[1]张树成,白玉作.儿童便秘的治疗手段及其应用指征[J].临床小儿外科杂志,2020,19(01):12-17,25.[doi:10.3969/j.issn.1671-6353.2020.01.003]
　Zhang Shucheng,Bai Yuzuo.Treatment of children with constipation and indications for its application[J].Journal of Clinical Pediatric Surgery,2020,19(01):12-17,25.[doi:10.3969/j.issn.1671-6353.2020.01.003]
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儿童便秘的治疗手段及其应用指征

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第19卷 期数: 2020年01期 页码: 12-17,25 栏目: 专家笔谈 出版日期: 2020-01-01
Title:
Treatment of children with constipation and indications for its application
作者:
张树成;  白玉作
中国医科大学附属盛京医院小儿外科(辽宁省沈阳市, 110004)
Author(s):
Zhang Shucheng;  Bai Yuzuo
Department of Pediatric Surgery, Affiliated Shengjing Hospital, China Medical University
关键词:
便秘; 治疗; 研究; 儿童
Keywords:
Constipatipn; Therapy; Research; Child
分类号:
R726;R574.62
DOI:
10.3969/j.issn.1671-6353.2020.01.003
摘要:
便秘是儿童期常见的消化道症状之一，严重影响患儿的身体健康和生活质量。对于儿童便秘目前有很多治疗措施，如行为治疗、药物治疗、生物反馈治疗及中医药疗法等，其中某些干预手段的顺利实施需要医生、患儿家长以及患儿本人的配合协作。每种方法具有自身适应证，并非适用于所有类型的便秘。本文对儿童便秘治疗手段进行简要回顾，并对这些治疗手段的应用指证进行探讨。
Abstract:
As a common pediatric problem,constipation often causes distress to both children and their parents.Up until now,numerous clinical studies on treating childhood constipation have been reported,such as pharmacotherapy,biofeedbacks and traditional Chinese medicine,etc.However,a cure requires prolonged supports of physicians and parents,medical interventions and patient cooperation.

参考文献/References:

