Cohortes de premedicación en endoscopia alta con simeticona, N-acetilcisteína, Hedera helix y validación de la escala visual / Cohorts of premedication for endoscopy of the upper gastrointestinal tract with simethicone, N-acetylcysteine, Hedera helix and visual scale validation

Resumen Los parámetros de calidad para endoscopia digestiva alta han introducido indicadores intraprocedimiento, dentro de los cuales la adecuada visibilidad de la mucosa, libre de saliva, moco o burbujas, puede aumentar la posibilidad de detección de lesiones en fase temprana. Sin embargo, el uso de mucolíticos y antiburbujas ha mostrado gran variabilidad de eficiencia según las soluciones, concentraciones, tiempos de exposición y escala de visibilidad aplicados. Objetivos: determinar la efectividad de diferentes soluciones de premedicación para la limpieza de la mucosa digestiva; validar, mediante una prueba de concordancia interobservador, una nueva escala de adecuada visualización de la mucosa (TVMS) para el esófago, estómago y duodeno; y reportar eventos adversos o complicaciones relacionadas con las soluciones utilizadas y los procedimientos realizados. Material y métodos: estudio de cohortes prospectivas comparativas. Se incluyeron 412 pacientes adultos, ASA I y ASA II, para endoscopia diagnóstica bajo sedación consciente, distribuidos en 6 cohortes similares, divididas en dos grupos: no premedicación, 2 cohortes C1 (ayuno de 6 a 8 horas)y C2 (agua 100 mL); premedicación, 4 cohortes C3 a C6 (C3: agua 100 m L + simeticona 1000 mg; C4: agua 100 mL + simeticona 200 mg + N-acetilcisteína 600 mg; C5: agua 100 mL + simeticona 200 mg + N-acetilcisteína 1000 mg; C6: agua 100 mL + simeticona 200 mg + Hedera helix 70 mg). Se ingirió la solución 15 a 30 minutos antes del paso por cricofaríngeo. Se realizó la prueba de Kappa para medir la concordancia interobservador de la escala TVMS. Resultados: De 412 pacientes, 58% fueron de sexo femenino; 23% (136) fue de cohortes C1 y C2 y 67% (276) fue de cohortes C3 a C6. El tiempo medio de exposición a cada solución fue de 24,4 minutos. El volumen de lavado para lograr una adecuada visualización fue significativamente diferente entre ambos grupos: en los pacientes con premedicación se utilizaron 75,6 mL, mientras que en los pacientes sin premedicación se utilizaron 124 mL (p = 0,000), con una calidad de TVMS excelente de 88,7% frente al 41,4%, respectivamente. La cohorte C4 (agua 100 mL + simeticona 200 mg + N-acetilcisteína 600 mg) mostró ser la más efectiva con una diferencia significativa (p = 0,001) frente a C1 (ayuno) y C2 (placebo con agua 100 mL), y también tuvo una eficiencia superior frente a C3, C5 y C6 en su orden. No se presentaron eventos adversos o complicaciones en relación con la endoscopia, la sedación y los productos usados en la premedicación. Conclusiones: la solución más efectiva como premedicación para lograr una excelente visibilidad de la mucosa digestiva correspondió a la cohorte C4 (SIM 200 + NAC 600 + H2O 100 mL). La escala TVMS propuesta es una herramienta muy completa y fácil de aplicar por más de un observador. La premedicación ingerida, con antiburbuja, mucolítico y agua hasta 100 mL, entre 15 y 30 minutos previos a endoscopia, es segura en las condiciones descritas en este estudio.

