钡条结肠传输试验的改进及在正常健康人群和慢性便秘患者中的应用
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摘要
目的:探讨不同年龄、性别、摄食习惯健康中国人群结直肠传输时间的变化规律,建立中国健康人群结肠传输时间的正常参考值。方法:目标病例数180例(湖北和河南各90例),按不同年龄段分组,分为18-35岁、36-50岁、51-70岁三个年龄段,每一年龄段各含30例,男女比例为1:1。均测定结肠传输时间和不同时间点钡条排除率。结果:①河南地区正常人群各个时间点钡条排除率均高于湖北地区志愿者,但差异并未发现统计学意义(P〉0.05)。男性志愿者在36、48和72小时钡条排除率明显高于女性(P值分别为0.001、0.001和0.044)。各个时间点钡条排除率在三个年龄组之间均无明显差异。②根据P1计算得出:摄食习惯对结肠传输时间有影响,摄食面食者传输明显快于大米者,差异主要在左半结肠;男性志愿者右半结肠、直乙状结肠和全结肠的传输时间明显快于女性(P=0.042、P=0.018和P=0.002)。三组志愿者在年龄上差异主要集中在SRCTT,总CTT和其他肠段CTT差异不明显。③根据P2计算得出:摄食大米为主者结肠传输明显慢于摄食面食为主者,且差异主要集中在直肠乙状结肠以上;男性志愿者左半结肠、右半结肠、直乙状结肠和全结肠的传输时间明显快于女性(P=0.028、P=0.005、P=0.007和P=0.000);志愿者结肠传输时间在各年龄组之间无明显差异(P>0.05)。④P2计算出的CTT值较P1稍延长,差异无统计学意义(P<0.05)。P2较P1更能反映志愿者结肠尤其是节段结肠传输时间的变化规律。结论:河南地区健康志愿者结肠传输快于湖北地区正常人群;男性结肠传输快于女性;结肠传输在年龄上无显著差异。
目的:探讨国人结肠传输时间和钡条排除率的影响因素。方法:测定180名健康志愿者结肠传输时间和不同时间点钡条排除率,探讨其影响因素。结果:(1)吸烟和饮酒均会延长结肠传输时间,降低钡条排除率,使得结肠传输减慢。(2)BMI与志愿者钡条排除率均为显著正相关(P<0.05);与志愿者结肠传输时间均为负相关(P<0.05)。(3)志愿者的平均每日饮水量和钡条排除率、结肠传输时间进行相关性分析,平均每日饮水量志愿者钡条排除率均为显著正相关(P<0.05);与志愿者结肠传输时间均为负相关(P<0.05)。仅左半结肠传输时间与进食量显著负相关(P<0.05)。(4)排便次数与志愿者钡条排除率均为显著正相关(P<0.05);与志愿者结肠传输时间均为负相关(P<0.05)。结论:结肠传输影响因素较多,吸烟和饮酒会延缓结肠传输,BMI越高,结肠传输越快,多喝水可以加快结肠传输。
目的:主要目的为以下3个方面:1.便秘患者一般情况和症状学调查;2.功能性便秘与便秘型IBS的结肠传输试验在便秘中应用的情况;3.钡条结肠传输试验诊断的输出梗阻型便秘与直肠肛管测压诊断的差异。方法:对112名慢性便秘(排除器质性疾病和药物因素)的结肠传输时间和直肠肛管压力进行研究,进一步了解改进后结肠传输试验在便秘病人中的应用,同时了解其与直肠肛管测压在反映出口梗阻型便秘检查中的差异。结果:(1)FC和IBS-C患者饮食和排便习惯的调查结果:绝大多数便秘患者(大于70%)每日的液体摄入量均小于2L,活动量偏少,进食量较多。大部分便秘患者有抑制便意和不定时排便的习惯,其中FC患者较IBS-C患者更易出现不定时排便,差异具有统计学意义。IBS-C人群较FC人群更易出现与便秘无关的症状。在上消化道症状调查中,IBS-C患者出现上腹痛、恶心和反酸的几率较FC患者明显升高,差异具有统计学意义(P<0.05);在报警和非特异性症状调查中,IBS-C患者较FD人群更易出现消瘦、肌肉酸痛和口腔异味(P<0.05)。(2)76名FC患者和36名IBS-C患者直肠肛管测压结果进行了比较,其中FC和IBS-C患者排便时肛门括约肌无松弛者分别为34和14名,差别无统计学意义(P<0.05)。(3)FC和IBS-C患者各时间点钡条排除率较正常人群均明显降低。FC患者60和72小时钡条排除率明显高于IBS-C患者(P<0.05),其余时间点无明显差别。与健康志愿者比较,FC与IBS-C患者RCTT、LCTT、RSCTT和CTT明显延长,提示其结肠传输较正常者明显减慢。与FC患者比较,IBS-C患者RCTT明显延长,差异有统计学意义(P<0.05)。(4)排便时肛门内括约肌无松弛导致结肠传输减慢,差异主要在直肠乙状结肠;RSCTT或CTT异常者多存在排便时肛门内括约肌无松弛。结论:FC和IBS-C患者结肠传输较正常人群均明显降低;排便时肛门内括约肌无松弛导致结肠传输减慢;钡条结肠传输试验和直肠肛管测压对于诊断出口梗阻型便秘结果一致。
Objective: To investigate the relationship among the colonic transit time(CTT), gender, age and different feeding habits in Chinese healthy volunteers Method: 180 adults were randomly included in our study. 15 men and 15 women in each of the three different age groups were recruited in both of Hubei province (mainly living on rice)and Henan province(mainly living on wheaten food). Every volunteer ingested 20 slender barium marks at the beginning of the experiment; then swallowed 20 round barium marks 12h later; and thereafter every 12h, 20 tubbiness barium markers were taken in separate four times. The abdominal plain film was performed 48hand 72h after the first ingestion of the barium strips. The exclusion ratio of barium strips at the different points, total colon transit time(CTT), right colon transit time(RCTT), left colon transit time(LCTT) and recto-sigmoid colon transit(RSCTT)could be calculated.
