朱易

摘 要 目的：探討地衣芽孢杆菌活菌胶囊治疗功能性便秘（FC）的疗效。方法：收集2018年1月—2019年1月上海市杨浦区长海街道社区卫生服务中心收治的慢传输型FC患者76例，随机分为A组和B组各38例。A组口服莫沙必利片治疗，5 mg/次，3次/d；B组在A组基础上联合地衣芽孢杆菌活菌胶囊治疗，0.5 g/次，3次/d。另选同期收治的排便障碍型FC患者70例，随机分为C组和D组各35例。C组给予聚卡波非钙片治疗，1 g/次，3次/d；D组在C组基础上联合地衣芽孢杆菌活菌胶囊治疗，0.5 g/次，3次/d。各组均治疗4周，观察患者治疗前后的每周排便次数，并采用Bristol粪便性状量表及便秘患者症状自评量表（PAC-SYM）评定疗效。结果：B组治疗总有效率为92.11%（35/38），高于A组的71.05%（27/38，P<0.05）；D组治疗总有效率为94.29%（33/35），高于C组的74.29%（26/35，P<0.05）。治疗后各组每周排便次数、Bristol粪便性状评分和PAC-SYM评分均较同组治疗前有明显改善（P<0.05），且B组Bristol粪便性状评分改善优于A组（P<0.05），D组PAC-SYM评分改善优于C组（P<0.05）。结论：联合使用地衣芽孢杆菌活菌胶囊治疗FC疗效优于单用药物，值得推广。

关键词 功能性便秘；地衣芽孢杆菌活菌胶囊；莫沙必利片；聚卡波非钙片；联合治疗

中图分类号：R256.35 文献标志码：A 文章编号：1006-1533（2021）12-0027-03

Observation of the curative effect of bacillus licheniformis capsules in the treatment of functional constipation

ZHU Yi

（Department of General Practice of Changhai Community Health Service Center of Yangpu District， Shanghai 200433， China）

ABSTRACT Objective： To discuss the effect of bacillus licheniformis capsule in the treatment of functional constipation（FC）. Methods： Seventy-six slow-transit FC patients treated in Changhai Community Health Service Center of Yangpu District， Shanghai from January 2018 to January 2019 were collected and randomly divided into group A and group B with 38 cases each. Group A was treated with mosapride tablets orally， 5 mg/time， 3 times/d. On the basis of group A， group B was treated with bacillus licheniformis capsules， 0.5 g/time， 3 times/d. Another 70 patients with defecation dysfunction FC who were admitted in the same period were randomly divided into group C and group D with 35 cases each. Group C was treated with polycarbofifcalcalcium tablets， 1 g/time， 3 times/d. On the basis of group C， group D was treated with bacillus licheniformis capsule， 0.5 g/time， 3 times/d. All groups were treated for 4 weeks. The number of defecation per week before and after treatment was observed， and the Bristol stool trait scale and the self-rating symptoms of constipation scale（PAC-SYM） were used to evaluate the curative effect. Results： The total effective rate of treatment in group B was 92.11%（35/38）， which was higher than that in group A 71.05%（27/38， P<0.05）. The total effective rate of treatment in group D was 94.29%（33/35）， which was higher than that in group C 74.29%（26/35， P<0.05）. After treatment， the number of bowel movements per week， Bristol stool trait score and PAC-SYM score in each group were significantly improved compared with the same group before treatment（P<0.05）. The improvement of Bristol stool character score in group B was better than that in group A（P<0.05）， and the improvement of PACSYM score in group D was better than that in group C（P<0.05）. Conclusion： The efficiency of the combined use of bacillus licheniformis capsules in the treatment of FC is better than that of the single drug alone， which is worthy of promotion.

KEY WORDS functional constipation； bacillus licheniformis capsule； mosapride tablet； polycarbofe calcium tablet； combination therapy

功能性便秘（FC）是消化内科常见疾病，主要表现为粪便干结、排便困难，严重影响人们生活质量。我国便秘发生率3.4%～27.2%[1]，随着年龄增长而明显增加，60岁以上发病率更高，女性患病率明显高于男性。根据临床特点按照罗马Ⅲ诊断标准[2]可分为慢性传输型和排便障碍型。慢性传输型临床特点为排便次数减少、粪便干硬、排便费力、缺乏便意。排便障碍型特点为排便费力、排便不尽感、排便时肛门直肠堵塞感、需要手法辅助排便[3]。枸橼酸莫沙必利片作为一种高选择性5-羟色胺4（5-HT4）受体激动剂，能增加肠道动力、缩短结肠传输时间，常作为促动力药，治疗慢性传输型FC。聚卡波非钙片作为一种新型容积性泻药，可通过增加肠道水分，增加粪便容量，用于治疗排便障碍型FC。……