芦比前列酮防治全膝关节置换术后便秘的有效性:一项多中心、前瞻性、随机对照试验

注册号:

Registration number:

ChiCTR2500107656 

最近更新日期:

Date of Last Refreshed on:

2025-08-15 16:52:34 

注册时间:

Date of Registration:

2025-08-15 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

芦比前列酮防治全膝关节置换术后便秘的有效性:一项多中心、前瞻性、随机对照试验

Public title:

Efficacy of Lubiprostone in Preventing Constipation After Total Knee Arthroplasty: A Multicenter, Prospective, Randomized Controlled Trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

芦比前列酮防治全膝关节置换术后便秘的有效性:一项多中心、前瞻性、随机对照试验

Scientific title:

Efficacy of Lubiprostone in Preventing Constipation After Total Knee Arthroplasty: A Multicenter, Prospective, Randomized Controlled Trial

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

王秋入 

研究负责人:

康鹏德 

Applicant:

Wang Qiuru 

Study leader:

Kang Pengde 

申请注册联系人电话:

Applicant telephone:

+86 159 5317 2865

研究负责人电话:

Study leader's
telephone:

+86 189 8060 1953

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

hnuy@foxmail.com

研究负责人电子邮件:

Study leader's E-mail:

kangpd@163.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

四川省成都市武侯区国学巷37号

研究负责人通讯地址:

四川省成都市武侯区国学巷37号

Applicant address:

37 Guoxue Lane, Wuhou District, Chengdu, Sichuan, China

Study leader's address:

37 Guoxue Lane, Wuhou District, Chengdu, Sichuan, China

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

四川大学华西医院

Applicant's institution:

West China Hospital of Sichuan University

研究负责人所在单位:

四川大学华西医院

Affiliation of the Leader:

West China Hospital of Sichuan University

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2025年审(1143)号

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

四川大学华西医院生物医学伦理审查委员会

Name of the ethic committee:

Ethics Review Committee of Biomedical Research, West China Hospital, Sichuan University

伦理委员会批准日期:

Date of approved by ethic committee:

2025-07-15 00:00:00

伦理委员会联系人:

邓绍林

Contact Name of the ethic committee:

Deng Shaolin

伦理委员会联系地址:

四川省成都市武侯区国学巷37号

Contact Address of the ethic committee:

37 Guoxue Lane, Wuhou District, Chengdu, Sichuan, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 28 8542 3237

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

四川大学华西医院

Primary sponsor:

West China Hospital of Sichuan University

研究实施负责(组长)单位地址:

四川省成都市武侯区国学巷37号

Primary sponsor's address:

37 Guoxue Lane, Wuhou District, Chengdu, Sichuan, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

四川省

市(区县):

成都市

Country:

China

Province:

Sichuan

City:

Chengdu

单位(医院):

四川大学华西医院

具体地址:

四川省成都市武侯区国学巷37号

Institution
hospital:

West China Hospital of Sichuan University

Address:

37 Guoxue Lane, Wuhou District, Chengdu, Sichuan, China

经费或物资来源:

北京陈菊梅公益基金会

Source(s) of funding:

Beijing Chen Jumei Foundation for Public Welfare

研究疾病:

便秘  

Target disease:

Constipation

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

上市后药物 

Study phase:

4

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

主要目的:探究芦比前列酮防治全膝关节置换术后便秘的有效性。 次要目的:探究芦比前列酮防治全膝关节置换术后便秘的安全性。  

Objectives of Study:

Primary Objective: To investigate the efficacy of lubiprostone in preventing and treating constipation after total knee arthroplasty (TKA). Secondary Objective: To evaluate the safety of lubiprostone for the prevention and treatment of post-TKA constipation.

药物成份或治疗方案详述:

试验组患者术后第二天(48 小时)开始口服芦比前列酮胶囊(24 μg ,每日一次),直至术后第 14 天。若连续 72 小时未排便,则使用开塞露一次。使用开塞露 48 小时后仍不缓解,则使用生理盐水清洁灌肠一次。若出现腹泻则停止口服芦比前列酮胶囊,但仍需观察至术后 14 天。腹泻被定义为 25%以上的排便为松散粪或水样粪,且不伴有明显的腹痛或腹胀不适。 对照组:患者术后不口服通便药物。若连续 72 小时未排便,则使用开塞露一次。使用开塞露 48 小时后仍不缓解,则使用生理盐水清洁灌肠一次。 

Description for medicine or protocol of treatment in detail:

Experimental Group: Patients began oral lubiprostone capsules (24 μg once daily) starting on the second postoperative day (48 hours after surgery) and continued until postoperative day 14. If no bowel movement occurred for 72 consecutive hours, a glycerin enema was administered once. If constipation persisted 48 hours after enema use, a normal saline cleansing enema was given once. Lubiprostone was discontinued if diarrhea occurred, but patients were still observed until postoperative day 14. Diarrhea was defined as >25% of bowel movements being loose or watery stools without significant abdominal pain or bloating. Control Group: Patients received no oral laxatives postoperatively. If no bowel movement occurred for 72 consecutive hours, a glycerin enema was administered once. If constipation persisted 48 hours after enema use, a normal saline cleansing enema was given once. 