Abstract Quality parameters for upper gastrointestinal endoscopy have introduced intraprocedural indicators, including adequate mucosal visualization free of saliva, mucus, or bubbles, which may increase the possibility of early-stage injury detection. The use of mucolytics and anti-foaming agents has shown great efficiency variability depending on the type of solution, concentrations, exposure times and visibility scale applied. Objectives: To determine the effectiveness of different premedication solutions for cleaning the digestive mucosa; to validate, by means of an interobserver concordance test, a new scale for the adequate visualization of the mucosa (TVMS) for the esophagus, stomach, and duodenum; and to report adverse events or complications associated with the solutions used and the procedures performed. Material and methods: Prospective, comparative cohort study. 412 adult patients, ASA I and ASA II, were included for diagnostic endoscopy under conscious sedation. They were distributed in 6 similar cohorts and divided into two groups: non-premedication, 2 in C1 (fasting 6 to 8 hours) and C2 (water 100 mL) cohorts; premedication, 4 C3 to C6 cohorts (C3: water 100 mL + simethicone 1000 mg; C4: water 100 ml + simethicone 200 mg + N-acetylcysteine 600 mg; C5: water 100 ml + simethicone 200 mg + N-acetylcysteine 1000 mg; C6: water 100 ml + simethicone 200 mg + Hedera helix 70 mg). The solution was swallowed 15 to 30 minutes passing through the cricopharyngeus muscle. The Kappa test was performed to measure interobserver concordance of the TVMS scale. Results: Of 412 patients, 58% were female; 23% (136) were included in the C1 and C2 cohorts; and 67% (276) were in the C3 to C6 cohorts. The average exposure time to each solution was 24.4 minutes. The wash volume for proper visualization was significantly different between the two groups. In premedicated patients, 75.6 mL of solution were used, while in patients without premedication, 124 mL were used (p = 0.000), with an excellent quality of TVMS of 88.7% versus 41.4%, respectively. The C4 cohort (water 100 mL + simethicone 200 mg + N-acetylcysteine 600 mg) was the most effective with a significant difference (p= 0.001) compared with the C1 (fasting) and C2 (placebo with water 100 mL) cohorts. It also had better efficiency compared to the C3, C5 and C6 cohorts in that order. There were no adverse events or complications associated with endoscopy, sedation, or premedication products. Conclusions: The most effective solution as a premedication to achieve excellent visibility of the digestive mucosa was that used in the C4 cohort (SIM 200 + NAC 600 + H2OR 100 mL). The proposed TVMS scale is a very complete and easy tool to apply by more than one observer. Premedication ingested, with anti-foam, mucolytic and water up to 100 mL, between 15 and 30 minutes before endoscopy, is safe under the conditions described in this study.

Effect of polyethylene glycol combined with simethicone on Boston intestinal preparation scale score and tolerance in patients undergoing colonoscopy / 中国综合临床

Objective:To investigate the effect of polyethylene glycol combined with simethicone on boston bowel preparation scale(BBPS) score and tolerance in patients with colonoscopy.Methods:From January 2018 to January 2019, 220 patients who underwent colonoscopy in Beijing Shijitan Hospital Affiliated to Capital Medical University were selected as the research objects.According to different bowel preparation schemes, they were divided into control group and observation group, 110 cases in each group.In the control group, 4 bags of compound polyethylene glycol electrolyte powder were added with cold boiled water to prepare 4 L solution for intestinal preparation.Starting 6 hours before endoscopy, 1 L solution was taken every hour, and the interval from the last time to the beginning of colonoscopy was≤4 h. On the basis of the control group, the observation group was given 30 mL simethicone emulsion 4 hours before endoscopy on the basis of the control group.The BBPS score, intracavitary liquid volume score, total score, tolerance and adverse reactions were compared between the two groups.Results:The whole colon score (7.16±0.61), left colon score (2.89±0.62), transverse colon score (2.78±0.64) and right colon score (1.58±0.49), intestinal cavity fluid score (1.47±0.48) and total score (8.84±0.87) of the observation group were higher than those of the control group ((5.13±0.76), (2.23±0.86), (2.15±0.76), (1.14±0.16), (0.91±0.55), (7.11±1.04)), and the differences were statistically significant ( t=21.854, 6.532, 6.652, 8.957, 8.054, 13.380, all P<0.05). The tolerance of the observation group (90.00%(99/110)) was higher than that of the control group (81.81%(90/110)), but the difference was not statistically significant( χ 2=3.043, P=0.081). The incidence of abdominal distension in the observation group (1.82%(2/110)) was lower than that in the control group (8.18%(9/110)), the difference was statistically significant(χ 2=4.690, P<0.05), and there was no significant difference in the incidence of electrolyte disorder, nausea and vomiting, hypoglycemia or hunger, palpitation and chest tightness between the two groups (all P>0.05). Conclusion:The application of polyethylene glycol combined with Spanish silicone oil in intestinal preparation can improve the intestinal cleanliness of patients, but does not increase the tolerance of patients compared with polyethylene glycol alone, but significantly reduces the incidence of abdominal distension.

Quality of life and psychometric evaluation of patients diagnosed with irritable bowel syndrome: an observational cohort study

ABSTRACT BACKGROUND: Very few data are available for evaluating health-related quality of life among people with irritable bowel syndrome (IBS) and even fewer data are available in relation to anxiety and depression status among these patients. OBJECTIVES: To evaluate the quality of life, anxiety and depression status of patients with IBS. DESIGN AND SETTING: Observational cohort study conducted in a tertiary-care university hospital. METHODS: Patients who had recently been diagnosed with IBS and who had been followed up for IBS-specific treatment for at least three months were included. A quality of life (QoL) survey, the Beck Anxiety Index (BAI) and the Hamilton Depression Index (HAM-D) were applied to the patients. RESULTS: In total, 274 patients with IBS were included in the study cohort. These patients presented very high baseline scores for anxiety and depression, and very poor QoL results. CONCLUSION: Our study showed that IBS had a very high impact on these patients, regarding their anxiety and depression levels, alongside very poor results relating to quality of life.