Result:①The exclusion ratio of barium strips at 36h,48h,60h and 72h in 180 healthy Chinese were 84.00±20.31、92.86±14.14、96.50±9.70 and 97.61±7.43. The exclusion ratio of barium strips at 36h、48h and 72h time point were much higher in male volunteers than in female ones (p<0.05). The difference in 36h and 48h exclusion ratio of barium strips were significant among three age groups(p<0.05).②The RCTT、LCTT、RSCTT and CTT were 8.08±4.66、5.09±6.86、7.73±7.58 and 20.90±12.26in 180 healthy adults. The female volunteers present longer CTT than male volunteers (p<0.05). The upper limit of normal value in Chinese population (Mean+2SD)was 45h(male:39h ;female:50h). However, the difference of transit time in different age group was not significant. The RCTT、LCTT and CTT in healthy volunteers of Hubei province were much slower than those in Henan province (p<0.05)..
Conclusion: The colonic transit time is shorter in Chinese healthy adults rather than western countries. Both gender and feeding habit effect CTT, while there were no significant difference in CTT among ages.
Objective: To investigate the influencing factors of the colonic transit time in Chinese healthy volunteers. Method: 180 adults were randomly included in our study. The colon transit time and the exclusion ratio of barium strips at different time points were determined in all volunteers. We discussed the influencing factors of colonic transit time. Result:①Smoking and drinking will extend colonic transit time, reduce the exclusion of barium, making slow colonic transit.②The rise in the BMI was directly related to the exclusion ratio of barium strips(P <0.05)and inversely related to the colonic transit time(P<0.05).③The rise in the average daily fluid intake was directly related to the exclusion ratio of barium strip(sP<0.05)and inversely related to the colonic transit time(P<0.05).④Frequency of defecation was directly related to the exclusion ratio of barium strips(P<0.05)and inversely related to the colonic transit time(P<0.05). Conclusion: The colonic transit time was inversely related to the BMI. Smoking and drinking may extend colonic transit time.
Objective: The main purpose was the following three aspects: 1. The general symptoms in constipation patients ; 2. the application of the colonic transit test in the cases of constipation patients ; 3. barium colonic transit test in the diagnosis of output obstructive constipation . Method: 112 constipation patients were included in our study. The colon transit time and the exclusion ratio of barium strips at different time points were determined in all patients. Result:①The daily fluid intake in most patients with constipation (more than 70%) were less than 2L; The IBS-C patients were more likely with irregular bowel habits than FC patients, the difference was statistically significant.②The anorectal manometry was done in 76 FC patients and 36 patients with IBS-C ; FC and IBS-C patients with no relaxation of anal sphincter during defecation were 34 and 14, respectively, the difference was not statistically significant (P <0.05).③The exclusion of barium strips at each time points in FC and IBS-C patients were significantly lower than the normal population(P <0.05). Compared with healthy volunteers, RCTT, LCTT, RSCTT and CTT in the FC and IBS-C patients were significantly prolonged, suggesting that the colonic transit were significantly slower than the normal. Compared with FC patients, RCTT in IBS-C patients was significantly longer, the difference was statistically significant (P <0.05).
Conclusion: The colonic transit in patients with FC and IBS-C were significantly lower than the normal population; defecation of anal sphincter without relaxation cause slow colonic transit.