1 van den Berg MM,Benninga MA,Di Lorenzo C.Epidemiology of childhood constipation:a systematic review[J].Am J Gastroenterol,2006,101(10):2401-2409.DOI:10.1111/j.1572-0241.2006.00771.x.
2 Bongers ME,van Wijk MP,Reitsma JB,et al.Long-term prognosis for childhood constipation:clinical outcomes in adulthood[J].Pediatrics,2010,126(1):e156-e162.DOI:10.1542/peds.2009-1009.
3 Nurko S.Advances in the management of pediatric constipation[J].Curr Gastroenterol Rep,2000,2(3):234-240.DOI:10.1007/s11894-000-0066-0.
4 van Ginkel R,Reitsma JB,Buller HA,et al.Childhood constipation:longitudinal follow-up beyond puberty[J].Gastroenterology,2003,125(2):357-363.DOI:10.1016/s0016-5085(03)00888-6.
5 Hyman PE,Milla PJ,Benninga MA,et al.Childhood functional gastrointestinal disorders:neonate/toddler[J].Gastroenterology,2006,130(5):1519-1526.DOI:10.1053/j.gastro.2005.11.065.
6 Benninga MA,Faure C,Hyman PE,et al.Childhood Functional Gastrointestinal Disorders:Neonate/Toddler[J].Gastroenterology,2016.DOI:10.1053/j.gastro.2016.02.016.
7 van Dijk M,Bongers ME,de Vries GJ,et al.Behavioral therapy for childhood constipation:a randomized,controlled trial[J].Pediatrics,2008,121(5):e1334-e1341.DOI:10.1542/peds.2007-2402.
8 Tabbers MM,Boluyt N,Berger MY,et al.Nonpharmacologic treatments for childhood constipation:systematic review[J].Pediatrics,2011,128(4):753-761.DOI:10.1542/peds.2011-0179.
9 Chan MF,Chan YL.Investigating factors associated with functional constipation of primary school children in Hong Kong[J].J Clin Nurs,2010,19(23-24):3390-3400.DOI:10.1111/j.1365-2702.2010.03362.x.
10 Chu H,Zhong L,Li H,et al.Epidemiology characteristics of constipation for general population,pediatric population,and elderly population in china[J].Gastroenterol Res Pract,2014,2014:532734.DOI:10.1155/2014/532734.
11 Nurko S,Zimmerman LA.Evaluation and treatment of constipation in children and adolescents[J].Am Fam Physician,2014,90(2):82-90.
12 Mueller-Lissner S,Kamm MA,Wald A,et al.Multicenter,4-week,double-blind,randomized,placebo-controlled trial of sodium picosulfate in patients with chronic constipation[J].Am J Gastroenterol,2010,105(4):897-903.DOI:10.1038/ajg.2010.41.
13 Liem O,Benninga MA,Mousa HM,et al.Novel and alternative therapies for childhood constipation[J].Curr Gastroenterol Rep,2007,9(3):214-218.DOI:10.1007/s11894-007-0021-4.
14 Nurko S,Youssef NN,Sabri M,et al.PEG3350 in the treatment of childhood constipation:a multicenter,double-blinded,placebo-controlled trial[J].J Pediatr,2008,153(2):254-261.DOI:10.1016/j.jpeds.2008.01.039.
15 Candy D,Belsey J.Macrogol (polyethylene glycol) laxatives in children with functional constipation and faecal impaction:a systematic review[J].Arch Dis Child,2009,94(2):156-160.DOI:10.1136/adc.2007.128769.
16 Lee-Robichaud H,Thomas K,Morgan J,et al.Lactulose versus polyethylene glycol for chronic constipation[J].Cochrane Database Syst Rev,2010,7(7):CD007570.DOI:10.1002/14651858.CD007570.pub2.
17 Loening-Baucke V.Prevalence,symptoms and outcome of constipation in infants and toddlers[J].J Pediatr,2005,146(3):359-363.DOI:10.1016/j.jpeds.2004.10.046.
18 Bongers ME,van den Berg MM,Reitsma JB,et al.A randomized controlled trial of enemas in combination with oral laxative therapy for children with chronic constipation[J].Clin Gastroenterol Hepatol,2009,7(10):1069-1074.DOI:10.1016/j.cgh.2009.06.018.
19 Chan KY,de Vries R,Leijten FP,et al.Functional characterization of contractions to tegaserod in human isolated proximal and distal coronary arteries[J].Eur J Pharmacol,2009,619(1-3):61-67.DOI:10.1016/j.ejphar.2009.07.010.
20 曾俊, 贾克东, 徐伟民. 生物反馈训练治疗出口梗阻性便秘的疗效观察[J]. 实用中西医结合临床, 2005(3):27-28.DOI:10.3969/j.issn.1671-4040.2005.03.020. Zeng J,Jia KD,Xu WM.Observation on the effect of biofeedback training on outlet obstructive constipation[J].Practical Clinical Journal of Integrated Traditional Chinese and Western Medicine,2005(3):27-28.DOI:10.3969/j.issn.1671-4040.2005.03.020.
21 Chiotakakou-Faliakou E,Kamm MA,Roy AJ,et al.Biofeedback provides long-term benefit for patients with intractable,slow and normal transit constipation[J].Gut,1998,42(4):517-521.DOI:10.1136/gut.42.4.517.