A influência do uso da simeticona nos resultados do exame salivar: estudo preliminar / The influence of simethicone use on salivary examination results: preliminary study

Introdução: o uso da simeticona após coleta salivar é pouco descrito na literatura, sendo indicado para a obtenção de quantitativo maior da amostra. Todavia poucos são os estudos sobre a possível interferência dessa substância nos resultados do exame salivar. Objetivo: Avaliar as propriedades físico-químicas de duas marcas de simeticona e verificar se o fármaco interfere nos resultados do exame salivar. Metodologia: o estudo foi realizado no Laboratório de Bioquímica Oral (ICS/UFBA). Na etapa in vitro, avaliou-se o potencial hidrogeniônico (pH), a acidez titulável total (ATT) e a presença de sólidos solúveis totais (SST) na simeticona das marcas A e B. Na etapa in vivo, foi avaliada a velocidade do fluxo salivar (VFS), pH e a capacidade tampão (CT) na amostra salivar de 23 voluntários, comparando-se os resultados sem e com o uso das medicações (marcas A e B). Resultados: as duas marcas estudadas obtiveram pH menor que o neutro, e os valores de ATT para obtenção do pH 7 foram maiores na marca A. Ambas apresentaram valores elevados de SST. Na etapa in vivo, 78,3% da amostra era de mulheres, com idade média de 21,1 anos e VFS dentro da normalidade. Não houve diferença estatística entre o VFS (p=0,022) e pH (p=0,419) entre os grupos estudados, enquanto os valores da CT relativos ao uso da simeticona da marca A foram diferentes em comparação com os dos dois outros grupos (p=0,005). Conclusão: as propriedades laboratoriais das marcas de simeticona estudadas apresentaram diferenças entre si. O uso da marca A parece ter interferido na CT da saliva coletada.

Introduction: the use of simethicone after salivary collection is controversial in the literature, being indicated to obtain a larger quantity of sample. However, there are few studies on its interference in salivary examination results. Objective: to evaluate the physical and chemical properties of two brands of simethicone. Also, check if the drug interferes with salivary examination results. Methodology: the study was conducted at the Oral Biochemistry Laboratory of ICS / UFBA. In the in vitro stage, the hydrogen potential (pH), the total titratable acidity (TTA) and the presence of total soluble solids (TSS) in the A and B simethicone brands were evaluated. In the in vivo step the salivary flow rate (SFR) was evaluated; also pH and buffer capacity (BC) in the salivary sample of 23 volunteers, comparing the results without and with the use of medications (brands A and B). Results: the two studied brands had lower pH than neutral and the TTA values to obtain pH 7 were higher in brand A. Both presented high values of TSS. In the in vivo stage, 78.3% of the sample was women, with a mean age of 21.1 years and normal SFR. There was no statistical difference between SFR (p = 0.022) and pH (p = 0.419) between the studied groups, while the TCs values for the use of brand A simethicone were different compared to the other two groups (p = 0.005). Conclusion: the laboratory properties of the simethicone brands studied differed from each other. The use of brand A seems to have interfered with the collected saliva BC.

Influencing factors of different bowel preparation regimens on the quality of colonoscopy / 中华消化杂志

Objective To explore the influencing factors of different bowel preparation before colonoscopy on the intestinal cleanliness and polyp detection rate .Methods From March to August in 2018, at the Center of Endoscopy of Huashan Hospital Affiliated to Fudan University , the patients who underwent colonoscopy were selected and their general data of bowel preparation regimens were collected .Self-factors of the patients, different bowel preparation regimens , bowel preparation quality and polyp detection rate were observed.The quality of bowel preparation was evaluated by Boston bowel preparation scale (BBPS).T test, and analysis of variance and chi-square test were used for statistical analysis .Results Among 1008 patients who underwent colonoscopy , there were 506 males and 502 females, and average age was (57.3 ±13.7) years. There were statistically significant differences in BBPS score of patients with different body mass index (BMI), Parkinson disease and history of abdominal surgery (F=3.319, t=-2.060 and -2.544;all P<0.05).The BBPS score of patients with three-day low residue diet before examination was higher than that of those without preparation before examination (6.04 ±2.50 vs.5.54 ±2.73), and the difference was statistically significant (t=2.514, P=0.010).The BBPS scores of 2000 mL polyethylene glycol electrolyte lavage solution (PEG) taken once , 2000 mL PEG taken separately , 3000 mL PEG taken once and 3000 mL PEG taken separately were 5.06 ±2.88, 6.11 ±2.44, 5.94 ±2.32 and 6.10 ±2.47, respectively, and the difference was statistically significant (F=7.242,P<0.01).There were significant differences in polyp detection rates among the patients with different age , gender, BMI, and with history of constipation , hypertension and diabetes mellitus (χ2 =33.170, 8.489, 12.024, 4.034, 26.790, 10.381;all P<0.05).The polyp detection rate of patients with oral methyl silicone oil was higher than that of patients without oral methyl silicone oil (52.6％, 30/57 vs.29.7％, 221/744), and the difference was statistically significant (χ2 =12.934, P<0.01).Age (odds ratio (OR)=1.328, 95％confidence interval (CI) 1.162 to 1.517) and BMI (OR=1.412, 95％CI 1.115 to 1.787) were independent risk factors for polyp detection rate .Conclusions Parkinson disease, history of abdominal surgery and BMI are the related factors affecting the quality of bowel preparation before colonoscopy .Age and BMI are independent risk factors for polyp detection rate .

