Lubiprostone muaj txiaj ntsig zoo hauv Kev Kho Mob Ntawm Kab Mob Idiopathic Constipation Thiab Irritable Plawv Syndrome: Kev Ntsuam Xyuas Txheej Txheem Thiab Meta-analysis Ntawm Randomized Controlled Trials

Kev cem quav ntev yog qhov tshwm sim thiab ntxhov siab. Kev cem quav tuaj yeem tshwm sim los ntawm ntau yam ua rau, nrog rau kev ua haujlwm (tseem hu ua idiopathic) ua rau ntau tshaj. Muaj ntau ntau yam tshuaj rau kev kho mob ntawm idiopathic cem quav. Ntawm

Kev cem quav ntev yog qhov tshwm sim thiab ntxhov siab. Kev cem quav tuaj yeem tshwm sim los ntawm ntau yam ua rau, nrog rau kev ua haujlwm (tseem hu ua idiopathic) ua rau ntau tshaj. Muaj ntau ntau yam tshuaj rau kev kho mob ntawm idiopathic cem quav. Ntawm lawv, lubiprostone accelerates plab hnyuv motility thiab txhawb nqa defecation los ntawm ib tug secretory mechanism. Nws muaj txiaj ntsig zoo rau mob plab idiopathic constipation (CIC) thiab chim siab plob tsis so tswj nrog cem quav (IBS-C). , opioid-induced cem quav tag nrho muaj cov kev kho mob zoo.

Nyem rau tam sim cem quav cov neeg laus

Cov kws tshawb fawb los ntawm Tuam Tshoj Lub Tsev Kawm Ntawv Tub Rog Thib Peb (tam sim no hloov npe hu ua Army Medical University ntawm Tuam Tshoj Cov Neeg Liberation Army) tau ua qhov kev tshuaj xyuas thiab kev tshuaj ntsuam xyuas ntawm randomized placebo-tswj kev sim ntawm lubiprostone hauv kev kho mob ntawm CIC thiab IBS-C thiab ntsuas lubiprostone. Kev ua tau zoo thiab kev nyab xeeb hauv ob qho tib si kab mob. Txoj kev tshawb no tau luam tawm nyob rau hauv Mayo Clinic Journal (kawg IF: 8.9).

Txoj kev tshawb fawb

Cov kws sau ntawv tau tshawb nrhiav MEDLINE, Cochrane, Google Scholar, thiab ClinicalTrials.gov databases txij lub Ib Hlis 1, 2005, txog Lub Ib Hlis 31, 2015.

Cov txheej txheem suav nrog yog: ① Randomized controlled trials (RCT); ② Kev kuaj mob lossis CIC lossis IBS-C; ③ Lubiprostone ua cov kev cuam tshuam loj. Cov khoom uas tsis yog kev sib piv ntawm cov placebo, cem quav vim yog lwm yam ua rau, tsis yog lus Askiv, kev sib txuas lus, kev tshuaj xyuas, kev kho, thiab cov ntaub ntawv xov xwm tsis suav nrog.

Cov txiaj ntsig tau txais txiaj ntsig suav nrog kev mob plab zom mov hauv ib lub lis piam, cem quav hnyav, quav quav, mob plab / tsis xis nyob, tso quav tso quav, thiab plab plab ntawm 1 lub lis piam, 1 hlis, thiab 3 lub hlis tom qab siv tshuaj.

Kev tshawb fawb tshwm sim

246 cov ntaub ntawv raug txheeb xyuas los ntawm kev tshawb nrhiav, thiab 8 cov ntaub ntawv (9 qhov kev sim) thaum kawg suav nrog hauv kev tshuaj ntsuam meta. Muaj tag nrho ntawm 2309 tus neeg mob, suav nrog 1468 tus neeg mob hauv pab pawg kho mob lubiprostone (sau npe rau 63.6%) thiab 841 tus neeg mob hauv pawg placebo (sau suav txog 36.4%). Zuag qhia tag nrho, cov kev tshawb fawb suav nrog muaj kev tsis ncaj ncees me ntsis.