22 Croffie JM,Ammar MS,Pfefferkorn MD,et al.Assessment of the effectiveness of biofeedback in children with dyssynergic defecation and recalcitrant constipation/encopresis:does home biofeedback improve long-term outcomes[J].Clin Pediatr (Phila),2005,44(1):63-71.DOI:10.1177/000992280504400108.
23 Leong LC,Yik YI,Catto-Smith AG,et al.Long-term effects of transabdominal electrical stimulation in treating children with slow-transit constipation[J].J Pediatr Surg,2011,46(12):2309-2312.DOI:10.1016/j.jpedsurg.2011.09.022.
24 Privitera AC,Oliveri CE,Randazzo G,et al.Biofeedback therapy for outlet dysfunction:our experience[J].Chir Ital,2009,61(3):281-288.
25 Higgins PD,Johanson JF.Epidemiology of constipation in North America:a systematic review[J].Am J Gastroenterol,2004,99(4):750-759.DOI:10.1111/j.1572-0241.2004.04114.x.
26 Gill HS,Guarner F.Probiotics and human health:a clinical perspective[J].Postgrad Med J,2004,80(947):516-526.DOI:10.1136/pgmj.2003.008664.
27 Banaszkiewicz A,Szajewska H.Ineffectiveness of Lactobacillus GG as an adjunct to lactulose for the treatment of constipation in children:a double-blind,placebo-controlled randomized trial[J].J Pediatr,2005,146(3):364-369.DOI:10.1016/j.jpeds.2004.10.022.
28 Allen AP,Clarke G,Cryan JF,et al.Bifidobacterium infantis [35624] and other probiotics in the management of irritable bowel syndrome.Strain specificity,symptoms,and mechanisms[J].Curr Med Res Opin,2017,33(7):1349-1351.DOI:10.1080/03007995.2017.1322571.
29 Sui SJ,Tian ZB,Wang QC,et al.Clostridium butyricum promotes intestinal motility by regulation of TLR2 in interstitial cells of Cajal[J].Eur Rev Med Pharmacol Sci,2018,22(14):4730-4738.DOI:10.26355/eurrev_201807_15533.
30 Miao RX,Zhu XX,Wan CM,et al.Effect of Clostridium butyricum supplementation on the development of intestinal flora and the immune system of neonatal mice[J].Exp Ther Med,2018,15(1):1081-1086.DOI:10.3892/etm.2017.5461.
31 Kim YG,Sakamoto K,Seo SU,et al.Neonatal acquisition of clostridia species protects against colonization by bacterial pathogens[J].Science,2017,356(6335):315-319.DOI:10.1126/science.aag2029.
32 Yan F,Polk DB.Probiotic bacterium prevents cytokine-induced apoptosis in intestinal epithelial cells[J].J Biol Chem,2002,277(52):50959-50965.DOI:10.1074/jbc.M207050200.
33 Otero MC,Nader-Macias ME.Inhibition of Staphylococcus aureus by H2O2-producing Lactobacillus gasseri isolated from the vaginal tract of cattle[J].Anim Reprod Sci,2006,96(1-2):35-46.DOI:10.1016/j.anireprosci.2005.11.004.
34 Guerra PV,Lima LN,Souza TC,et al.Pediatric functional constipation treatment with Bifidobacterium-containing yogurt:a crossover,double-blind,controlled trial[J].World J Gastroenterol,2011,17(34):3916-3921.DOI:10.3748/wjg.v17.i34.3916.
35 Everhart JE,Ruhl CE.Burden of digestive diseases in the United States part I:overall and upper gastrointestinal diseases[J].Gastroenterology,2009,136(2):376-386.DOI:10.1053/j.gastro.2008.12.015.
36 Linetzky Waitzberg D,Alves Pereira CC,Logullo L,et al.Microbiota benefits after inulin and partially hydrolized guar gum supplementation:a randomized clinical trial in constipated women[J].Nutr Hosp,2012,27(1):123-129.DOI:10.1590/S0212-16112012000100014.
37 Olano-Martin E,Gibson GR,Rastell RA.Comparison of the in vitro bifidogenic properties of pectins and pectic-oligosaccharides[J].J Appl Microbiol,2002,93(3):505-511.DOI:10.1046/j.1365-2672.2002.01719.x.
38 Ustundag G,Kuloglu Z,Kirbas N,et al.Can partially hydrolyzed guar gum be an alternative to lactulose in treatment of childhood constipation?[J].Turk J Gastroenterol,2010,21(4):360-364.DOI:10.4318/tjg.2010.0121.
39 Granstrom AL,Husberg B,Nordenskjold A,et al.Laparoscopic-assisted pull-through for Hirschsprung’s disease,a prospective repeated evaluation of functional outcome[J].Journal Of Pediatric Surgery,2013,48(12):2536-2539.DOI:10.1016/j.jpedsurg.2013.07.017.

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备注/Memo

收稿日期:2019-11-22。
通讯作者:白玉作,Email:baiyz@sj-hospital.org

更新日期/Last Update: 1900-01-01