Aplicación de una escala de visualización de la mucosa gástrica, durante la esofagogastroduodenoscopia en pacientes premedicados con N-acetilcisteína más simeticona: experiencia en Ocaña, Norte de Santander / Experience in Ocaña, Norte de Santander, with a Scale for Visualization of the Gastric Mucosa during Esophagogastroduodenoscopy in Patients Medicated with N-acetylcysteine plus Simethicone

Resumen Introducción: la visibilidad de la mucosa gástrica puede verse limitada por el moco adherente y la formación de burbujas durante la endoscopia de vías digestivas altas. Objetivos: conocer los puntajes de visualización de la mucosa gástrica y el número de lavados para aclarar la superficie gástrica de burbujas y espumas, aplicando la escala de Kuo modificada por Chang en pacientes premedicados antes de la esofagogastroduodenoscopia. Materiales y métodos: estudio descriptivo, prospectivo, se incluyeron 120 pacientes entre octubre y diciembre de 2016 a los que se les premedicó con N-acetilcisteína (NAC) al 4%, 400 mg (10 cc) más simeticona (SIM) (dimetilpolisiloxano) 133,3 mg (2 cc) y agua tibia 100 cc, 20 minutos antes del procedimiento; los datos se tabularon en Excel y, ulteriormente, sus frecuencias y porcentajes se analizaron con el paquete estadístico Epi Info CDC (versión 7,2 para Windows, Estados Unidos); se consideró significancia estadística una p <0,05. Resultados: la puntuación total de visibilidad de la mucosa gástrica considerada como óptima con un puntaje de 4 fue 57 (47,50%), con 5 puntos fueron 36 (30%), con 6 y 7 puntos 10 (8,33%), con 8 puntos 6 (5%) y, por último, con 9 puntos 1 (0,83%); no hubo casos en las puntuaciones de 10 a 16. 100 (83,3%) pacientes no necesitaron lavados adicionales con agua para visualizar la mucosa gástrica, contra 13 (10,83%) que requirieron menos de 50 cc y 7 (5,83%) que necesitaron más de 50 cc (p = 0,00). Limitaciones: un solo observador realizó el estudio, lo que pudo generar sesgos de detección; además, la muestra es pequeña. Conclusiones: con la administración de una solución de NAC más SIM diluidas en 100 cc de agua tibia previa a la endoscopia de vías digestivas altas se obtuvo una visualización óptima de la mucosa gástrica en la mayoría de los casos y se observó la necesidad de un menor volumen de agua para aclarar la cavidad gástrica de moco y espuma.

Abstract Introduction: During upper digestive tract endoscopy, visibility of the gastric mucosa can be limited by adherent mucus and bubbles. Objectives: This is a study of visualization of the gastric mucosa and the number of washes needed to clear bubbles and foam from the gastric surface. The modified Kuo scale by Chang was used with patients medicated prior to esophagogastroduodenoscopy. Materials and methods: This is a descriptive and prospective study of 120 patients who were medicated with 400 mg (10cc) of 4% N-acetylcysteine plus 133.3 mg (2cc) of simethicone (Dimethylpolysiloxane) and 100 cc of warm water 20 minutes prior to esophagogastroduodenoscopy from October to December 2016. Data were tabulated in Excel and frequencies and percentages were analyzed using the Epi Info statistical package from the Centers for Disease Control version 7.2 for Windows. Statistical significance was considered to be p <0.05. Results: The optimal score for total visibility of four was achieved 57 patients (47.50%). Thirty-six patients (30%) had scores of five points, ten patients (8.33%) had scores of six or seven points, six patients had scores of eight points (5%), and one patient (0.83%) had a score of nine points. There were no scores from 10 to 16. Hundred patients (83,3%) did not need additional washes with water to visualize the gastric mucosa, thirteen patients (10,83%) required less than 50 cc, and seven (5,83%) required more than 50 cc (p = 0.00). Limitations: This study was done by a single observer which could result in detection biases. Also, the sample is small. Conclusions: Administration of a solution of N-acetylcysteine ​​plus Simethicone diluted in 100 cc of warm water prior to upper digestive tract endoscopy provides for optimal visualization of the gastric mucosa in most cases. A smaller volume of water was needed to clear the gastric cavity of mucus and foam.

