渗透性泻药联合双岐活菌三联治疗老年人非器质性便秘的疗效评估

摘要

Objective To evaluate the efficacy of combination therapy with osmotic laxatives and bifid triple viable for the elderly persons suffering non-orgnic constipation. Methods Inpatients and outpatients aged 60 and over 60 were randomly divided into five groups, patients in group A treated with glycol 4000, group B treated with lactulose, group C treated with bifid triple viable, patients in group D treated with combination of glycol 4000 and bifid triple viable, patients in group E treated with combination of lactulose and bifid triple viable. Results In the primary 2 weeks, the effective rates of groups of A, B, C, D and E were 50. 9% , 50. 9% , 43.7% , 70. 5% and 73. 2% respectively. Logistic regression showed there was no difference on therapeutic effect among groups of A, B and C, but effective rate of group D or E was higher than groups of A, B and C. Furthermore, there was no significant difference between group D and group E. In 6 months, ineffectiveness and recurrence ratios of groups of A, B, C, D and E were 68. 4% , 66. 0% , 72.9% , 57.4% and 35.7% respectively. Kaplan-Meier survival analysis showed the ineffectiveness and recurrence rate of group E was the most lowest compared with the other four groups. Conclusions Bifid triple viable can improve the therapeutic efficacy of osmotic laxatives for the elderly persons with non-orgnic constipation. Combination of glycol 4000 and bifid triple viable can improve short-term therapeutic efficacy, while combination of lactulose and bifid triple viable can enhance both short-term and long-term therapeutic efficacy.%目的 评估渗透性泻药联合双歧活菌三联治疗老年人非器质性便秘的效果.方法 以60岁及以上非器质性便秘患者为研究对象,随机分为5组:A组予聚乙二醇4000治疗；B组予乳果糖治疗；C组予双岐活菌三联胶囊治疗；D组接受聚乙二醇4000与双岐活菌三联胶囊联合治疗；E组接受乳果糖与双岐活菌三联胶囊联合治疗.观察2周与6个月治疗效果.结果 2周疗程中,A、B、C、D、E组有效率分别为:50.9％、50.9％、43.7％、70.5％、73.2％.Logistic回归分析显示:D、E组有效率高于A、B、C组,且D、E两组之间无明显差异.6个月疗程中,A、B、C、D、E组总体无效及复发率分别为:68.4％、66.0％、72.9％、57.4％、35.7％.Kaplan-Meier生存分析示:E组总体无效及复发率低于A、B、C、D组,A、B、C、D组之间差异无统计学意义.结论 与双歧杆菌三联胶囊联合应用能够提高渗透性泻药对老年人非器质性便秘的治疗效果.其中聚乙二醇4000与双歧杆菌三联胶囊联合应用能提高短期疗效；乳果糖与双歧杆菌三联胶囊联使用短期、长期疗效均能提高.