聚乙二醇(PEG),比沙科迪尔,据报道,在治疗便秘患者方面,普鲁卡必利比安慰剂更有效,但仍有约50%的患者对这些药物没有反应。只有比沙可啶和普鲁卡必利有望在体内直接刺激人的结肠运动。由于以前的研究没有这样做,这项研究的目的是调查PEG的作用,比沙科迪尔,与安慰剂相比,通过高分辨率测压(HRM)评估健康受试者的结肠运动。
10名健康受试者参加了急性、开放标签,随机化,读者失明,交叉研究,并要求接受结肠镜辅助的HRM,测量其结肠运动前后口服13.8g(两个剂量)PEG,10毫克比沙可啶,2毫克普鲁卡必利,和安慰剂。
在人类准备的结肠中,口服PEG显着增加低振幅长距离传播收缩的数量(p=0.007vs安慰剂),而比沙可迪显着增加高振幅传播收缩(HAPC)的数量(所有p<0.01vsPEG,普鲁卡必利,和安慰剂)。Prucalopride对传播收缩的数量没有主要影响,但增加了HAPCs的振幅(p=0.01)。
在人类中,PEG,普鲁卡必利,比沙可啶对结肠运动有明显的影响。这些信息有临床意义,因为它表明普鲁卡必利和比沙可啶的组合,通常在临床实践中不考虑,可有效治疗单一药物难治性便秘患者。
Polyethylene glycol (PEG), bisacodyl, and
prucalopride have been reported to be more effective than placebo in treating patients with constipation but about 50% of the patients still do not respond to these medications. Only bisacodyl and
prucalopride are expected to directly stimulate the colonic motility in humans in vivo. As no previous
study has done this, the aim of the
study was to investigate the effect of PEG, bisacodyl, and prucalopride as compared to placebo on colonic motility assessed by means of the high-resolution manometry (HRM) in healthy subjects.
Ten healthy subjects have been enrolled in an acute, open label, randomized, reader-blinded, crossover
study and requested to undergo a colonoscopy-assisted HRM measuring their colonic motility before and after oral administration of 13.8 g (two doses) PEG, 10 mg bisacodyl, 2 mg prucalopride, and placebo.
In the human prepared colon, oral administration of PEG significantly increases the number of low-amplitude long distance propagating contractions (p = 0.007 vs placebo) while bisacodyl significantly increases the number of high-amplitude propagating contractions (HAPCs) (all p < 0.01 vs PEG, prucalopride, and placebo). Prucalopride has no major effect on the number of propagating contractions but increases HAPCs amplitude (p = 0.01).
In humans, PEG,
prucalopride, and bisacodyl have distinct effects on colonic motility. This information has clinical implication, as it indicates that the combination of prucalopride and bisacodyl, normally not considered in clinical practice, could be effective in treating patients with constipation refractory to single medications.