Effects of pre?procedure simethicone on detection of pharynx by upper gastrointestinal endoscopy / 中华消化内镜杂志

Objective To evaluate the clinical efficacy of pre-procedure simethicone on detection of pharynx by upper gastrointestinal endoscopy. Methods A total of 100 patients with esophageal squamous cell carcinomas ( ESCCs) were enrolled in this prospective controlled trial and randomly assigned into two groups. The study group was given gargle with 5 mL simethicone plus 5 mL water combined with conventional procedure before gastroscopy. The control group was prepared according to the conventional procedure. The age, gender, tumor stage, lesion size, doctor＇s satisfaction and examination time between two groups were analyzed. Results The basic conditions between the two groups, including age, gender, and tumor stage were not significantly different (all P＞0. 05). The detection rate of superficial lesion in pharynx was higher in the study group than that in the control group, with no significant difference [8. 16%(4/49) VS 2. 04%( 1/49), P＝0. 362]. The median time of pharyngeal observation in the study group was less than that in the control group (21. 7 s VS 33. 9 s, P＝0. 000). The doctor was more satisfied in the study group than the control group (P＝0. 001). Conclusion Pre-procedure with simethicone improves the endoscopic visibility and detection rate of superficial squamous cell carcinoma with less observation time.

Application of simethicone before colonoscope examination / 中国内镜杂志

Objective To explore the application effect of simethicone combined with compound polyethylene glycol electrolyte powder before colonoscope examination. Methods 106 cases underwent colonoscope examination from October 2013 to December 2015 were enrolled in the study. Then all the cases were divided into 2 groups randomly, each with 53 cases. Patients in the control group were treated with simple oral administration of compound polyethylene glycol electrolyte powder, patients in observation group were combined using simethicone and polyethylene glycol electrolyte powder. The preoperative bowel preparation score, lesion detection and the changes of liver and renal function and electrolyte in the two groups were recorded respectively. Results Patients in the observation group were better than the control group in both the bowel preparation score and the detection rate (P < 0.05). There were no obvious adverse reactions in the course of the two groups. Conclusions Simethicone can eliminate intestinal bubbles, and combined use with polyethylene glycol electrolyte powder before colonoscope examination can significantly improve intestinal cleaning effect, improve the colonoscope examination image, enhance the detection rate of lesions.

Comparison of four different bowel preparation methods for colonoscopy / 中国基层医药

Objective To investigate the clinical effects of four different bowel preparation methods for colonoscopy.Methods 620 patients examined by coloscopy were randomized into four groups (group A,B,C and D),with each group in 155 cases.Group A received magnesium sulfate.Group B received compound polyethylene glycol.Group C received magnesium sulfate combined with simethicone.Group D received compound polyethylene glycol combined with simethicone.The quality and influencing factors,the detection of polyps and adverse events were compared between the four groups.Results The good bowel cleaning rate of group A,B,C and D were respectively 84.52％,91.61％,85.81％ and 94.19％.The good bowel cleaning rates of group A and C were higher than those of group B and D (x2 =4.32,P ＜ 0.05;x2 =7.63,P ＜ 0.05;x2 =4.10,P ＜ 0.05;x2 =6.06,P ＜ 0.05.).The bubble free rate of group A,B,C and D were 86.45 ％,87.74％,92.26％ and 90.96％.The bubble free rates of group C and D were higher than those of group A and B (x2 =4.17,P ＜ 0.05;x2 =4.76,P ＜ 0.05;x2 =5.02,P ＜ 0.05;x2 =4.23,P ＜ 0.05).The polyp detection rates of group A,B,C and D were 35.4％,36.8％,51.6％ and 54.2％.Group C and D showed higher quality of foam eliminating and detection rate of polyps as compared with group A and B (x2 =8.24,P ＜0.05;x2 =11.04,P ＜0.05;x2 =6.95,P ＜0.05;x2 =9.53,P ＜0.05).The incidence of adverse reactions of group A and C (21.3％ and 19.4％) were higher than group B and D (7.8％ and 6.5％) (x2 =11.86,P＜0.05;x2 =14.95,P ＜0.05;x2 =9.18,P ＜0.05;x2 =11.95,P ＜0.05).The frequency of colonoscopy,constipation,medication and examination time interval,bowel preparation methods and adverse events were the the influ ence factors of bowel preparation.Conclusion The quality of bowel preparation of compound polyethylene glycol electrolyte powder is better than magnesium sulfate with high security.Treatment of combination with simethicone can improve bowel preparation quality.Many factors can affect bowel preparation,which need to be paid attention to.