1. Muaj pes tsawg lub plab zom mov hauv ib lub lis piam

Tag nrho cov kev kho mob ua ke ntawm lubiprostone yog ntau dua li cov placebo (cov qauv sib txawv ntawm qhov nruab nrab yog {{0}}}.419; 95% CI: 0.088 ~ 0.750; P<0.001). The number of spontaneous bowel movements at 1 week and 1 month was significantly higher in patients treated with lubiprostone than in patients treated with placebo.

2. Kev cem quav hnyav heev

Tag nrho cov kev kho mob ua ke ntawm lubiprostone yog ntau dua li cov placebo (cov qauv sib txawv ntawm qhov nruab nrab yog {{0}}}.379; 95% CI: 0.207 ~ 0.550; P<0.001). Constipation severity was higher in the lubiprostone treatment group than in the placebo group at all time points, but the difference was statistically significant only at 1 week and 1 month after treatment.

3. Cov yam ntxwv ntawm quav

Tag nrho cov kev kho mob ua ke ntawm lubiprostone yog ntau dua li cov placebo, nrog rau cov qauv sib txawv ntawm qhov nruab nrab ntawm {{0}}.884 (95% CI, 0.072 txog 1.695; P=0. 03). Ib lub lis piam thiab ib hlis tom qab kev kho mob, cov khoom fecal ntawm pab pawg kho mob lubiprostone tau zoo dua li cov placebo pab pawg.

4. Mob plab / tsis xis nyob

Muaj qhov sib txawv ntawm tag nrho cov kev kho mob sib xyaw ua ke ntawm lubiprostone thiab cov placebo, nrog rau cov qauv sib txawv ntawm qhov kev hloov pauv yog {{0}}}.297 (95% CI: 0.024 txog 0.569. ; P=0.03). Qib ntawm qhov mob plab / tsis xis nyob tom qab 1 lub lis piam ntawm kev kho mob yog qhov sib txawv ntawm ob pawg.

5. Straining thaum defecation

Muaj qhov sib txawv ntawm tag nrho cov kev kho mob sib xyaw ua ke ntawm lubiprostone thiab cov placebo, qhov sib xyaw ua ke sib txawv ntawm qhov kev hloov pauv yog {{0}}.421; 95% CI: 0.209 ~ 0.633; P<0.0010). The degree of defecation straining after 1 week and 1 month of treatment was significantly different between the two groups.

6. Kev mob plab plab

Muaj qhov sib txawv ntawm tag nrho cov kev kho mob sib xyaw ua ke ntawm lubiprostone thiab placebo, qhov sib xyaw ua ke sib txawv ntawm qhov kev hloov pauv yog {{0}}.169; 95% CI: 0.092 ~ 0.246; P<0.001). Improvement in abdominal distension was significantly better in the lubiprostone-treated group than in the placebo-treated group at all time points.

7. Kev tsom xam pab pawg

Cov kws tshawb fawb tau soj ntsuam cais ntawm cov neeg mob CIC thiab cov neeg mob IBS-C. Cov txiaj ntsig tau pom tias tom qab 1 lub hlis ntawm kev kho mob nrog lubiprostone, tag nrho cov txiaj ntsig ntawm CIC cov neeg mob tau zoo tuaj. Tsuas yog kev txhim kho mob plab / tsis xis nyob thiab mob plab hauv cov neeg mob IBS-C, uas tsis ncav cuag qhov tseem ceeb piv nrog cov placebo, tag nrho lwm cov txiaj ntsig tau tshwm sim kuj tau txhim kho zoo. Zuag qhia tag nrho, qhov cuam tshuam loj ntawm kev kho lubiprostone ntawm tus naj npawb ntawm cov plab hnyuv siab raum hauv ib lub lis piam thiab lub zog thaum lub plab zom mov tau siab dua rau cov neeg mob CIC (P=0.01).

8. Kev ruaj ntseg

Qhov tshwm sim ntawm cov xwm txheej tsis zoo yog tsawg (<5% in all studies) and mostly unrelated to treatment. The most common adverse events are gastrointestinal adverse reactions, such as nausea, vomiting, or diarrhea.

