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El objetivo del estudio es evaluar los efectos de los probióticos en la calidad de vida en los pacientes con Síndrome de Intestino Irritable (SII) en pacientes que reciben bromuro de pinaverio como monoterapia versus los que reciben bromuro de pinaverio más probióticos mediante el cuestionario de calidad de vida SF-36, antes y después del tratamiento. Fue un estudio experimental, comparativo, prospectivo y aleatorizado donde se incluyó a 160 pacientes de ambos sexos mayores de 15 años, en la consulta externa del Instituto de Gastroenterología Boliviano Japonés de La Paz - Bolivia, durante la gestión 2017 y 2018.Se utilizaron variables del cuestionario de calidad de vida SF-36 que evaluaron la Función física, rol físico, dolor corporal, salud general, vitalidad, función social, rol emocional y salud mental. Los resultados concluyen en síndrome de Intestino irritable (SII) variedad estreñimiento al 43.95%, SII variedad mixto al 33.7% y el SII variedad diarrea al 24.2%. La calidad de vida de los pacientes con SII variedad estreñimiento mejoro con resultado estadísticamente significativo en el grupo que recibió bromuro de pinaverio mas la combinación de probióticos de 44.9% a un 74.4.6%. El uso de bromuro de pinaverio como monoterapia y la combinación de probióticos mas bromuro de pinaverio ha mejorado la calidad de vida en los pacientes con Síndrome de Intestino Irritable
The objective of the study is to evaluate the effects of probiotics on the quality of life in patients with Irritable Bowel Syndrome (IBS) in patients receiving pinaverium bromide as monotherapy versus those receiving pinaverium bromide plus probiotics through the questionnaire of SF-36 quality of life, before and after treatment. It was an experimental, comparative, prospective and randomized study where 160 patients of both sexes older than 15 years were included, in the external consultation of the Japanese Bolivian Gastroenterology Institute La Paz - Bolivia, during the years 2017 and 2018. The variables were used of the SF-36 quality of life questionnaire that evaluated physical function, physical role, body pain, general health, vitality, social function, emotional role and mental health. The results conclude in Irritable Bowel Syndrome (SII) constipation variety with 43.95%, mixed variety IBS with 33.7% and diarrhea variety IBS with 24.2%., the quality of life of patients with constipation variety IBS improved with statistically significant result in the group that received pinaverium bromide plus the combination of probiotics from 44.9% to 74.4.6%. The use of pinaverium bromide as monotherapy and the combination of probiotics plus pinaverium bromide has improved the quality of life in patients with irritable bowel syndrome.
Subject(s)
Male , Female , Adolescent , Irritable Bowel SyndromeABSTRACT
Objective: To observe the clinical efficacy difference in treating irritable bowel syndrome-diarrhea (IBS-D) of liver-qi stagnation and spleen-deficiency pattern with different treatment protocols, and the effects on serum levels of 5-hydroxytryptamine (5-HT), substance P (SP) and vasoactive intestinal peptide (VIP), for unveiling the mechanism of intradermal needle therapy plus pinaverium bromide in treating IBS-D. Methods: A total of 123 IBS-D patients were divided into an observation group, a Western medication group and an integrated Western and Chinese medication group using the random number table method, with 41 cases in each group. The Western medication group was given oral pinaverium bromide, 50 mg each time and 3 times a day. The integrated Western and Chinese medication group was given additional Chinese herbal medicine Tong Xie Yao Fang, one dose each day. The observation group was given additional intradermal needle therapy on the basis of the Western medication group. The whole intervention lasted for 6 weeks. Before and after treatment, the scores of gastrointestinal symptoms, traditional Chinese medicine (TCM) symptoms, irritable bowel syndrome (IBS) symptom severity scale (IBS-SSS) and IBS quality of life (IBS-QOL) questionnaire, as well as the serum levels of 5-HT, SP and VIP were observed. The clinical efficacy was estimated. Results: The total effective rate was 92.7％ in the observation group, 68.3％ in the Western medication group and 78.1％ in the integrated Western and Chinese medication group. The total effective rate was higher in the observation group than in the other two groups, and higher in the integrated Western and Chinese medication group than in