目的:探讨国人结肠传输时间和钡条排除率的影响因素。方法:测定180名健康志愿者结肠传输时间和不同时间点钡条排除率,探讨其影响因素。结果:(1)吸烟和饮酒均会延长结肠传输时间,降低钡条排除率,使得结肠传输减慢。(2)BMI与志愿者钡条排除率均为显著正相关(P<0.05);与志愿者结肠传输时间均为负相关(P<0.05)。(3)志愿者的平均每日饮水量和钡条排除率、结肠传输时间进行相关性分析,平均每日饮水量志愿者钡条排除率均为显著正相关(P<0.05);与志愿者结肠传输时间均为负相关(P<0.05)。仅左半结肠传输时间与进食量显著负相关(P<0.05)。(4)排便次数与志愿者钡条排除率均为显著正相关(P<0.05);与志愿者结肠传输时间均为负相关(P<0.05)。结论:结肠传输影响因素较多,吸烟和饮酒会延缓结肠传输,BMI越高,结肠传输越快,多喝水可以加快结肠传输。
目的:主要目的为以下3个方面:1.便秘患者一般情况和症状学调查;2.功能性便秘与便秘型IBS的结肠传输试验在便秘中应用的情况;3.钡条结肠传输试验诊断的输出梗阻型便秘与直肠肛管测压诊断的差异。方法:对112名慢性便秘(排除器质性疾病和药物因素)的结肠传输时间和直肠肛管压力进行研究,进一步了解改进后结肠传输试验在便秘病人中的应用,同时了解其与直肠肛管测压在反映出口梗阻型便秘检查中的差异。结果:(1)FC和IBS-C患者饮食和排便习惯的调查结果:绝大多数便秘患者(大于70%)每日的液体摄入量均小于2L,活动量偏少,进食量较多。大部分便秘患者有抑制便意和不定时排便的习惯,其中FC患者较IBS-C患者更易出现不定时排便,差异具有统计学意义。IBS-C人群较FC人群更易出现与便秘无关的症状。在上消化道症状调查中,IBS-C患者出现上腹痛、恶心和反酸的几率较FC患者明显升高,差异具有统计学意义(P<0.05);在报警和非特异性症状调查中,IBS-C患者较FD人群更易出现消瘦、肌肉酸痛和口腔异味(P<0.05)。(2)76名FC患者和36名IBS-C患者直肠肛管测压结果进行了比较,其中FC和IBS-C患者排便时肛门括约肌无松弛者分别为34和14名,差别无统计学意义(P<0.05)。(3)FC和IBS-C患者各时间点钡条排除率较正常人群均明显降低。FC患者60和72小时钡条排除率明显高于IBS-C患者(P<0.05),其余时间点无明显差别。与健康志愿者比较,FC与IBS-C患者RCTT、LCTT、RSCTT和CTT明显延长,提示其结肠传输较正常者明显减慢。与FC患者比较,IBS-C患者RCTT明显延长,差异有统计学意义(P<0.05)。(4)排便时肛门内括约肌无松弛导致结肠传输减慢,差异主要在直肠乙状结肠;RSCTT或CTT异常者多存在排便时肛门内括约肌无松弛。结论:FC和IBS-C患者结肠传输较正常人群均明显降低;排便时肛门内括约肌无松弛导致结肠传输减慢;钡条结肠传输试验和直肠肛管测压对于诊断出口梗阻型便秘结果一致。
Objective: To investigate the relationship among the colonic transit time(CTT), gender, age and different feeding habits in Chinese healthy volunteers Method: 180 adults were randomly included in our study. 15 men and 15 women in each of the three different age groups were recruited in both of Hubei province (mainly living on rice)and Henan province(mainly living on wheaten food). Every volunteer ingested 20 slender barium marks at the beginning of the experiment; then swallowed 20 round barium marks 12h later; and thereafter every 12h, 20 tubbiness barium markers were taken in separate four times. The abdominal plain film was performed 48hand 72h after the first ingestion of the barium strips. The exclusion ratio of barium strips at the different points, total colon transit time(CTT), right colon transit time(RCTT), left colon transit time(LCTT) and recto-sigmoid colon transit(RSCTT)could be calculated.
Result:①The exclusion ratio of barium strips at 36h,48h,60h and 72h in 180 healthy Chinese were 84.00±20.31、92.86±14.14、96.50±9.70 and 97.61±7.43. The exclusion ratio of barium strips at 36h、48h and 72h time point were much higher in male volunteers than in female ones (p<0.05). The difference in 36h and 48h exclusion ratio of barium strips were significant among three age groups(p<0.05).②The RCTT、LCTT、RSCTT and CTT were 8.08±4.66、5.09±6.86、7.73±7.58 and 20.90±12.26in 180 healthy adults. The female volunteers present longer CTT than male volunteers (p<0.05). The upper limit of normal value in Chinese population (Mean+2SD)was 45h(male:39h ;female:50h). However, the difference of transit time in different age group was not significant. The RCTT、LCTT and CTT in healthy volunteers of Hubei province were much slower than those in Henan province (p<0.05)..
Conclusion: The colonic transit time is shorter in Chinese healthy adults rather than western countries. Both gender and feeding habit effect CTT, while there were no significant difference in CTT among ages.