Kev xaus thiab kev xav

Cov kev tshawb fawb suav nrog hauv txoj kev tshawb no yog tag nrho cov RCTs tsom rau cov neeg mob CIC lossis IBS-C, nrog lubiprostone ua kev kho mob tseem ceeb. Cov txiaj ntsig tau pom tias lubiprostone tuaj yeem txo qis cem quav, txhim kho cov quav hauv plab, thiab txo qhov mob plab, ntuav, thiab mob plab (kev txhim kho plab tsis tseem ceeb ntawm 1 lub hlis) tom qab 3 lub hlis ntawm cov tshuaj. Ib lub hlis tuaj yeem txo qis plab plab. Thaum 3 lub hlis ntawm kev kho mob, cov txiaj ntsig ntawm lubiprostone piv nrog cov placebo ntawm lwm cov ntsiab lus kawg tsis tau ncav cuag qhov tseem ceeb, uas tej zaum yuav cuam tshuam nrog cov ntaub ntawv txwv tsis pub muaj rau kev tshuaj xyuas. 3-cov ntaub ntawv lub hli tau los ntawm tsuas yog 2 kab lus (tag nrho ntawm 3 RCTs) nrog cov lus xaus sib xyaw, ib qho uas pom tau tias kev txhim kho hauv pawg lubiprostone tau loj dua li cov placebo hauv tag nrho 6 qhov kawg ntawm 3 lub hlis. . Pab pawg. Tsis tas li ntawd, kev txheeb xyuas cov ntaub ntawv hauv ob kab lus no tau ua raws li kev xav-rau-kho cov pej xeem. Tej zaum yuav muaj qee tus neeg mob tsis siv tshuaj thaum ntxov vim tias lawv tau txiav txim tias "ua tiav hauv kev kho mob," uas tuaj yeem ua rau muaj qhov tsis txaus ntseeg ntawm cov txiaj ntsig ntawm lubiprostone.

Kev tsom xam pab pawg pom tau hais tias nyob rau hauv cov neeg mob nrog CIC, kev kho lubiprostone tuaj yeem txhim kho tag nrho cov txiaj ntsig tau soj ntsuam, thaum nyob rau hauv cov neeg mob nrog IBS-C, lubiprostone tuaj yeem ua rau muaj qhov ua rau lub plab zom mov, txo qis kev cem quav, thiab txhim kho cov quav. thiab txo qis hauv qhov quav, tab sis tsis tshua muaj kev txhim kho hauv plab mob / tsis xis nyob thiab ua rau lub plab zom mov. Qhov no kuj qhia txog qhov sib txawv ntawm cov kab mob pathogenesis thiab cov tsos mob ntawm CIC thiab IBS-C.

Lubiprostone cov txheej txheem ntawm kev ua yog txawv ntawm lwm cov tshuaj siv los kho CIC thiab IBS-C. Raws li bicyclic fatty acid compound muab los ntawm prostaglandin metabolites, lubiprostone tuaj yeem qhib hom 2 chloride ion channels hauv apical membrane ntawm plab hnyuv epithelial hlwb, ua kom cov kua dej tso rau hauv plab, thiab txhawb txoj hnyuv motility, yog li txhim kho cem quav. Cov tshuaj yuav luag tsis nqus tom qab kev tswj hwm qhov ncauj, cov tshuaj concentration yuav luag tsis tuaj yeem kuaj pom hauv plasma, thiab nws tau txais txiaj ntsig zoo. Tsuas yog cov xwm txheej tsis zoo tshwm sim thaum siv tshuaj, xws li xeev siab thiab ntuav, uas tuaj yeem cuam tshuam nrog kev qeeb me ntsis ntawm lub plab khoob los ntawm lubiprostone. Kev noj tshuaj nrog dej thiab zaub mov tuaj yeem pab txo qis qhov tshwm sim ntawm xeev siab.

Hauv cov ntsiab lus, qhov kev tshuaj xyuas thiab kev tshuaj ntsuam xyuas meta no qhia tau tias lubiprostone muaj kev nyab xeeb thiab siv tau rau lub sijhawm luv (3 lub hlis) kev kho mob ntawm CIC thiab IBS-C.

