| Objective Constipation is a common complaint in clinical practice and usually refers to persistent,difficult,infrequent,or seemingly incomplete defecation.The diagnosis of functional constipation is made according to the RomeⅢcriteria after having ruled out secondary causes.The diagnosis of constipation-predominant IBS is made according to the RomeⅢCriteria for the Diagnosis of IBS.Therapies are always guided according to functional subtype slow-transit constipation,dyssynergic defecation,and constipation-predominant irritable bowel.Traditionally,the pharmacologic treatment of constipation uses laxatives included bulking agents, osmotic agents,stool softeners,and stimulants of the gastrointestinal tract.However, often these therapies do not provide the desired effect of treatment especially on intractable constipation.Thus,there is a clinical need for new,more potent medicines for constipated patients who are not satisfactorily treated by conventional therapies.This study is to determine the possible efficacy of compound azintamide on constipation resulted from functional constipation or IBS-C and with a control group of patients treated by PEG 4000(osmotic laxative).Methods A sample of 59 people with functional constipation or IBS-C which were diagnoesd according to the RomeⅢcriteria by a simple stool description from July 2008 to February 2009 was included and randomized in two groups.The two groups were assigned to 4 weeks of different medicine therapies:compound azintamide enteric-coated tablets,2 tablets three times daily,and PEG 4000,20g,once daily.Stool frequency should be recorded every week.The Bristol Stool Form scale plays an important role in assessment of stool form and consistency changing.Visual analogue scale is contributory in the evaluation of patients presenting,such as perception of difficult defecation(the perception of hard stools or excessive straining),flatulence and abdominal pain,with constipation.Results After 4 weeks,according to the Visual Analogue Scale,the scores of defecation effort,abdominal pain and abdominal flatulence were obviously decreased(P＜0.05) in both compound azintamide group and PEG 4000 group compared with baseline.The total effective rate of three types of symptoms in two groups were 67.86%and 61.29%,75.00%and 71.43%,86.36%and 66.67%,respectively.The Bristol score of stool consistency of two groups were both obviously increased(P＜0.05) after 4 weeks of treatment.There were no significant differences between two groups with these clinical symptoms.The median weekly frequency of bowel movement of two groups were both obviously increased(P＜0.05) after 4 weeks of treatment.Conclusions Compound azintamide is a kind of drug which could promote the biliary secretion,not only increase the volume of bile secretion,but also increase the inherent components of bile secretion。Cholic acid,as a kind of endogenous catharsis substances,could be secreted into the intestine with bile.Increased secretion of cholic acid can stimulate colonic secretion and cause secretory diarrhea.PEG 4000 was a kind of long-chain polymers,which used as a permeability laxative in the clinical application.It allows an increase of intestinal fluid after oral application,which can cause diarrhea.PEG 4000 has an obvious therapeutic effect to those cases with functional constipation or IBS-C.It can increase frequency of bowel movement and improve the stool consistency.In this dissertation it was proved that compound azintamide indeed has an obvious therapeutic effect to those cases with functional constipation or IBS-C.It can improve the clinical symptoms,and can obviously release the pain of patients.There were no significant differences between compound azintamide and PEG 4000 in therapeutic effect except stool times perweek which was not compared.
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