普芦卡必利和莫沙必利分别联用小剂量聚乙二醇治疗老年难治性功能性便秘的短期疗效比较

摘要

目的 比较普芦卡必利、莫沙必利分别联用小剂量聚乙二醇治疗老年难治性功能性便秘的短期疗效.方法 对2014年5月至2016年2月在该院门诊诊治的老年难治性功能性便秘患者90例进行回顾性分析.入选病例分为两组,每组45例.普芦卡必利组:琥珀酸普芦卡必利片,2 mg,每日1次;莫沙必利组:枸橼酸莫沙必利胶囊,5 mg,每日3次.两组均联用复方聚乙二醇电解质散(PEG)13.125 g,每日2次,疗程4周.观察两组患者首次排便和排便困难缓解时间、每周完全自发排便(SCBM)平均次数、排便困难、大便性状、不良反应及生命质量的变化.结果 两组慢传输型、排便障碍型的治疗有效率比较,差异均有统计学意义(P<0.05),混合型差异无统计学意义(P>0.05).与莫沙必利组比较,普卢卡必利组首次排便时间和排便困难缓解时间均较短,差异有统计学意义(P<0.05).治疗后4周,两组患者SCBM>3次,普卢卡必利组次数更多;普芦卡必利组排便困难改善更为明显,差异有统计学意义(P<0.05).大便性状改善组间比较,差异无统计学意义(P>0.05).两组总有效率比较差异有统计学意义(P<0.05),不良反应发生率比较差异无统计学意义(P>0.05).治疗后4周,两组患者便秘患者生存质量自评量表(PAC-QOL)评分的总均分均有下降,普芦卡必利组降低更为明显,差异有统计学意义(P<0.05).结论 普芦卡必利+PEG治疗老年难治性功能性便秘起效更快,且在总体疗效及生命质量改善方面有优势,尤适用于慢传输型和排便障碍型.%Objective To compare the short-term curative effects of prucalopride and mosapride respectively combined with low dose polyethylene glycol in treating elderly refractory functional constipation.Methods Ninety patients with elderly refractory functional constipation in the outpatient department of our hospital from May 2014 to February 2016 were retrospectively analyzed and divided into two groups randomly,45 cases in each group.the prucalopride group:Prucalopride Succinate Tablets,2mg,4 times daily;the mosapride group:Mosapride Citrate Capsules,5mg,3 times daily.Polyethylene Glycol Electrolytes Powder(PEG) was also used in the two groups,13.125g,twice daily.The course of treatment was 4 weeks.The first defecating time and defecation difficulty relief time,average weekly spontaneous complete bowel movements (SCBM),defecating difficulty,stool character,adverse reactions and change of life quality were observed in the two groups.Results The treatment effective rate of slow transit constipation(STC) and defecatory disorder had the statistical difference between the two groups (P<0.05).The comparison of the effective rates in mixed type showed no statistical difference between the two groups(P>0.05).Compared with the mosapride group,the first defecating time and defecation difficulty relief time in the prucalopride group were shorter with statistical difference (P<0.05).After 4-week treatment,SCBM times per week in the two groups were more than 3 times;the times of the prucalopride group were even more.In the prucalopride group,the defecation difficulty improvement was more obvious,the difference between the two groups had statistical significance (P<0.05).As for the comparison of the stool character improvement,the difference had no statistical significance(P>0.05).The total effective rate had statistical difference between the two groups(P<0.05).The incidence rate of adverse reactions had no statistical difference between the two groups(17.78% vs.15.56%,P<0.05).The total average score of PAC-QOL after treatment in the two groups were both decreased,moreover the decrease in the prucalopride group was more obvious;the difference between the two groups had statistical significance(P<0.05).Conclusion Prucalopride +PEG take effect faster in the treatment of elderly refractory functional constipation and has the advantages in the aspects of overall curative effect and life quality improvement,which is specially suitable for STC and defecatory disorder type.