Effect of simethicone in colonoscopy preparation and nursing medication / 中国生化药物杂志

Objective To analysis the effect of simethicone in colonoscopy preparation and observe nursing medication. Methods 200 patients from January 2016 to January 2017, were examined by colonoscopy, and randomly divided into the control group and the experimental group, each with 100 cases. In the control group were examined before giving Hengkangzhengqing laxative, oral. The experimental group was given the Spanish silicon oil on this basis. Two groups of patients were given appropriate nursing measures, the intestinal cleaning and intestinal foam in the experimental group and the control group were compared and analyzed. Results In the control group, 50 cases of intestinal cleaning efficacy of A, and 38 cases of B grade. In the experimental group, 49 cases had clean bowel effect, and 38 cases were grade B. The results showed that the intestinal cleaning efficacy of the experimental group was 87 %, and that of the control group was 88 %, and there was no significant difference between the two groups on the effect of intestinal cleaning (AB) in the control group (AB). The rate of I and II in the intestinal tract of the control group was 67 %, which was significantly lower than that of the experimental group, and the proportion of I and II was 87 %, which was statistically significant (P<0.05). The average time of the test group was (7.12±2.32) min, which was significantly shorter than that of the control group(9.23±3.21) min, with statistical significance(P<0.05). Conclusion Simethicone in colonoscopy preparation application of medication, can effectively remove the intestinal foam and the intestinal cleanliness, the clinical effect is ideal.

Effect of simethicone in colonoscopy preparation and nursing medication / 中国生化药物杂志

Objective To analysis the effect of simethicone in colonoscopy preparation and observe nursing medication. Methods 200 patients from January 2016 to January 2017, were examined by colonoscopy, and randomly divided into the control group and the experimental group, each with 100 cases. In the control group were examined before giving Hengkangzhengqing laxative, oral. The experimental group was given the Spanish silicon oil on this basis. Two groups of patients were given appropriate nursing measures, the intestinal cleaning and intestinal foam in the experimental group and the control group were compared and analyzed. Results In the control group, 50 cases of intestinal cleaning efficacy of A, and 38 cases of B grade. In the experimental group, 49 cases had clean bowel effect, and 38 cases were grade B. The results showed that the intestinal cleaning efficacy of the experimental group was 87 %, and that of the control group was 88 %, and there was no significant difference between the two groups on the effect of intestinal cleaning (AB) in the control group (AB). The rate of I and II in the intestinal tract of the control group was 67 %, which was significantly lower than that of the experimental group, and the proportion of I and II was 87 %, which was statistically significant (P<0.05). The average time of the test group was (7.12±2.32) min, which was significantly shorter than that of the control group(9.23±3.21) min, with statistical significance(P<0.05). Conclusion Simethicone in colonoscopy preparation application of medication, can effectively remove the intestinal foam and the intestinal cleanliness, the clinical effect is ideal.

Clinical application of simethicone emulsion on bowel preparation for colonoscopy / 中华消化内镜杂志

Objective To assess the clinical effects of simethicone emulsion combined with polyethylene glycol on bowel preparation for colonoscopy. Methods Two hundred out-patients, who underwent colonoscopy,were randomly divided into the study group and the control group. The study group was given simethicone in addition with polyethylene glycol, and the control group was given polyethylene glycol only. The differences on bowel preparation scores, air bubble reduction rate, colon lens sharpness, ileocecal region arrival time, colon polyp detection rate, the number of colon poly detection, and adverse event rate between the two groups were compared. Results The air bubble reduction rate, colon lens sharpness score and ileocecal region arrival time of the study group was 1(0-3)score,1.0(0-2)score,and 9(5-21)min,respectively,which was 2(1-3)score,1.5(0-2)score and 12(6-22)min, respectively in the control group. Differences between the two groups were statistically significant(Z=-9.490,P=0.000;Z=-6.768,P=0.000;Z=-5.521,P=0.000). For the bowel preparation score, colonoscopy polyp detection rate,the detection rate of colon polyp of diameter less than 5 mm, and number of colonoscopy polyp detection,there was no statistical difference between the two groups(P>0.05). No adverse events were observed in the both two groups. Conclusion The bowel preparation using simethicone combined with polyethylene glycol could effectively decrease the number of air bubble, enhance colon lens sharpness and shorten operation time,which contributes significant improvement for colonoscopy quality.