Objective: To investigate the influencing factors of the colonic transit time in Chinese healthy volunteers. Method: 180 adults were randomly included in our study. The colon transit time and the exclusion ratio of barium strips at different time points were determined in all volunteers. We discussed the influencing factors of colonic transit time. Result:①Smoking and drinking will extend colonic transit time, reduce the exclusion of barium, making slow colonic transit.②The rise in the BMI was directly related to the exclusion ratio of barium strips(P <0.05)and inversely related to the colonic transit time(P<0.05).③The rise in the average daily fluid intake was directly related to the exclusion ratio of barium strip(sP<0.05)and inversely related to the colonic transit time(P<0.05).④Frequency of defecation was directly related to the exclusion ratio of barium strips(P<0.05)and inversely related to the colonic transit time(P<0.05). Conclusion: The colonic transit time was inversely related to the BMI. Smoking and drinking may extend colonic transit time.
Objective: The main purpose was the following three aspects: 1. The general symptoms in constipation patients ; 2. the application of the colonic transit test in the cases of constipation patients ; 3. barium colonic transit test in the diagnosis of output obstructive constipation . Method: 112 constipation patients were included in our study. The colon transit time and the exclusion ratio of barium strips at different time points were determined in all patients. Result:①The daily fluid intake in most patients with constipation (more than 70%) were less than 2L; The IBS-C patients were more likely with irregular bowel habits than FC patients, the difference was statistically significant.②The anorectal manometry was done in 76 FC patients and 36 patients with IBS-C ; FC and IBS-C patients with no relaxation of anal sphincter during defecation were 34 and 14, respectively, the difference was not statistically significant (P <0.05).③The exclusion of barium strips at each time points in FC and IBS-C patients were significantly lower than the normal population(P <0.05). Compared with healthy volunteers, RCTT, LCTT, RSCTT and CTT in the FC and IBS-C patients were significantly prolonged, suggesting that the colonic transit were significantly slower than the normal. Compared with FC patients, RCTT in IBS-C patients was significantly longer, the difference was statistically significant (P <0.05).
Conclusion: The colonic transit in patients with FC and IBS-C were significantly lower than the normal population; defecation of anal sphincter without relaxation cause slow colonic transit.
引文
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[1] Bennink R, Peeters M, Van den Maegdenbergh V, et al. Evaluation of small-bowel transit for solid and liquid test meal in healthy men and women. Eur J Nucl Med. 1999 ;26(12):1560-6.
[2] Price JM, Davis SS, Sparrow RA, Wilding IR. The effect of meal composition on the gastrocolonic response: implications for drug delivery to the colon. Pharm Res. 1993;10(5):722-6.
[3] Lopes AC, Victoria CR. Fiber intake and colonic transit time in functional constipated patients rq Gastroenterol. 2008 Jan-Mar;45(1):58-63.
[4] Hinton JM ,Lennard—Jones JE,Young AC.A new method for studying gut transit time using fa—dlopaque markers.Gut-1969l10(5)t 842
[5] Chaussade S, Roche H, Khyari A, Couturier D, Guerre J. Measurement of colonic transit time: description and validation of a new method. Gastroenterol. Clin. Biol. 1986; 10: 385–9.
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[9] Arhan P, Devroede G, Jehannin B et al. Segmental colonic transit time. Dis. Colon Rectum 1981; 24: 625–9.
[10] Meir R, Beglinger C, Dederding JP et al. [Age- and sexspecific standardvalues of colonic transit time in healthy subjects.] Schweiz. Med. Wochenschr. 1992; 122: 940–43 (in German).
[11] Rausch T, Beglinger C, Alam N, Gyr K, Meier R. Effect of transdermal application of nicotine on colonic transit in healthy nonsmoking volunteers. Neurogastroenterol. Motil. 1998; 10: 263–70.
[1] Locke GRⅢ, Pemberton JH, Phillips SF. AGA technical review on constipation. Gastroenterology 2000;119;1161-78.
[2] Herz MJ, Kahan E, Zalevsiki S, et al. Constipation: A different entity for patients and doctors. Fam Pract 1996;13;156-9.
[3] Satish SC, RaoMD, Ph D, FRCP (Lon) . Clinical utility of diagnostic tests for constipation in adults: a systematic review. Am J Gastroenterol, 2005, 100 (7) : 1605-1615.
[4] Metcalf A, Phillips S, Zinsmeister A, et al. Simplified-Asse ssment 0f Segmental Co lonic T ransit . Gastr oenterology , 1987, 92: 40.
[5]刘世信,张殿文,吴菲,等.结肠运输试验对诊断便秘的价值.中华医学杂志, 1993, 73 ( 2) : 75.
[6]陈延,王学勤,戴菲,等.不透X线标记物检测胃肠道运动的临床应用.实用放射学杂志, 2001, 17 (9) : 647-650.
[7]展淑琴,罗金燕,龚均.便秘患者胃肠通过时间测定及意义.西安医科大学学报, 1999, 20 (3) : 329-331.