the Western medication group, showing statistical significance (all P<0.05). After treatment, the scores of gastrointestinal symptoms, TCM symptoms and IBS-SSS showed significant decreases in the three groups, presenting statistical significance compared with the baseline (all P<0.05); the scores of gastrointestinal symptoms, TCM symptoms and IBS-SSS were notably lower in the observation group than in the other two groups (all P<0.05), and lower in the integrated Western and Chinese medication group than in the Western medication group (all P<0.05). After treatment, the eight component scores of IBS-QOL showed significant increases in the three groups compared with the baseline (all P<0.05); the eight component scores in IBS-QOL were significantly higher in the observation group than in the other two groups (all P<0.05), and higher in the integrated Western and Chinese medication group than in the Western medication group (all P<0.05). After treatment, the serum levels of 5-HT, SP and VIP decreased markedly in the three groups compared with the baseline (all P<0.05); the serum levels of 5-HT, SP and VIP were significantly lower in the observation group than in the other two groups (all P<0.05), and lower in the integrated Western and Chinese medication group than in the Western medication group (P<0.05). Conclusion: Treatment with intradermal needle therapy plus pinaverium bromide results in significant improvements in the gastrointestinal symptoms and quality of life in patients with IBS-D of liver-qi stagnation and spleen deficiency pattern, and effectively regulates the gastrointestinal hormone production.
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Resumen El uso de los antiespasmódicos forma parte de la piedra angular del tratamiento en el síndrome de intestino irritable (SII), independientemente del subtipo. Consideramos relevante hacer una revisión de los medicamentos antiespasmódicos disponibles actualmente en Colombia, los cuales son usados crónicamente, de manera frecuente, en esta enfermedad.
Abstract Although antispasmodics are the cornerstone of treating irritable bowel syndrome, there are a number of antispasmodic medications currently available in Colombia. Since they are frequently used to treat this disease, we consider an evaluation of them to be important.
Subject(s)
Humans , Role , Therapeutics , Pharmaceutical Preparations , Irritable Bowel Syndrome , ParasympatholyticsABSTRACT
OBJECTIVE： To systematically review therapeutic efficacy and safety of mirtazapine combined with selective calcium channel blocker （SCCB） in the treatment of irritable bowel syndrome （IBS）， and provide evidence-based reference for clinical medication. METHODS： Retrieved from the Cochrane Library， PubMed， Embase， Medline， CNKI， VIP and Wanfang database， randomized controlled trials （RCTs） about mirtazapine combined with SCCB （trial group） versus SCCB （control group） for IBS were collected. After literature screening and data extraction， quality evaluation was performed by using Cochrane system evaluator manual 5.1.0 recommend bias risk evaluation tool. Meta-analysis was performed by using Stata 14.0 software. RESULTS： A total of 14 RCTs involving 1 005 patients were included. The results of Meta-analysis showed that the total response rate [RR＝1.34，95％CI（1.25，1.44），P＜0.001]，neuropeptide-Y level after treatment [SMD＝0.77，95％CI（0.49，1.05），P＜0.001]， response rate of abdominal pain therapy [RR＝1.32，95％CI（1.06，1.66），P＝0.014] and response rate of treatment for abnormal stool characteristics [RR＝1.75，95％CI（1.36，2.27）， P＜0.001] were significantly higher than control group； the scores of depression scale after treatment [SMD＝－1.87， 95％CI （－2.35， －1.39）， P＜0.001]， anxiety scale after treatment [SMD＝－2.25， 95％CI （－3.35， －1.15）， P＜0.001]， abdominal pain symptom score after treatment [SMD＝－7.41， 95％CI （－8.30，－6.51）， P＜0.001]， diarrhea symptom score after treatment [SMD＝－6.39， 95％CI （－7.96，－4.81）， P＜0.001] were significantly lower than those of the control group. There were no statistical significance in response rate of abdominal distension therapy [RR＝1.07，95％CI（0.90，1.28），P＝0.421] and response rate of abnormal defecation therapy [RR＝1.05，95％CI（0.88，1.26），P＝0.588]， the incidence of abdominal pain [RR＝0.45，95％CI（0.11，1.97）， P＝0.291] and exhaustion [RR＝5.00，95％CI（0.60，41.79），P＝0.137] between 2 groups. CONCLUSIONS： Mirtazapine combined with SCCB can significantly improve therapeutic efficacy of IBS patients， promote clinical symptoms， but do not increase the occurrence of ADR as abdominal pain and exhaustion.
