Clinical Application of Linaclotide Combined with Compound Polyethylene Glycol Electrolyte in Bowel Preparation in Patients with Chronic Constipation
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摘要:
目的 研究利那洛肽联合复方聚乙二醇电解质（PEG）在慢性便秘患者肠道准备中的效果及安全性。 方法 选取2021 年 3月至2022年2月在青岛市第八人民医院行结肠镜检查的174 例慢性便秘患者作为研究对象，采用随机数字表法分为A组、B组、C组 ，每组各58 例。A组患者采用3LPEG分次清肠，B组患者采用3粒利那洛肽联合3LPEG分次清肠，C组患者采用4LPEG分次清肠。比较3组患者的肠道准备质量、结肠镜检查时间及不良反应发生率。 结果 B组和C组的左半结肠、横结肠、右半结肠评分及Boston肠道准备量表（BBPS）总评分均高于A组（P < 0.05）；B组的左半结肠、横结肠、右半结肠评分及BBPS总评分与C组比较，差异无统计学意义（P > 0.05）。老年便秘患者中，B组的左半结肠、横结肠、右半结肠评分及BBPS总评分与C组比较，高于C组（P < 0.05）。B组和C组进境时间、退镜时间、肠镜总时间均小于A组（P < 0.05）；B组的进境时间、退镜时间、肠镜总时间与C组比较，小于C组（P < 0.05）。A组和B组与C组比较，每项不良反应发生率均小于C组（P < 0.05）。 结论 利那洛肽联合分次口服3LPEG相对单独分次口服3LPEG而言，提高了肠道准备质量并缩短了结肠镜检查时间，相对单独分次口服4LPEG而言，可以达到同样的肠道准备效果，且可以降低不良反应的发生率，安全性较高。对于老年慢性便秘患者，利那洛肽联合分次口服3LPEG与单独分次口服4LPEG比较，肠道准备效果更佳。 -
关键词:
- 肠道准备 /
- 复方聚乙二醇电解质散 /
- 利那洛肽 /
- 慢性便秘
Abstract:Objective To study the effect and safety of linaclotide combined with compound polyethylene glycol electrolyte （PEG） in bowel preparation in patients with chronic constipation. Methods A total of 174 patients with chronic constipation who underwent colonoscopy in Qingdao Eighth People’s Hospital from March 2021 to February 2022 were selected as the research subjects, and they were divided into group A, group B, and group C by random number table method, with 58 cases in each group. Patients in group A were treated with 3LPEG fractionated bowel cleansing, patients in group B were treated with 3 capsules of linaclotide combined with 3LPEG fractional bowel cleansing, and group C patients were given 4LPEG fractional bowel cleansing. The quality of bowel preparation, colonoscopy time and incidence of adverse reactions were compared among the three groups. Results The scores of the left semicolon, transverse colon, right semicolon and Boston bowel preparation scale （BBPS） total score in groups B and C were higher than those in group A （P < 0.05）. There was no significant difference in the scores of the left semicolon, transverse colon, right semicolon and total BBPS score between group B and group C （P > 0.05）. Among the elderly patients with constipation, the scores of the left semicolon, transverse colon, right semicolon and BBPS total score in group B were higher than those in group C （P < 0.05）. The entry time, exit time and total colonoscopy time of groups B and C were all shorter than those of group A （P < 0.05）. Compared with group C, the entry time, exit time and total colonoscopy time of group B were shorter than those of group C （P < 0.05）. Compared with group C, the incidence of each adverse reaction in groups A and B was lower than that in group C （P < 0.05）. Conclusions Linaclotide combined with fractional oral 3LPEG improves the quality of bowel preparation and shortens the time of colonoscopy compared with single fractional oral 3LPEG. Compared with fractional oral 4LPEG alone, it can achieve the same bowel preparation effect and can reduce the incidence of adverse reactions, with high safety. For elderly patients with chronic constipation, linaclotide combined with fractional oral 3LPEG has a better bowel preparation effect than fractional oral 4LPEG alone. -
