的作用，并在每次增加洛哌丁胺剂量前将肠道功能恢复到个体认为正常的状态。乳果糖、番泻叶和复方芦荟胶囊分别被选作软化性、刺激性和复方泻药的示例。观察指标包括所用泻药的剂量、粪便形态和频率、排便难易程度、主观肠道功能评分量表以及不良反应的发生情况。每种泻药由十名志愿者服用，结果表明所有泻药都能够维持正常的肠道功能。刺激性泻药与软化性泻药联合使用最有可能以最低剂量维持正常肠道功能且不良反应最少。乳果糖的平均最终剂量对患病患者来说过高。番泻叶与其他泻药相比，不良反应明显更多，主要是腹痛（P < 0.001）。这种便秘模型可能为测定口服泻药的临床疗效提供一种标准化方法。