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Objective To research the survivability of pinaverium bromide in elderly colonoscopy preoperative preparation to improve the quality of the elderly colonoscopy.Methods Three hundred elderly outpatient who underwent colonoscopy were enrolled in this study and were randomly divided into observation group and control group,with 150 patients in each group.The patients in observation group were given pinaverium bromide100 mg,3 times a day with the meal,and at the last time they took 100 mg before 2 h of colonoscopy.The patients in control group took nothing.The entry time and abdominal pain class were recorded by endoscopic doctors and assistants and compared between two groups.Results The completion rate of observation group and control group was 98.0％(147/150)and 93.3％(140/150),the successful rate of observation group and control group was 78.0％(117/150) and 65.3％(98/150),and there were significant differences (x2 =3.94,5.93,P ＜ 0.05).The number of entry time ＜ 5 min,5-10 min,＞ 10 min in observation group was 25,60,62 cases,in control group was 10,53,77 cases,and there was significant difference (P ＜ 0.05).The abdominal pain class Ⅰ,Ⅱ,Ⅲ,Ⅳin observation group was 32,85,30,3 cases,in control group was 21,77,42,10 cases,and there was significant difference (P ＜ 0.05).There was no adverse reaction in observation group.Conclusions Taking pinaverium bromide before colonoscopy 1 d in elderly patients can help to alleviate the symptoms of conventional colonoscopy abdominal pain and increase the tolerance of elderly.
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<p><b>OBJECTIVE</b>To compare the efficacy differences between abdominal acupuncture and western medication for diarrhea irritable bowel syndrome (IBS-D).</p><p><b>METHODS</b>Sixty-one patients with IBS-D were randomly assigned into an acupuncture group (30 cases after 1 dropping) and a western medication group (28 cases after 2 dropping). Acupuncture was used atpoints [Zhongwan (CV 12), Xiawan (CV 10), Qihai (CV 6), Guanyuan (CV 4)],points [bilateral Huaroumen (ST 24), Wailing (ST 26)],point [bilateral Daheng (SP 15)], once every other day, 3 times a week. Pinaverium bromide tablet was used orally in the western medication group, 50 mg a time, 3 times a day. All the treatment was given for 4 weeks in the two groups. IBS symptom severity score (IBS-SSS) and clinical symptom scores for abdominal pain and distension, diarrhea, poor stool output, defecation urgency and stool abnormality were observed before and after the treatment as well as 3 months after treatment. Adverse reactions were recorded and the effects were evaluated.</p><p><b>RESULTS</b>①After treatment and at follow-up, the IBS-SSS scores of the two groups were lower than those before treatment (all<0.01). Compared with the western medication group, the scores and the improvements between the two time points and before treatment were better in the acupuncture group (<0.05,<0.01). ②The symptom scores in the two groups after treatment were lower than those before treatment including abdominal pain, abdominal distension, diarrhea, poor stool output, defecation urgency and stool abnormality (<0.05,<0.01), and the scores of abdominal pain, abdominal distension, diarrhea, poor stool output and stool abnormality in the acupuncture group were lower than those in the western medication group (<0.05,<0.01). ③The total effective rate and the cured and remarkable effective rate of the acupuncture group were higher than those of the western medication group [(86.7% (26/30) vs 64.3% (18/28),<0.05; 70.0% (21/30) vs 35.7% (10/28),<0.01)], and the therapeutic efficacy of the acupuncture group was better than that of the western medication group (<0.05). There was no adverse reaction.</p><p><b>CONCLUSION</b>Abdominal acupuncture is more effective for IBS-D than western medication and can relieve abdominal pain, abdominal distension, diarrhea, poor stool output, stool abnormality, with long-term effect.</p>
