Voderholzer W A, Schatke W, Mühldorfer B E, Klauser A G, Birkner B, Müller-Lissner S A
Medizinische Klinik, Klinikum Innenstadt, University of Munich, Germany.
Am J Gastroenterol. 1997 Jan;92(1):95-8.
To determine the clinical outcome of dietary fiber therapy in patients with chronic constipation.
One hundred, forty-nine patients with chronic constipation (age 53 yr, range 18-81 yr, 84% women) at two gastroenterology departments in Munich, Germany, were treated with Plantago ovata seeds, 15-30 g/day, for a period of at least 6 wk. Repeated symptom evaluation, oroanal transit time measurement (radiopaque markers), and functional rectoanal evaluation (proctoscopy, manometry, defecography) were performed. Patients were classified on the basis of the result of dietary fiber treatment: no effect, n = 84; improved, n = 33; and symptom free, n = 32.
Eighty percent of patients with slow transit and 63% of patients with a disorder of defecation did not respond to dietary fiber treatment, whereas 85% of patients without a pathological finding improved or became symptom free.
Slow GI transit and/or a disorder of defecation may explain a poor outcome of dietary fiber therapy in patients with chronic constipation. A dietary fiber trial should be conducted before technical investigations, which are indicated only if the dietary fiber trial fails.
确定膳食纤维疗法对慢性便秘患者的临床疗效。
德国慕尼黑两个胃肠病科的149例慢性便秘患者（年龄53岁，范围18 - 81岁，84%为女性）接受了车前草籽治疗，剂量为每天15 - 30克，为期至少6周。进行了反复的症状评估、口-肛门转运时间测量（不透X线标志物）和功能性直肠肛门评估（直肠镜检查、测压、排粪造影）。根据膳食纤维治疗结果对患者进行分类：无效，n = 84；改善，n = 33；无症状，n = 32。
80%的慢传输型患者和63%的排便障碍型患者对膳食纤维治疗无反应，而85%无病理发现的患者症状改善或消失。
胃肠传输缓慢和/或排便障碍可能解释了慢性便秘患者膳食纤维治疗效果不佳的原因。在进行仅在膳食纤维试验失败时才进行的技术检查之前，应先进行膳食纤维试验。