Effects of simethicone on the quality of video capsule endoscopy examination / 中华消化杂志

Objective To investigate the effects of simethicone on the quality of video capsule endoscopy (VCE) examination.Methods A prospective study was performed in 90 patients received VCE examination from February 2010 to October 2014.The randomized table was set according to different dosage of simethicone the patients received,by which patients were divided into three groups.Group 1 (35 cases) received 15 mL simethicone,group 2 (30 cases) received 30 mL simethicone and control group (25 cases) received no simethicone.The small intestinal visualization quality of VCE was scored by segments.Segment A was proximal small intestine (one hour after VCE passing pylorus).Segment B was distal small intestine (one hour before VCE passing ileocecal valve).Segment A and B were scored according to the air bubbles and degree of cleanliness.Gastric transit time,small bowel transit time and VCE completion rate were recorded.Student's t test,Mann Whitney rank sum test and chi square test were performed for statistical analysis.Results The average scores of segment A of group 1,group 2 and control group were 0.58,0.33 and 1.67,respectively,and the average socres of segment B were 0.25,0.00 and 1.17,respectively.The lesion detection rates of group 1,group 2 and control group were 68.6％ (24/35),80.0％ (24/30) and 52.0％ (13/25),respectively,and the differences was statistically significant (x2 =8.238,P=0.016).The detection rate of group 2 was significantly higher than those of group 1 and control group (x2 =7.354 and 9.349,P=0.034 and 0.005).The detection rates of small intestinal erosion of group 1,group 2 and control group were 22.9％ (8/35),70.0％ (21/30) and 32.0％ (8/25),respectively,and the differences was statistically significant (x2=8.714,P=0.013).The detection rate of group 2 was significantly higher than those of group 1 and control group (x2 =10.600 and 7.380,P=0.005 and 0.025).There was no statistically significant difference in the detection rates of ulcer,vascular malformation and protrusion among the three groups (all P＞0.05).The detection rates of lesions＜0.5 cm of group 1,group 2 and control group were 37.1％ (13/35),66.7％ (20/30) and 32.0％ (8/25),respectively,and the differences was statistically significant (x2 =8.242,P=0.016).The detection rate of group 2 was significantly higher than those of group 1 and control group (x2 =9.250 and 7.842,P =0.011 and 0.017).Conclusion Oral adminstration of 30 mL simethicone could obviously decrease air bubbles in small intestine,and increase lesion detection rate of VCE.

Value of premedication of pronase and simethicone for upper gastrointestinal endoscopy / 中华消化内镜杂志

Objective To evaluate the efficacy of premedication of pronase and simethicone before upper gastrointestinal endoscopy. Methods A total of 4 690 patients undergoing upper gastrointestinal en?doscopy from January 2014 to November 2014 were recruited at gastrointestinal endoscopy center in Beijing Military General Hospital. All patients were randomized into 3 groups. The pronase plus simethicone group( n=1 602) took 40 ml mixed solution of pronase, sodium bicarbonate and simethicone orally 20 minutes before endoscopy. The simethicone group( n=1 548) took 40 ml simethicone orally 20 minutes before endoscopy. And the control group( n=1 540) took 10 ml lidocaine hydrochloride mucilage orally 5 minutes before endos?copy. The visibility during gastroscopy was observed. Results Each patient underwent gastroscopy, and no severe adverse event occurred during the procedure. The visibility of 82?3%( n=1 318) of the pronase plus simethicone group, 67?7%( n=1 048) of the simethicone group and 28?1% patients( n=432) of the control group respectively reached grade A or B. The visibility during gastroscopy in the pronase plus simethicone group was higher than that in the simethicone group(χ2=89?42, P=0?000) , while that in the simethicone group was higher than that of the control group(χ2=486?30, P=0?000). Conclusion Premedication of pronase and simethicone can improve the visibility during gastroscopy.

The effect of different doses of simethicone on colonoscopy bowel preparation / 中华消化内镜杂志

Objective To observe the clinical effect of different doses of simethicone on the colonoscopy bowel preparation.Methods One hundred and fifty outpatients who received colonoscopy were randomly divided into three groups:group A1 (PEG plus 5 ml simethicone),group A2 (PEG plus 10 ml simethicone) and group B (PEG =polyethylene glycol electrolyte).The colonic cleaness,effect of removing bubbles,total procedure time,patients' satisfaction and tolerance were observed during the examination.Results The satisfaction with bubbles removal were 98.0％ (49/50),100.0％ (50/50) and 80.0％ (40/50) with significant difference(x2 =17.855,P =0.000).However,there was no difference in cleaness (x2 =1.500,P =0.472),total procedure time (Z =-0.333,P =0.765),patients' satisfaction (x2 =6.303,P =0.178) and tolerance (x2 =8.238,P =0.083).Conclusion Simethicone is of benefit for colonoscopic bowel preparation in removing air bubbles,which can enhance visibility.Five ml dose of simethicone can meet the basic need of removing air bubbles,and 10 ml dose of simethicone can exert better effects.