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Objective To investigate the efficacy of flupentixol and melitracen combined with pinaverium bromide in the treatment of patients with irritable bowel syndrome. Methods A total of 64 patients with irritable bowel syndrome from October 2014 to October 2015 in department of gastroenterology of Zhuji People’s Hospital were collected and randomly divided into two groups, with 32 cases in each group.Patients in control group received with pinaverium bromide by oral, patients in combination group received flupentixol and melitracen by oral on the basis of control group.The gastrointestinal symptom rating scale (GSRS), self-rating anxiety scale (SAS), self-rating depression scale (SDS) score and clinical efficacy pre-and post-treatment were compared between two groups.Results Compared with pre-treatment, the main symptoms score in two groups decreased significantly (P<0.05); compared with control group, the main symptoms score in combination group decreased significantly(P <0.05).Compared with pre-treatment, the SAS and SDS scores decreased significantly(P <0.05); compared with control group, the SAS and SDS scores in combination group decreased significantly ( P <0.05 ) .There was no significant difference in total efficacy between control group and combination group ( 93.75%vs.81.25%, χ2 =1.237,P=0.266).There was no adverse event in two groups during treatment.Conclusion Flupentixol and melitracen combined with pinaverium bromide could significantly improve the anxiety and depression in the treatment of irritable bowel syndrome, which could promote the recovery of gastrointestinal function.
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Objective To discuss the clinical observation of diarrhea type irritable bowel syndrome with Shu-gan Jianpi prescription.Methods 82 cases of diarrhea-predominant irritable bowel syndrome were selected using a random number table,the observation group(n=45 )was treated with relieving liver and reinforcing spleen methods;the control group(n=37 )was treated with the universal application of clinical Pinaverium bromide,were observed after treatment of irritable bowel syndrome score,treatment effects as well as the clinical symptoms,the results were processed using SPSS 17.0 analysis.Results The scores of the two groups at 1 month after treatment,the control group was (157.38 ±72.72),the observation group was (101.52 ±60.16)(t=-7.994,P=0.000).The score of the two groups at 3 months after treatment,the control group was (172.71 ±62.91 ),the observation group was (109.92 ±42.38)(t=-8.428,P=0.000),the results had statistical significance;The total efficiency of the two groups at 1 month after treatment,the control group was 75.7%,the observation group was 95.6%(χ2 =6.909,P=0.019),the total efficiency of the two groups at 3 months after treatment,the control group was 86.5%,the observation group was 100%,the comparison was(χ2 =6.476,P=0.016),the results had statistical significance.On the aspect of the relieve of clinical symptoms,On the abdominal pain,the control group controlled 21cases,the observation group controlled 38 cases,compared(χ2 =7.713,P=0.007),On the diarrhea,the control group relieved 15 cases,the observation group relieved 30 cases,compared(χ2 =7.713,P=0.007),both had statistical significance.Conclusion The methods with relieving liver and reinforcing spleen,to the patients with irritable bowel syndrome medicine syndrome differentiation,play each medicine spleen and stomach,benefit lung and kidney tonic win effect,can effectively reduce symptoms and reduce IBS integration,reduce symptoms treatment results.
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A síndrome do intestino irritável (SII) é um distúrbio funcional do trato digestivo altamente prevalente, que causa significativo prejuízo da qualidade de vida e impacto econômico e no sistema de saúde. A fisiopatologia da SII é complexa e envolve alterações da motilidade intestinal, bem como aumento da sensibilidade visceral. Pela inexistência de um tratamento etiológico da SII, a abordagem terapêutica usual visa promover o alívio dos sintomas e a melhora da qualidade de vida. Juntamente com a dieta rica em fibras os antiespasmódicos são as medicações mais utilizadas no tratamento da SII. Assim, discutimos a eficácia e a segurança das medicações antiespasmódicas no tratamento da SII.
