便秘:诊断和治疗方面的进步
1Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison.
有效的慢性便秘治疗包括药和排便障碍治疗. 治疗慢性异常性便秘 (CIC) 和阿片类药物引起的便秘 (OIC) 的选择应以成本和疗效为指导.
科学领域:
- 胃肠病学
- 药理学
背景情况:
- 慢性便秘影响数以百万计的人,
- 片引起的便秘 (OIC) 是一个普遍的挑战.
- 现有的慢性异常便秘治疗包括药和排便障碍治疗.
研究的目的:
- 审查慢性便秘治疗的现有证据.
- 提供对初始治疗耐药性CIC的管理指南.
- 强调对药效果和成本进行比较研究的需要.
主要方法:
- 对慢性便秘的已知和新兴治疗方法的审查.
- 对耐火性CIC的治疗算法进行讨论
- 重点是局部受限的μ-阿片类受体抗剂.
主要成果:
- 刺激剂和透性松剂,分泌剂和μ-阿片酸受体对抗剂显示出强烈的疗效.
- 生物反和处理排便障碍对于耐火性CIC至关重要.
- 长期使用诸如塞纳和比萨科迪尔之类的兴奋剂是安全有效的.
- 便宜的便秘药和新的便秘药之间缺乏比较研究.
结论:
- 对CIC和OIC的治疗决定必须平衡成本和疗效.
- 患有难治性便秘的患者需要在便和结肠过境研究专业的中心进行专业评估.
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