[8]查慧,谢小平,侯晓华.不同类型便秘患者直肠敏感性的差异[J].临床内科杂志,2006,23(5):317-379
[9] Brusciano L, Limongelli P, del Genio G, et al. Useful parameters helping proctologists to identify patients with defaecatory disorders that may be treated with pelvic floor rehabilitation[J]. Tech Coloproctol,2007,11(1):45-50
[10]张义侠,刘峥艳,吕森,等.慢性便秘的分型和肛门直肠测压表现[J].中华消化杂志,2001,21(8):488
[11] Karlbom U, Lund in E, GrafW, et a.l Anorectal physiology in relat ion to clinical subgroups of patients with severe constipation. Colorectal D is,2004, 6: 343-349.
[12]舒斯特等.胃肠动力学. 19章:不透射线的标志物及结肠转运.
[13]尉秀清,陈旻湖.广州市居民功能性便秘流行病学调查.胃肠病学和肝脏病学杂志, 2001; 10( 2) : 150- 152
[14]郭晓峰,柯美云,潘国宗,等.北京地区成人慢性便秘整群、分层、随机流行病学调查及其相关因素分析[ J] .中华消化杂志, 2002, 22( 10) : 637
[15]刘世信,赵丽中,殷淑珍,等.天津市区人群便秘患病率流行病学研究.中国实用外科杂志, 1994, 14(9) : 533- 535
[16]向国春,房殿春等.重庆市人群便秘患病率流行病学研究.重庆医学杂志10(10)2004,1541-43.
[17] Steward WF, Liberman JN, Sandler RS, et al . Epidemiology of constipation (EPOC) study in the Unit ed States: relation of clinical subtypes to sociodemographic features. Am J Gastroenterol, 1999, 94( 12) : 3530- 3540
[18] Talley NJ. Overlapping upper and lower gastrointestinal symptoms in irritable bowel syndrome . Am J Gastroenterol 2003; 98: 2454-2459
[19] Schiller L R. Review article: the therapy of constipation. Aliment Pharmacol Ther. 2001;15:749–763
[20] Mertz H, Naliboff B, Mayer E: Physiology of refractory chronic constipation. Am J Gastroenterol 1999, 94:609–615. 23
[21] Annie On On Chan, Gigi Leung, Teresa Tong, Nina YH Wong. Increasing dietary fiber intake in terms of kiwifruit improves constipation in Chinese patients. World J Gastroenterol 2007 September 21; 13(35): 4771-4775
[22] M. Bouchoucha ? G. Devroede ? E. Dorval ? A. Faye ? P. Arhan ? M. ArsacDifferent segmental transit times in patients with irritable bowel syndrome and “normal”colonic transit time: is there a correlation with symptoms? Tech Coloproctol (2006) 10:287–296.
[23] Chaussade S,Khyari A,Roche H et al. Determination of total and segmental colonic transit time in constipated patients.Results in 91 patients with a new simplified method. Dig Dis Sci 1989;34;1168-72.
[1] Hale EM, Smith E, St James J, Wojner-Alexandrov AW (2007) Pilot study of the feasibility and effectiveness of a natural laxative mixture. Geriatric Nursing 28(2): 104-11
[2] Bennett N, Dodd T, Flatley J et al (1995) Health Survey for England. HMSO, London British National Formulary (2009) British National Formulary. British Medical Association, London
[3] Brown SR, Cann PA, Read NW (1990) Effect of coffee on distal colonic function. Gut 31: 450-53
[4] Campbell AJ, Busby WJ, Horwath CC (1993) Factors associated with constipation in a community based sample of people aged 70 years and over. Journal of Epidemiology and Community Health 47: 23-26
[5] Chiarelli P, Brown W, McElduff P (2000) Constipation in Australian women: prevalence and associated factors. International Urogynaecological Journal 11(2): 71-78
[6] Kinnunen O (1991) Study of constipation in a geriatric hospital, day hospital, old people’s home and at home. Ageing 3(2): 161-70Archives of Disease in Childhood - Education and Practice 90(3): 58-67
[7] Davies C (2004) The use of phosphate enemas in the treatment of constipation. Nursing Times 100(18): 32-34
[8] Cope K (1996)‘Malnutrition in the elderly: A national crisis.’the obvious: a model for preventing constipation’. Journal of Gerontological Nursing 24(3): 38-44
[9] Clinical Knowledge Summaries (2008) Constipation - Management. NHS Institute for Innovation and Improvement.