A clinical observation of simethicone, mosapride combined with flupentixol-meiltracen for treatment of patients with functional dyspepsia / 中国基层医药

ObjectiveTo observe the efficacy of simethicone, mosapride combined with flupentixol-meiltracen in the treatment for functional dyspepsia(FD). MethodsThe diagnosis of functional dyspepsia patients treated according to Zung Self-rating Anxiety Scale (SAS) ＞ 40, Hamilton Depression Scale(HAMD) ＞ 17 for inclusion criteria,a total of 64 patients were selected and randomly divided into two groups. The treatment group( simethicone,mosapride combined with flupeentixol-meiltracen) in 33 cases and the control group ( single flupenthixol melitracen) in 31cases. 2 groups of the period of treatment was 4 weeks. Evaluation before and after treatment with mood disorder scale score changes and syndrome efficacy and adverse reactions. ResultsThe treatment group after treatment, regardless of scale score change of mood disorders, syndrome treatment efficacy were significantly better than the control group,especially in the syndrome efficacy difference was significant( P ＜0.05 ,P ＜0.01 ) ;after the treatment without obvious adverse reaction. ConclusionThe simethicone, mosapride combined with flupentixol-meiltracen treatment with anxiety and depression in patients with functional dyspepsia could effectively relieve the symptoms of functional dyspepsia,and relieve the patient's psychological disorder;certainly result in fewer adverse reactions.

The Effect of Simethicone as a Bowel Preparative: Is a Higher Dosage More Helpful? / 대한소화기내시경학회지

BACKGROUND/AIMS: Simethicone has been effectively used as a preprocedure drink during colonoscopy because it causes bubbles in the lumen to coalesce. We tried to confirm whether simethicone could effectively lessen the bubble formation and shorten the procedure time. In addition, we tried to determine the proper dose of this medication. METHODS: Patients were randomized to receive 0 mg as a control group (group I), 200 mg of simethicone at 7 PM in the evening before the procedure (group II), or 200 mg at 7 PM in the evening and 200 mg at 7 AM in the next morning (group III). The bubbles were scored as follows: 0, none or small amounts of bubbles that don't require any jet of water; 1, moderate amounts of bubbles that require two or three jets of water due to the focal distribution; And 2, large amounts of bubbles that require repeated jets (> or = 4) of water due to the extensive distribution. RESULTS: 101 patients were included in this study. The number of patients in groups I, II and III were 38, 35 and 28, respectively. The procedure time was statistically similar among the three groups. Severe bubbles (score 2) were significantly more likely to occur in group I than in groups II and III (p=0.014). On the other hand, the presence of significant bubbles (> or = 1) was not different between groups II and III. CONCLUSIONS: Simethicone significantly diminished the presence of bubbles. We recommend using 200 mg of simethicone in the evening before the colonoscopy.

Efficacy and safety of cinnamon stomachic mixture for patients with functional dyspepsia.

Health care personnel at a community hospital have used cinnamon stomachic mixture for treatment of patients with functional dyspepsia for many years and they claimed that cinnamon stomachic mixture was effective without any supportive evidence. Objective: To determine the efficacy, safety, patients’ compliance and satisfaction with the treatment of cinnamon stomachic mixture. Methods: This was a randomized controlled study in 318 adults with functional dyspepsia presenting to 6 community hospitals. The patients were randomized to receive 105 mg of simethicone three times a day or 30 ml of cinnamon stomachic mixture three times a day for 7 to 14 days. The patients were evaluated for improvement of symptoms, compliance to medication and patients’ satisfaction with the treatment. The data were analysed by descriptive statistics, chi-square statistics, student t test, analysis of variance and non-parametric tests where appropriate. Results: One hundred and fifty patients received simethicone and 168 patients received cinnamon stomachic mixture. The baseline characteristics of the patients in both groups were not significantly different. The patients’ compliance to simethicone and cinnamon stomachic mixture was 82% and 89.3% respectively (p=0.09). The severity of the symptoms after treatment and the response rates were not significantly different between both groups. Side effects were observed in 9.3% and 9.5% in the simethicone group and the cinnamon stomachic mixture group respectively. Most of the patients in both groups were satisfied with the treatments they received. The cost of a 14-day course of cinnamon stomachic mixture was 36 baht compared with 84 baht for that of simethicone. Conclusion: Cinnamon stomachic mixture is effective and safe for the treatment of the patients with functional dyspepsia similar to simethicone.

Effect of alumina, magnesia, and simethicone tablet ongastric acid and pepsin activity in rats / 中国临床药理学与治疗学

Aim To study the effects of alumina, magnesia,and simethicone tabet on the secretion of gastric acid and pepsin activity in rats. Methods The pharmacodynamic indices were measured by the secretion of gastric acid and pepsin activity. Results and Conclusion Compared with the control group,alumina, magnesia, and simethicone inhibited gastric acid and increased pH of gastric juice.A significant decrease occurred in pepsin activity after a doses of 180 mg?kg-1 and 600 mg?kg-1 (P