The Korean Journal of Gastroenterology (대한소화기학회지)

The Korean Society of Gastroenterology (대한소화기학회)
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Comparative Study on Bowel Preparation Efficacy of Ascorbic Acid Containing Polyethylene Glycol by Adding Either Simethicone or 1 L of Water in Health Medical Examination Patients: A Prospective Randomized Controlled Study

건강검진 환자에서 Polyethylene Glycol with Ascorbic Acid를 이용한 대장내시경 전처치에서 Simethicone 병합, 물 1 L 추가 복용의 효과 비교: 전향적 무작위 대조군 연구

  • Yeo, Se Hwan (Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine) ;
  • Kwak, Jae Hoon (Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine) ;
  • Kim, Yeo Un (Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine) ;
  • Kwon, Tae Ho (Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine) ;
  • Park, Jeong Bae (Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine) ;
  • Park, Jun Hyung (Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine) ;
  • Lee, Yong Kook (Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine) ;
  • Lim, Yun Jeong (Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine) ;
  • Yang, Chang Heon (Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine)
  • 여세환 (동국대학교 의과대학 동국대학교경주병원 내과학교실) ;
  • 곽재훈 (동국대학교 의과대학 동국대학교경주병원 내과학교실) ;
  • 김여운 (동국대학교 의과대학 동국대학교경주병원 내과학교실) ;
  • 권태호 (동국대학교 의과대학 동국대학교경주병원 내과학교실) ;
  • 박정배 (동국대학교 의과대학 동국대학교경주병원 내과학교실) ;
  • 박준형 (동국대학교 의과대학 동국대학교경주병원 내과학교실) ;
  • 이용국 (동국대학교 의과대학 동국대학교경주병원 내과학교실) ;
  • 임윤정 (동국대학교일산병원 내과학교실) ;
  • 양창헌 (동국대학교 의과대학 동국대학교경주병원 내과학교실)
  • Received : 2016.01.14
  • Accepted : 2016.03.23
  • Published : 2016.04.25
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Abstract

Background/Aims: There are no studies that looked into the bubble eliminating efficacy of polyethylene glycol with ascorbic acid (PEGA), which has been one of the shortcomings of polyethylene glycol (PEG). In this study, we compared newly introduced PEGA regimen by adding either simethicone or 1 L of water. Methods: A prospective randomized controlled study was carried out at Dongguk Universtiy Gyeongju Hospital from July 2014 to September 2014. A total of 90 patients were randomly assigned to 3 groups; PEGA group (n=30) which served as control, simethicone addition group (n=30) to which simethicone 400 mg was additionally prescribed, and water addition group (n=30) to whom additional 1 L of water was given. Cleansing effectiveness, gas elimination efficacy, side effects, and patient satisfaction were compared between the groups. Results: PEGA group demonstrated the highest cleansing effectiveness, but there was no statistically significant difference among the groups. Simethicone addition group showed significantly lesser amount of bubbles than the other groups ($2.57{\pm}2.05$ vs. $1.10{\pm}1.83$ vs. $2.60{\pm}2.84$, p=0.017). The rates of side effects in each group were 20.00% vs. 16.77% vs. 53.33%. Water addition group had significantly more side effects than the PEGA group and the simethicone addition group (p=0.003). The patient satisfaction score of each group was $3.37{\pm}0.85$ vs. $3.73{\pm}0.74$ vs. $3.20{\pm}0.66$ with simethicone addition group showing significantly higher satisfaction than water addition group (p=0.020). Conclusions: PEGA bowel preparation agent showed satisfactory bowel cleansing despite the decrease in dosage, and addition of simethicone resulted in better bubble elimination.

목적: 기존에 널리 사용된 PEG의 단점을 보완하고자 새롭게 도입된 PEGA에 있어 점막 내 기포 제거에 주안점을 둔 연구가 없었다. 이에 이번 연구에서 기포 제거제인 simethicone 추가군과 대장 점막의 flushing 효과를 기대한 물 1리터 추가군을 두어 대장 정결도, 점막 기포도, 부작용, 환자 만족도 등을 알아보고자 하였다. 대상 및 방법: 전향적 무작위 대조 연구이며, 건강 검진을 위해 내원한 외래 수검자 90명의 환자 중 각각 30명씩 PEGA군, simethicone 추가군, 물 1리터 추가군에 무작위로 배정하여 대장 정결도, 점막 기포도, 환자가 호소하는 부작용 및 만족도를 평가하였다. 결과: PEGA군에서 대장 정결도가 가장 높았으나, 통계적 유의성은 없었다. 점막 기포도는 세 군에서 $2.57{\pm}2.05$ vs. $1.10{\pm}1.83$ vs. $2.60{\pm}2.84$로 나타났으며, simethicone 추가군이 통계적으로 유의하게 점막 기포도가 낮은 것으로 나타났다(p=0.017). 환자가 호소하는 부작용은 세 군에서 20.0% vs. 16.7% vs. 53.3%로 나타났으며, 물 1리터 추가군이 다른 두 군에 비해 통계적으로 유의하게 많은 것으로 나타났다(p=0.003). 환자의 만족도는 세 군에서 $3.37{\pm}0.85$점, $3.73{\pm}0.74$점, $3.20{\pm}0.66$점으로 나타났으며, 이들 중 simethicone 추가군이 물 1리터 추가군보다 통계적으로 유의하게 높은 것으로 나타났다(p=0.020). 결론: PEGA가 복용량의 감소에도 불구하고 수긍할 만한 대장 정결도를 보였으며, 점막 기포 제거에 있어서 simethicone 병합요법이 필요할 것으로 판단된다.

Keywords

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