Application of the combination of prucalopride and lactulose in the refractory constipation

Objective To evaluation of the efficacy of the combination of prucalopride and lactulose in the patients with refractory constipation. Methods From January 2013 to June 2015, thirty-five cases of patients with refractory constipation whom were not benefited from single drug treatment (prucalopride, 2 mg/day, for 4 weeks, and the average weekly complete spontaneous bowel movements<3 times) were treated by the combination of prucalopride (2 mg/day) and lactulose (15 ml×2 times/day) for 8 weeks. The time and number of complete spontaneous bowel movements (CSBMs) was observed. The bristol stool scale, gastrointestinal quality of life score (GIQLI), Wexner constipation score and a 36-item short-form (SF-36) were compared before and after combined treatment of prucalopride and lactulose in patients with refractory constipation to observe the improvement of constipation and quality of life, and the adverse reaction events. Results The first time of CSBM is (6.7±3.2) d and (2.4±2.1) d h (t=10.161, P<0.01) in the study group before and after combined medication. The average number of CSBMs is (0.86±0.77) times/week (4 weeks before combined medication) and (5.26±6.09) times/week (8 weeks after combined medication), respectively (t=-4.363, P<0.01). Compared to the single drug medication, the constipation symptoms and quality of life of the patients were significantly improved after combined medication (all P<0.01). 25 cases in 35 patients with refractory constipation has CSBMs more than 3 times a week after 8 weeks of combination of prucalopride and lactulose, with the effective rate 71.4% (25/35). Only little mild and moderate adverse reactions such as nausea, headache and abdominal distension were observed and were natural disappeared several days after medication. Conclusion The combination of prucalopride and lactulose can be effectively improved the related symptoms and quality of life of the patients with refractory constipation, which is worthy of clinical application. Key words: Constipation; Therapy; Prucalopride; Lactulose; Combined combination; Effect