Sun W M, Read N W, Verlinden M
Royal Adelaide Hospital, South Australia.
Scand J Gastroenterol. 1997 Jan;32(1):34-8. doi: 10.3109/00365529709025060.
Loperamide improves anorectal function in patients with chronic diarrhoea. We wished to investigate whether the prodrug loperamide oxide has similar effects.
Eleven patients with chronic diarrhoea and faecal incontinence participated in a randomized, placebo-controlled, double-blind, crossover study of the effects of loperamide oxide (4 mg twice daily for 1 week).
Loperamide oxide reduced wet stool weight and improved the patients' ratings of symptoms. Mouth-to-caecum transit time was not altered, but whole-gut transit time was prolonged. There were limited effects on anorectal function, but the mean minimum basal pressure mainly contributed by the internal anal sphincter (IAS) was increased, as was the mean volume infused before leakage occurred in the saline continence test.
Loperamide oxide is effective in the treatment of diarrhoea with faecal incontinence; normalization of colon transit time and an increase in the tone of the IAS seem to be the main determinants of efficacy.
洛哌丁胺可改善慢性腹泻患者的肛肠功能。我们希望研究前体药物氧化洛哌丁胺是否有类似作用。
11例慢性腹泻伴大便失禁患者参与了一项关于氧化洛哌丁胺（每日2次，每次4mg，共1周）作用的随机、安慰剂对照、双盲、交叉研究。
氧化洛哌丁胺可降低湿粪重量并改善患者症状评分。口至盲肠转运时间未改变，但全肠道转运时间延长。对肛肠功能的影响有限，但主要由肛门内括约肌（IAS）产生的平均最低基础压力增加，盐水控便试验中出现漏液前注入的平均容量也增加。
氧化洛哌丁胺对伴有大便失禁的腹泻有效；结肠转运时间正常化和IAS张力增加似乎是疗效的主要决定因素。
