van Gorkom B A, Karrenbeld A, Limburg A J, Kleibeuker J H
Department of Gastroenterology and Hepatology, University Hospital, Groningen, The Netherlands.
Z Gastroenterol. 1998 Jan;36(1):13-8.
A single high dose of sennosides is often used to optimize bowel preparation for diagnostic procedures. From previous studies it is suspected that sennosides in such a dose cause acute damage to the colonic mucosa. This study was designed to determine any effects of sennosides on histology of colonic mucosa and on bowel preparation.
In a prospective study 171 patients were randomized for bowel preparation. 84 patients received 1 ml/kg (maximal 75 ml) of a syrup containing 2.0 mg/ml sennoside A and B and 3-5 l of a lavage solution (Sen), 87 patients only received 3-5 l lavage solution (NSen). All patients completed a questionnaire on which patient tolerance was scored. Another questionnaire was completed by the endoscopist, recording quality of the preparation. From the 40 patients with a normal colon (19 Sen, 21 NSen) a biopsy was taken from the sigmoid colon and analyzed for morphological abnormalities. No difference could be demonstrated in tolerance or quality of bowel preparation between the two groups. A marked increase of mononuclear infiltrate in the lamina propria was observed in Sen compared to NSen: in 10/19 vs. 2/21 patients respectively, p < 0.0005.
As these microscopic effects could hamper the interpretation of colonic biopsies, bowel preparation without sennosides is to be recommended.
单剂量高剂量的番泻苷常用于优化诊断程序中的肠道准备。从先前的研究怀疑，这种剂量的番泻苷会对结肠黏膜造成急性损伤。本研究旨在确定番泻苷对结肠黏膜组织学和肠道准备的任何影响。
在一项前瞻性研究中，171名患者被随机分配进行肠道准备。84名患者接受1毫升/千克（最大75毫升）含有2.0毫克/毫升番泻苷A和B的糖浆以及3-5升灌洗液（Sen组），87名患者仅接受3-5升灌洗液（非Sen组）。所有患者都完成了一份关于患者耐受性评分的问卷。内镜医师完成了另一份问卷，记录准备质量。从40名结肠正常的患者（19名Sen组，21名非Sen组）中，取乙状结肠活检并分析形态学异常。两组在耐受性或肠道准备质量方面没有差异。与非Sen组相比，Sen组固有层单核细胞浸润明显增加：分别为10/19和2/21患者，p<0.0005。
由于这些微观效应可能会妨碍结肠活检的解读，因此建议不使用番泻苷进行肠道准备。