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Objetivos - O objetivo da revisão foi atualizar revisão sistemática da Cochrane, que avaliou a eficácia da terapia medicamentosa no controle dos sintomas da SII e apresentar os resultados do brometo de pinavério em relação aos demais antiespasmódicos nos desfechos de melhora da dor, dos escores de sintomas da SII, melhora global e/ou qualidade de vida. Métodos - Realizamos busca eletrônica nas bases de dados Medline, CINAHL, PsychInfo, Cochrane RCT databases e EMBASE. A eficácia dos tratamentos foi avaliada em relação a melhora global dos sintomas, dor abdominal, escore de sintomas e qualidade de vida. Para a análise da diferença dos efeitos dos subgrupos de drogas, utilizamos o método Newcombe-Wilson sem correção de continuidade. Quando expressado em diferenças de médias, utilizamos o método que assume igual variância nas duas populações. Resultados - Foram encontrados 70 artigos, dos quais oito estavam de acordo com os critérios de inclusão. Foram analisados os agentes formadores de bolo, antiespasmódicos ou antidepressivos. Foi observado que os antiespasmódicos são eficazes em melhorar a dor, propiciar melhora global e do escore de sintomas do paciente. Entre eles, destaca-se o brometo de pinavério, que demonstra eficácia consistente em todos os três desfechos estudados, melhora da dor (RR 1.57; IC 1.08 a 2.26), melhora global (RR 1.66; IC 1.25 a 2.19) e do escore de sintomas do paciente (SMD 0.51; IC 0.19 a 0.84). Conclusão - Dada a grande disponibilidade e o baixo custo do tratamento as drogas antiespasmódicas devem ser encaradas como tratamento de primeira linha da SII. Os antidepressivos devem ser utilizados caso não haja resposta satisfatória com as drogas de primeira linha ou, ainda, quando o paciente apresentar comorbidade psiquiátrica, adequadamente avaliada.
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Objective To observe the clinical effect of acupuncture plus ginger-partitioned moxibustion in treating diarrhea-predominant irritable bowel syndrome (D-IBS). Method Ninety D-IBS patients were randomized into an acupuncture-moxibustion group (acupuncture plus ginger-partitioned moxibustion), an acupuncture group, and a Western medication group (Pinaverium bromide), 30 patients in each group. The clinical effect, symptom score, and quality of life in the 3 groups were observed. Result The general clinical effect of the acupuncture-moxibustion group was significantly higher than that of the acupuncture group and Western-medication group (P＜0.05), but there was no significant difference in comparing the total effective rate between the acupuncture group and acupuncture-moxibustion group (P>0.05). After treatment, the Western medication group showed marked decreases in abdominal pain, abdominal distension and discomfort, defecation property, and defecation frequency (P＜0.01);the acupuncture group showed significant decreases in abdominal pain, abdominal distension and discomfort, mucous stool, and appetite (P＜0.05, P＜0.01); the acupuncture-moxibustion group had significant decreases in abdominal pain, abdominal distension and discomfort, defecation property, defecation frequency, mucous stool, and appetite (P＜0.01). The quality of life score changed significantly in all groups after treatment (P＜0.05, P＜0.01);the changes of quality of life score in the acupuncture group and acupuncture-moxibustion group were both significantly higher than that in the Western-medication group (P＜0.01);the change of quality of life score in the acupuncture-moxibustion group was significantly higher than that in the acupuncture group (P＜0.01). Conclusion Acupuncture plus ginger-partitioned moxibustion and acupuncture alone both can produce a higher therapeutic efficacy than Pinaverium bromide in treating D-IBS; acupuncture plus ginger-partitioned moxibustion is superior to acupuncture alone.
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Objective To investigate clinical effect of pinaverium bromide combined with probiotics in the treatment of patients with irritable bowel syndrome (IBS).Methods 156 patients with IBS were randomly divided into observation group and control group.Cases in control group received pinaverium bromide tablets,and cases in observation group received bifid triple viable capsule plus pinaverium bromide tablets.Duration of treatment was 4 weeks in both groups.Clinical efficacy was evaluated after treatment.Results Total effective rates of observation group and control group were respectively 85.9％ and 70.5％.Total effective rate of observation group was significantly better than that of control group(x2 =8.557,P ＜ 0.05).The systolic pressure of anorectum was significantly lower than that of control group after treatment(t =4.432,P ＜ 0.01),but resting pressure and diastolic pressure were not significantly different after treatment(t =0.812,0.142,all P ＞ 0.05).First sensation volume,defecating sensation volume and pain volume in observation group were significantly lower than those in control group (t =3.440,4.671,3.697,all P ＜ 0.01).Conclusion Treatment of IBS with pinaverium bromide combined with probiotics is effective,and it can improve the anorectal dynamic and isceral sensitivity in patients with IBS.