[10] De Lillo A, Rose S (2000) Functional bowel disorders in the geriatric patient: constipation, faecal impaction and faecal incontinence. The American Journal ofGastroenterology. 95(4): 901-905
[11] De Schryver AM, Keulemans YC, Peters HP et al (2005). Effects of regular physical activity on defecation pattern in middle-aged patients complaining of chronic constipation. Scandinavian Journal of Gastroenterology. 40: 422-29
[12] Goodman M, Wilkinson S (2005) Constipation Management in Palliative Care: A survey of practices in the United Kingdom. Journal of Pain and Symptom Management. 29(3): 238-44
[13] Addison R, Davies C, Haslam D et al (2003). A national audit of chronic constipation in the community. Nursing Times 99(11): 34-35
[14] Harari D, Gurwitz JH, Avorn J et al (1996) Bowel habit in relation to age & gender: findings from the National Health Interview Survey and Clinical Implications. Archives of Internal Medicine 156(Feb 12): 315-19
[15] Harari D (2004)‘Bowel care in old age.’Cited in Norton C, Chelvanayagam S Bowel Continence Nursing.
[16] Hojgaard L, Arffmann S, Jorgensen M, Karg E (1981) Tea consumption: A cause of constipation? British Journal of Medicine. 282: 864
[17] Johanson JF, Kralstein J (2007) Chronic constipation: a survey of the patient perspective.Alimentary Pharmacology and Therapeutics 25: 599-608
[18] Clayden GS, Keshtgar AS, Carcani-Rathwell I, Abhyankar A (2005) The management of chronic constipation and related faecal incontinence in childhood.
[19] Kunimoto M et al (1998) The relation between irregular bowel movements and the life style of working women. Hepato-Gastoenterology 45(2): 956-60
[20] Kyle G (2007) A guide to managing constipation. Part 2. Nursing Times 103(19):42-3
[21] Kyle G (2008) A proactive approach to the treatment of constipation. Continence UK 2(4): 36-44
[2] Price JM, Davis SS, Sparrow RA, Wilding IR. The effect of meal composition on the gastrocolonic response: implications for drug delivery to the colon. Pharm Res. 1993;10(5):722-6.
[3] Lopes AC, Victoria CR. Fiber intake and colonic transit time in functional constipated patients rq Gastroenterol. 2008 Jan-Mar;45(1):58-63.
[4] Chan YK, Kwan AC, Yuen H, Yeung YW, Lai KC, Wu J, Wong GS, Leung CM, Cheung WC, Wong CK (2004) Normal colontransit time in healthy Chinese adults in Hong Kong. J Gastroenterol Hepatol 19(11):1270–1275.
[5] Hinton JM ,Lennard—Jones JE,Young AC.A new method for studying gut transit time using fa—dlopaque markers.Gut-1969l10(5)t 842
[6] Chaussade S, Roche H, Khyari A, Couturier D, Guerre J. Measurement of colonic transit time: description and validation of a new method. Gastroenterol. Clin. Biol. 1986; 10: 385–9.
[7] Metcalf AM, Phillips SF, Zinsmeister AR, MacCarty RL, Beart RW, Wolff BG. Simplified assessment of segmental colonic transit. Gastroenterology 1987; 92: 40–47.
[8] Arhan P, Devroede G, Jehannin B et al. Segmental colonic transit time. Dis. Colon Rectum 1981; 24: 625–9.
[9] Meir R, Beglinger C, Dederding JP et al. [Age- and sexspecific standard values of colonic transit time in healthy subjects.] Schweiz. Med. Wochenschr. 1992; 122: 940–43 (in German).
[10] Martelli H, Devroede G, Arhan P, Duguay C, Dornic C, Faverdin C. Someparameters of large bowel motility in normal man. Gastroenterology 1978; 75: 612–18.
[11] Sadik R, Abrahamsson H, Stotzer PO (2003) Gender differences in gut transit shown with a newly developed radiological procedure. Scand J Gastroenterol 38(1):36–42.
[12]柯美云,李若群等.胃肠通过时间测定及其生理和病理意义的探讨。中华内科杂志. 29(12) 1990.
[13]展淑琴,罗金燕等.胃肠通过时间生理及病理生理研究。西安医科大学学报. 4(12)1998.
[14]展淑琴,罗金燕等.年龄、性别对胃肠通过时间的影响。西安医科大学学报. 6(12)2000.
[15]舒斯特等.胃肠动力学. 19章:不透射线的标志物及结肠转运.
[16] M. Bouchoucha ? G. Devroede ? E. Dorval ? A. Faye ? P. Arhan ? M. Arsac Different segmental transit times in patients with irritable bowel syndrome and“normal”colonic transit time: is there a correlation with symptoms? Tech Coloproctol (2006) 10:287–296.
[17] Bouchoucha M, Thomas SR (2000) Error analysis of classic colonic transit time estimates. Am J Physiol Gastrointest Liver Physiol 279:G520–G527.
[18] Chaussade S,Khyari A,Roche H et al. Determination of total and segmental colonic transit time in constipated patients.Results in 91 patients with a new simplified method. Dig Dis Sci 1989;34;1168-72.
[1] Bennink R, Peeters M, Van den Maegdenbergh V, et al. Evaluation of small-bowel transit for solid and liquid test meal in healthy men and women. Eur J Nucl Med. 1999 ;26(12):1560-6.