Ntuj Herbal Tshuaj Rau Relieving cem quav-Cistanche

Cistanche yog ib tug genus ntawm parasitic nroj tsuag uas belongs rau tsev neeg Orobanchaceae. Cov nroj tsuag no paub txog lawv cov khoom siv tshuaj thiab tau siv hauv Cov Tshuaj Suav Tshuaj (TCM) rau ntau pua xyoo. Cov hom Cistanche feem ntau pom muaj nyob hauv thaj av qhuav thiab suab puam ntawm Tuam Tshoj, Mongolia, thiab lwm qhov chaw ntawm Central Asia. Cistanche nroj tsuag yog tus cwj pwm los ntawm lawv cov nqaij tawv, yellowish stems thiab muaj nuj nqis heev rau lawv cov txiaj ntsig kev noj qab haus huv. Hauv TCM, Cistanche ntseeg tau tias muaj cov khoom siv tonic thiab feem ntau yog siv los kho lub raum, txhim kho qhov tseem ceeb, thiab txhawb kev ua haujlwm ntawm kev sib deev. Nws kuj yog siv los daws cov teeb meem ntsig txog kev laus, qaug zog, thiab kev noj qab haus huv tag nrho. Thaum Cistanche muaj keeb kwm ntev ntawm kev siv tshuaj ib txwm siv, kev tshawb fawb tshawb fawb txog nws txoj kev ua tau zoo thiab kev nyab xeeb yog tsis tu ncua thiab txwv. Txawm li cas los xij, nws paub tias muaj ntau yam bioactive tebchaw xws li phenylethanoid glycosides, iridoids, lignans, thiab polysaccharides, uas tuaj yeem ua rau nws cov teebmeem tshuaj.

Wecistanche covcistanche hmoov, cistanche ntsiav tshuaj, cistanche capsules, thiab lwm yam khoom tsim los sivsuab puamcistancheraws li cov khoom siv raw, txhua yam muaj txiaj ntsig zoo rau kev tshem tawm cem quav. Cov txheej txheem tshwj xeeb yog raws li hauv qab no: Cistanche ntseeg tau tias muaj cov txiaj ntsig zoo rau kev tshem tawm cem quav raws li nws cov kev siv ib txwm siv thiab qee cov tshuaj uas nws muaj. Txawm hais tias kev tshawb fawb tshawb fawb tshwj xeeb ntawm Cistanche qhov cuam tshuam rau cem quav yog txwv, nws tau xav tias muaj ntau lub tswv yim uas yuav ua rau nws muaj peev xwm txo tau cem quav. Laxative nyhuv: Cistanche tau ntev tau siv nyob rau hauv Tsoos Suav Tshuaj raws li ib tug tshuaj rau cem quav. Nws ntseeg tau tias muaj cov nyhuv laxative me me, uas tuaj yeem pab txhawb kev zom zaub mov thiab ua rau cem quav. Cov nyhuv no tuaj yeem raug ntaus nqi rau ntau lub tebchaw nyob hauv Cistanche, xws li phenylethanoid glycosides thiab polysaccharides. Moistening cov hnyuv: Raws li kev siv ib txwm siv, Cistanche suav hais tias muaj cov khoom siv moisturizing, tshwj xeeb yog tsom rau cov hnyuv. Txhawb nqa dej thiab lubrication ntawm cov hnyuv yuav pab tau cov cuab yeej soften thiab yooj yim dua, yog li no relieving cem quav. Anti-inflammatory Effect: cem quav tej zaum yuav txuam nrog o nyob rau hauv lub plab zom mov. Cistanche muaj qee qhov sib txuas, suav nrog phenylethanoid glycosides thiab lignans, uas ntseeg tau tias muaj cov tshuaj tiv thaiv kab mob. Los ntawm kev txo cov kab mob hauv cov hnyuv, nws tuaj yeem pab txhim kho kev zom zaub mov tsis tu ncua thiab txo qhov cem quav.