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AvaliaÃÃo da eficÃcia terapÃutica da tintura de jalapa no tratamento da constipaÃÃo intestinal funcional. / Evaluation of the Therapeutical Effectiveness of the Tintura of Jalapa in the Treatment of the Functional ConstipationGilmara Holanda da Cunha 12 January 2009 (has links)
CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / A Operculina alata, conhecida como jalapa, à uma planta cuja raiz à utilizada pela populaÃÃo em virtude do seu efeito laxante. Um ensaio clÃnico duplo cego, controlado por placebo, randomizado e paralelo avaliou a eficÃcia terapÃutica da tintura de jalapa no tratamento da constipaÃÃo intestinal funcional, na Unidade de Farmacologia ClÃnica, CearÃ, Brasil. Foram dois grupos de tratamento, o grupo Jalapa e o grupo Placebo, ambos compostos por 38 voluntÃrios com constipaÃÃo intestinal funcional. O estudo teve 3 fases, cada uma com duraÃÃo de 7 dias, em que o voluntÃrio registrava num diÃrio dados das evacuaÃÃes. No prÃ-tratamento houve a seleÃÃo de voluntÃrios. No tratamento ocorreu a randomizaÃÃo e administraÃÃo da tintura de jalapa ou placebo. No pÃs-tratamento os voluntÃrios foram observados apÃs suspensÃo da tintura de jalapa ou placebo. A eficÃcia foi avaliada atravÃs das variÃveis primÃrias: frequÃncia mÃdia de evacuaÃÃes (FME), consistÃncia mÃdia das fezes (CMF) e melhora global da constipaÃÃo (MGC). As variÃveis secundÃrias foram proporÃÃo de evacuaÃÃes com dor (PED), proporÃÃo de evacuaÃÃes com esforÃo (PEE), nÃmero de dias seguidos sem evacuar (DSE) e grau de melhora da constipaÃÃo. Todos os voluntÃrios participantes foram do sexo feminino. No grupo Placebo houve perda de segmento de 5 voluntÃrias e no grupo Jalapa, apenas duas desistiram. A maioria das voluntÃrias procedia da cidade de Fortaleza. O menor grau de escolaridade encontrado foi o ensino fundamental incompleto representado por 10,5% da amostra. Havia uso de agentes laxativos por 69,8% das voluntÃrias. No prÃ-tratamento, os grupos Jalapa e Placebo mostraram semelhanÃa estatÃstica quanto à idade, IMC e CMF, mas diferiram quanto a FME, onde o grupo Placebo (0321  0,108) apresentou valores maiores que os grupo Jalapa (0,262  0,132). No tratamento e pÃs-tratamento, a FME e a CMF foram significantemente maiores no grupo Jalapa que no grupo Placebo, com 55,26% dos voluntÃrios do grupo Jalapa apresentando aumento simultÃneo dos valores da FME e CMF, o que foi representado pela MGC, com probabilidade 3,5 vezes maior de melhorar da constipaÃÃo com a tintura de jalapa que com o placebo. Os valores da PED, da PEE e do DSE no grupo Jalapa foram menores e estatisticamente significantes que os do grupo Placebo nas fases de tratamento e pÃs-tratamento. A proporÃÃo de voluntÃrios do grupo Jalapa que relataram alÃvio razoÃvel e total dos sintomas da constipaÃÃo nas fases de tratamento e pÃs-tratamento foram significantemente maiores que no grupo Placebo. Houve alteraÃÃes da pressÃo arterial sistÃlica, diastÃlica e frequÃncia cardÃaca, mas foram consideradas sem relevÃncia clÃnica. NÃo ocorreram alteraÃÃes de massa corporal e eventos adversos graves, mas destacaram-se a tontura, cefalÃia e dor abdominal. Este estudo concluiu que a tintura de jalapa à eficaz no tratamento agudo da constipaÃÃo intestinal funcional nos voluntÃrios estudados. / The Operculina alata, known as Jalapa, is a plant whose root is used by the population because of its laxative effect. A double-blind clinical trial, placebo controlled, randomized, parallel evaluated the therapeutic efficacy of tincture of Jalapa in the treatment of functional constipation in the Unit of Clinical Pharmacology, CearÃ, Brazil. There were two treatment groups, the Jalapa group and the Placebo group, both consisting of 38 volunteers with functional constipation. The study had 3 phases, seven days in each phase, in which the volunteer data recorded in a diary of bowel movements. During the pre-treatment there was the selection of volunteers. In the treatment occurred the randomization and administration of tincture of Jalapa or placebo. The post-treatment were observed after the voluntary suspension of tincture of Jalapa or placebo. The effectiveness was evaluated through the primary variables: average frequency of evacuations (AFE), average consistency of faeces (ACF) and global improvement of constipation (GIC). Secondary variables were the proportion of evacuations with pain (PED), proportion of effort evacuations (PEE), number of consecutive days without evacuation (DWE) and degree of improvement in constipation. All volunteer participants were female. In the placebo group there was lost segment of 5 volunteers and in the Jalapa group, only two were removed. Most volunteers came from the city of Fortaleza. The lower level of education found the primary school was represented by 10.5% of the sample. There was use of laxative agents by 69.8% of volunteers. In the pre-treatment, Jalapa and Placebo groups showed statistically similar in age, BMI and ACF, but differed in the AFE, where the Placebo group (0321  0108) showed that the largest group Jalapa (0262  0132). In the treatment and post-treatment, the AFE and ACF were significantly higher in Jalapa group than in the Placebo group, with 55.26% of volunteers of the Jalapa group showing increased values of AFE and ACF, which was represented by the GIC with 3.5 times more likely to improve the constipation with the tincture of Jalapa that with placebo. The values of the PED, the PEE and the DWE in Jalapa group were lower and statistically significant than those in the placebo group during treatment and post-treatment. The proportion of volunteers reported that the Jalapa group reasonable and complete relief of symptoms of constipation during treatment and after treatment was significantly higher than in the placebo group. There were changes in systolic blood pressure, diastolic and heart rate, but were without clinical relevance. There were no changes in body mass and serious adverse events, but highlighted to dizziness, headache and abdominal pain. This study found that the tincture of Jalapa is effective in the acute treatment of functional constipation in volunteers studied.
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