[2] Price JM, Davis SS, Sparrow RA, Wilding IR. The effect of meal composition on the gastrocolonic response: implications for drug delivery to the colon. Pharm Res. 1993;10(5):722-6.
[3] Lopes AC, Victoria CR. Fiber intake and colonic transit time in functional constipated patients rq Gastroenterol. 2008 Jan-Mar;45(1):58-63.
[4] Hinton JM ,Lennard—Jones JE,Young AC.A new method for studying gut transit time using fa—dlopaque markers.Gut-1969l10(5)t 842
[5] Chaussade S, Roche H, Khyari A, Couturier D, Guerre J. Measurement of colonic transit time: description and validation of a new method. Gastroenterol. Clin. Biol. 1986; 10: 385–9.
[6] Chan YK, Kwan AC, Yuen H, Yeung YW, Lai KC, Wu J, Wong GS, Leung CM, Cheung WC, Wong CK (2004) Normal colontransit time in healthy Chinese adults in Hong Kong. J Gastroenterol Hepatol 19(11):1270–1275.
[7] Drossman DA, Corazziari E, Delvaux M, Spiller RC, Talley NJ, Thompson WG, Whitehead WE. Rome III: The functional gastrointestinal disorders. Third Edition(KS). Allen Press, Inc., 2006: 492
[8] Metcalf AM, Phillips SF, Zinsmeister AR, MacCarty RL, Beart RW, Wolff BG. Simplified assessment of segmental colonic transit. Gastroenterology 1987; 92: 40–47.
[9] Arhan P, Devroede G, Jehannin B et al. Segmental colonic transit time. Dis. Colon Rectum 1981; 24: 625–9.
[10] Meir R, Beglinger C, Dederding JP et al. [Age- and sexspecific standardvalues of colonic transit time in healthy subjects.] Schweiz. Med. Wochenschr. 1992; 122: 940–43 (in German).
[11] Rausch T, Beglinger C, Alam N, Gyr K, Meier R. Effect of transdermal application of nicotine on colonic transit in healthy nonsmoking volunteers. Neurogastroenterol. Motil. 1998; 10: 263–70.
[1] Locke GRⅢ, Pemberton JH, Phillips SF. AGA technical review on constipation. Gastroenterology 2000;119;1161-78.
[2] Herz MJ, Kahan E, Zalevsiki S, et al. Constipation: A different entity for patients and doctors. Fam Pract 1996;13;156-9.
[3] Satish SC, RaoMD, Ph D, FRCP (Lon) . Clinical utility of diagnostic tests for constipation in adults: a systematic review. Am J Gastroenterol, 2005, 100 (7) : 1605-1615.
[4] Metcalf A, Phillips S, Zinsmeister A, et al. Simplified-Asse ssment 0f Segmental Co lonic T ransit . Gastr oenterology , 1987, 92: 40.
[5]刘世信,张殿文,吴菲,等.结肠运输试验对诊断便秘的价值.中华医学杂志, 1993, 73 ( 2) : 75.
[6]陈延,王学勤,戴菲,等.不透X线标记物检测胃肠道运动的临床应用.实用放射学杂志, 2001, 17 (9) : 647-650.
[7]展淑琴,罗金燕,龚均.便秘患者胃肠通过时间测定及意义.西安医科大学学报, 1999, 20 (3) : 329-331.
[8]查慧,谢小平,侯晓华.不同类型便秘患者直肠敏感性的差异[J].临床内科杂志,2006,23(5):317-379
[9] Brusciano L, Limongelli P, del Genio G, et al. Useful parameters helping proctologists to identify patients with defaecatory disorders that may be treated with pelvic floor rehabilitation[J]. Tech Coloproctol,2007,11(1):45-50
[10]张义侠,刘峥艳,吕森,等.慢性便秘的分型和肛门直肠测压表现[J].中华消化杂志,2001,21(8):488
[11] Karlbom U, Lund in E, GrafW, et a.l Anorectal physiology in relat ion to clinical subgroups of patients with severe constipation. Colorectal D is,2004, 6: 343-349.
[12]舒斯特等.胃肠动力学. 19章:不透射线的标志物及结肠转运.
[13]尉秀清,陈旻湖.广州市居民功能性便秘流行病学调查.胃肠病学和肝脏病学杂志, 2001; 10( 2) : 150- 152
[14]郭晓峰,柯美云,潘国宗,等.北京地区成人慢性便秘整群、分层、随机流行病学调查及其相关因素分析[ J] .中华消化杂志, 2002, 22( 10) : 637
[15]刘世信,赵丽中,殷淑珍,等.天津市区人群便秘患病率流行病学研究.中国实用外科杂志, 1994, 14(9) : 533- 535
[16]向国春,房殿春等.重庆市人群便秘患病率流行病学研究.重庆医学杂志10(10)2004,1541-43.