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Introducción: en un grupo de ratas se produjo diarrea o estreñimiento inducido por el uso de medicamentos favorecedores de la secreción o medicamentos constipadores. En estas ratas se utilizo el bromuro de pinaverio y el tegaserod como medicamentos favorecedores o de la disminución de la frecuencia defecatoria o como promotores de la defecación, respectivamente. Este trabajo tiene como objetivo averiguar hasta que punto estos medicamentos pueden ser utilizados como tratamiento efectivo en el síndrome de intestino irritable. Métodos: se utilizaron 12 ratas femeninas, adultas, de la raza Sprague Dowley, las cuales se distribuyeron de la siguiente manera: 2 ratas control para diarrea, 4 a las que se les indujo diarrea con una mezcla de fenolftaleina y sulfato de magnesio y 2 de ellas se trataron con tegaserod y 2 con bromuro de pinaverio. En el estreñimiento se utilizaron 2 ratas control, a 4 de ellas se les aplicó loperamida para inducir el estreñimiento y se trataron 2 con tegaserod y 2 con bromuro de pinaverio. Resultados: ratas con diarrea: con respecto a estas ratas las variaciones de peso conseguidas entre los controles y la medicadas fueron altamente significativas, indicando que ambos medicamentos mejoraron el estado patológico de las mismas. Ratas con estreñimiento: con respecto a estas ratas lo único importante es que la ganancia de peso fue significativa en las que recibieron bromuro de pinaverio. Conclusión: en nuestro estudio demostramos que tanto el tegaserod como el bromuro de pinaverio pueden ser efectivos en la diarrea, así como en el estreñimiento en un modelo experimental en ratas.
Introduction: Diarrhea or constipation was induced in a group of rats by the use of drugs that stimulate secretion or drugs inducing constipation. In these rats pinaverium bromide and tegaserod were used as a drug inducing less bowel movement or as a facilitator of defecacion, respectively. This work has as its main objective to find out until what point can these drugs be used as an efective treatment for irritable bowel syndrome. Methods: 12 adult female rats, Sprague Dowley breed, were used. They were distributed in the following way: 2 as control for diarrhea, 4 of them had induced diarrhea with a phenolphthalein mixture and magnesium sulphate; 2 with Tegaserod and 2 with Pinaverium Bromide. In constipation, 2 rats were used as control, 4 of them were administered loperamide to induce constipation, and 2 were treated with Tegaserod and 2 with Pinaverium Bromide. Results: Rats with Diarrhea: With respect to these rats, the variations in weight obtained among controls and the medicated group were highly significant, indicating that both drugs improved their pathological condition. Rats with Constipation: With respect to these rats the one important thing is that gain weight was significant only in the group that received Pinaverium Bromide. Conclusion: In our study we demonstrated that both, Tegaserod and Pinaverium Bromide can be effective treating diarrhea and constipation in an experimental model in rats.
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Objective To investigate the therapeutic effects of pinaverium bromide on irritable bowel syndrome (IBS), and to study its effect on rectal visceral perception and anorectal manometry. Methods Eighty four patients with IBS received pinaverium bromide 50 mg t.i.d for 2 weeks. The score of symptoms was assessed before, after one week and 2 weeks of threatment. Rectal visceral perception thresholds, rectal compliance and anorectal manometry were measured before and after administration of pinaverium bromide. Results Pinaverium bromide 150 mg/d significantly improved the score of abdominal pain, abdominal distension and mucus stool(2.13?0.36 vs 1.28?0.35,2.49?0.73 vs 1.35?0.17,1.03?0.27 vs 0.43?0.12, P