表 1 3组患者一般资料比较[（
$ \bar x \pm s $ ）/n（%）]Table 1. Comparison of general data of three groups of patients [（
$ \bar x \pm s $ ）/n（%）]组别 性别
（n）年龄
（岁）身高
（cm）体重
（kg）腹部手术 糖尿病 A组 30/28 57.72 ± 13.87 164.19 ± 6.07 68.12 ± 7.88 6（10.3） 9（15.5） B组 27/31 58.10 ± 13.26 164.02 ± 6.65 67.16 ± 7.73 5（8.6） 6（10.3） C组 32/26 61.28 ± 9.98 164.10 ± 5.58 69.75 ± 6.69 7（12.1） 8（13.8） F/χ2 0.874 1.416 0.012 1.796 0.372 2.649 P 0.646 0.246 0.989 0.169 0.083 0.618 
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表 2 3组老年患者一般资料比较[（
$\bar x \pm s $ ）/n（%）]Table 2. Comparison of general data of three groups of elderly patients [（
$ \bar x \pm s $ ）/n（%）]组别 性别
（n）年龄
（岁）身高
（cm）体重
（kg）腹部手术 糖尿病 A组 17/13 68.73 ± 5.72 165.03 ± 6.62 67.83 ± 7.39 3（10.0） 6（20.0） B组 13/14 69.70 ± 6.22 163.15 ± 5.45 64.90 ± 7.59 3（11.1） 4（14.8） C组 21/11 68.44 ± 5.22 164.22 ± 7.32 67.28 ± 5.26 4（12.5） 5（15.6） F/χ2 1.836 0.385 0.012 1.492 0.980 0.326 P 0.399 0.681 0.989 0.231 0.952 0.849
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表 3 3组患者BBPS评分比较[（
$\bar x \pm s$ ），分]Table 3. Comparison of BBPS score in three groups of patients [（
$ \bar x \pm s $ ），points]组别 n 右半结肠评分 横结肠评分 左半结肠评分 BBPS总评分 A组 58 2.24 ± 0.47 2.22 ± 0.50 2.24 ± 0.43 6.72 ± 0.74 B组 58 2.74 ± 0.44 2.71 ± 0.46 2.67 ± 0.47 8.12 ± 0.73△ C组 58 2.72 ± 0.45 2.78 ± 0.42 2.76 ± 0.43 8.25 ± 0.79△ F 22.62 24.78 22.39 72.78 P < 0.001* < 0.001* < 0.001* < 0.001* *P < 0.05；与A组比较，△P < 0.05。
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表 4 3组中老年便秘患者（ ≥60岁）BBPS评分比较[（
$ \bar x \pm s $ ），分]Table 4. Comparison of BBPS scores in three groups of elderly patients with constipation （≥60 years old） [（
$ \bar x \pm s $ ），points]组别 n 右半结肠评分 横结肠评分 左半结肠评分 BBPS
总评分A组 30 2.17 ± 0.38 2.20 ± 0.48 2.17 ± 0.38 6.53 ± 0.63△ B组 27 2.78 ± 0.42 2.78 ± 0.42 2.74 ± 0.45 8.30 ± 0.78 C组 32 2.44 ± 0.50 2.47 ± 0.51 2.47 ± 0.51 7.38 ± 0.94△ F 13.68 10.50 11.67 34.78 P < 0.001* < 0.001* < 0.001* < 0.001* *P < 0.05；与B组比较，△P < 0.05。
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表 5 进镜时间、退镜时间、肠镜总时间比较[（
$ \bar x \pm s $ ），min]Table 5. Comparison of entry time，exit time，and total colonoscopy time [（
$ \bar x \pm s $ ），min]组别 n 进镜时间 退镜时间 肠镜总时间 A组 58 9.78 ± 2.00 9.36 ± 2.63 19.13 ± 2.96# B组 58 7.39 ± 1.49 7.40 ± 1.58 14.45 ± 1.92△ C组 58 8.07 ± 1.35 6.77 ± 1.09 15.93 ± 1.95△# F 32.78 23.72 61.40 P < 0.001* < 0.001* < 0.001* *P < 0.05；与A组比较，△P < 0.05；与B组比较，#P < 0.05。
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表 6 3组患者不良反应率的比较[n（%）]
Table 6. Comparison of adverse reaction rates among the three groups of patients [n （%）]
不良反应 A组 B组 C组 χ2 P 恶心 7（12.1） 6（10.3） 17（29.3） 8.942 0.001* 呕吐 4（6.9） 3（5.2） 12（20.7） 8.626 0.013* 嗳气 4（6.9） 5（8.6） 13（22.4） 7.597 0.022* 腹胀 6（10.3） 5（8.6） 15（25.9） 8.230 0.016* 腹痛 2（3.4） 3（5.2） 11（19.0） 10.049 0.007* 头晕 1（1.7） 2（3.4） 9（15.5） 10.204 0.006* 头痛 1（1.7） 2（3.4） 8（13.8） 8.346 0.015* 乏力 5（8.6） 4（6.9） 14（24.1） 9.118 0.010* 失眠 8（13.8） 7（12.1） 18（31.0） 8.302 0.016* *P < 0.05。
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