[17] Steward WF, Liberman JN, Sandler RS, et al . Epidemiology of constipation (EPOC) study in the Unit ed States: relation of clinical subtypes to sociodemographic features. Am J Gastroenterol, 1999, 94( 12) : 3530- 3540
[18] Talley NJ. Overlapping upper and lower gastrointestinal symptoms in irritable bowel syndrome . Am J Gastroenterol 2003; 98: 2454-2459
[19] Schiller L R. Review article: the therapy of constipation. Aliment Pharmacol Ther. 2001;15:749–763
[20] Mertz H, Naliboff B, Mayer E: Physiology of refractory chronic constipation. Am J Gastroenterol 1999, 94:609–615. 23
[21] Annie On On Chan, Gigi Leung, Teresa Tong, Nina YH Wong. Increasing dietary fiber intake in terms of kiwifruit improves constipation in Chinese patients. World J Gastroenterol 2007 September 21; 13(35): 4771-4775
[22] M. Bouchoucha ? G. Devroede ? E. Dorval ? A. Faye ? P. Arhan ? M. ArsacDifferent segmental transit times in patients with irritable bowel syndrome and “normal”colonic transit time: is there a correlation with symptoms? Tech Coloproctol (2006) 10:287–296.
[23] Chaussade S,Khyari A,Roche H et al. Determination of total and segmental colonic transit time in constipated patients.Results in 91 patients with a new simplified method. Dig Dis Sci 1989;34;1168-72.
[1] Hale EM, Smith E, St James J, Wojner-Alexandrov AW (2007) Pilot study of the feasibility and effectiveness of a natural laxative mixture. Geriatric Nursing 28(2): 104-11
[2] Bennett N, Dodd T, Flatley J et al (1995) Health Survey for England. HMSO, London British National Formulary (2009) British National Formulary. British Medical Association, London
[3] Brown SR, Cann PA, Read NW (1990) Effect of coffee on distal colonic function. Gut 31: 450-53
[4] Campbell AJ, Busby WJ, Horwath CC (1993) Factors associated with constipation in a community based sample of people aged 70 years and over. Journal of Epidemiology and Community Health 47: 23-26
[5] Chiarelli P, Brown W, McElduff P (2000) Constipation in Australian women: prevalence and associated factors. International Urogynaecological Journal 11(2): 71-78
[6] Kinnunen O (1991) Study of constipation in a geriatric hospital, day hospital, old people’s home and at home. Ageing 3(2): 161-70Archives of Disease in Childhood - Education and Practice 90(3): 58-67
[7] Davies C (2004) The use of phosphate enemas in the treatment of constipation. Nursing Times 100(18): 32-34
[8] Cope K (1996)‘Malnutrition in the elderly: A national crisis.’the obvious: a model for preventing constipation’. Journal of Gerontological Nursing 24(3): 38-44
[9] Clinical Knowledge Summaries (2008) Constipation - Management. NHS Institute for Innovation and Improvement.
[10] De Lillo A, Rose S (2000) Functional bowel disorders in the geriatric patient: constipation, faecal impaction and faecal incontinence. The American Journal ofGastroenterology. 95(4): 901-905
[11] De Schryver AM, Keulemans YC, Peters HP et al (2005). Effects of regular physical activity on defecation pattern in middle-aged patients complaining of chronic constipation. Scandinavian Journal of Gastroenterology. 40: 422-29
[12] Goodman M, Wilkinson S (2005) Constipation Management in Palliative Care: A survey of practices in the United Kingdom. Journal of Pain and Symptom Management. 29(3): 238-44
[13] Addison R, Davies C, Haslam D et al (2003). A national audit of chronic constipation in the community. Nursing Times 99(11): 34-35
[14] Harari D, Gurwitz JH, Avorn J et al (1996) Bowel habit in relation to age & gender: findings from the National Health Interview Survey and Clinical Implications. Archives of Internal Medicine 156(Feb 12): 315-19
[15] Harari D (2004)‘Bowel care in old age.’Cited in Norton C, Chelvanayagam S Bowel Continence Nursing.
[16] Hojgaard L, Arffmann S, Jorgensen M, Karg E (1981) Tea consumption: A cause of constipation? British Journal of Medicine. 282: 864
[17] Johanson JF, Kralstein J (2007) Chronic constipation: a survey of the patient perspective.Alimentary Pharmacology and Therapeutics 25: 599-608
[18] Clayden GS, Keshtgar AS, Carcani-Rathwell I, Abhyankar A (2005) The management of chronic constipation and related faecal incontinence in childhood.
[19] Kunimoto M et al (1998) The relation between irregular bowel movements and the life style of working women. Hepato-Gastoenterology 45(2): 956-60
[20] Kyle G (2007) A guide to managing constipation. Part 2. Nursing Times 103(19):42-3
[21] Kyle G (2008) A proactive approach to the treatment of constipation. Continence UK 2(4): 36-44