纳入标准:

Inclusion criteria

排除标准:

(1)心、肺等重要脏器功能衰竭患者; (2)肝、肾功能异常(ALT、AST>正常值 1.5倍,血 BUN>-8.3 mmoll,血 Scr>115 umol/L); (3)糖尿病患者且血糖水平控制不佳(空腹血糖>10.0 mmol/L 或 随机血糖>16.7 mmol/L 或 HbA1c>9.0%),经研究者判断有感染风险者; (4)合并意识障碍或精神疾病; (5)凝血功能严重障碍患者; (6)合并严重内、外科疾病或体质弱,无法耐受手术; (7)严重不稳定且使用韧带保留的 TKA 无法治愈; (8)体内存在活动性感染灶(全身或局部有感染病变); (9)膝关节周围具有代谢性骨病、放射性骨病、肿瘤; (10)整个临床研究期间计划生育、哺乳期及妊娠期妇女; (11)3 个月之内参加过其他临床试验者; (12)研究者认为因其他原因不适宜参加本次临床试验者; (13)膝关节屈曲畸形≥30°或内外翻畸形≥30°; (14)对本研究中使用药物过敏者; (15)阿片类药物成瘾者; (16)语言障碍及不能完成术后评估者; (17)通便药物应用禁忌的患者:如存在肠道器质性病变、梗阻性疾病的患者; (18)术前存在便秘,且对以下治疗反应不足:渗透性泻剂(如聚乙二醇、乳果糖)足量使用≥4 周;刺激性泻剂(如比沙可啶、番泻叶、麻仁丸、芦荟等)按需使用;膳食纤维补充(每日 25-30g)联合饮水≥2L,近 3 个月内每周自发排便<3 次; (19)有严重胃部疾病需要长期服用含铝抗酸剂、质子泵抑制剂、钙剂、铋剂、抗胆碱能药物、铁剂等(连续服用超过 6 个月); (20)对本研究中应用药物过敏者。

Exclusion criteria:

(1) Patients with severe dysfunction of vital organs (e.g., heart, lung, liver, or kidney); (2) Abnormal liver or kidney function (ALT/AST > 1.5×ULN, BUN > 8.3 mmol/L, Scr > 115 μmol/L); (3) Poorly controlled diabetes (fasting glucose > 10.0 mmol/L, random glucose > 16.7 mmol/L, or HbA1c > 9.0%) with infection risk as judged by investigators; (4) Patients with cognitive impairment or psychiatric disorders; (5) Severe coagulation disorders; (6) Severe concurrent medical or surgical conditions or frailty making surgery intolerable; (7) Severe instability not amenable to ligament-retaining TKA; (8) Active systemic or local infections; (9) Metabolic bone disease, radiation-induced bone disease, or tumors around the knee; (10) Women planning pregnancy, currently pregnant, or breastfeeding during the study; (11) Participation in another clinical trial within the past 3 months; (12) Investigator-determined ineligibility for other reasons; (13) Knee flexion deformity >= 30° or varus/valgus deformity >= 30°; (14) Allergy to study medications; (15) Opioid addiction; (16) Language barriers or inability to complete postoperative assessments; (17) Contraindications to laxatives (e.g., bowel obstruction or organic intestinal diseases); (18) Preoperative constipation refractory to: >= 4 weeks of osmotic laxatives (e.g., PEG, lactulose) at full dose, PRN stimulant laxatives (e.g., bisacodyl, senna, hemp seed pills, aloe), Dietary fiber (25-30g/day) + fluid intake >= 2L/day, <3 spontaneous bowel movements/week in the past 3 months. (19) Severe gastric diseases requiring long-term (>6 months) use of: Aluminum antacids, PPIs, calcium/bismuth supplements, Anticholinergics, or iron preparations. (20) Hypersensitivity to any study drug.

研究实施时间:

Study execute time:

From 2025-08-15 00:00:00 To 2027-08-15 00:00:00  

征募观察对象时间:

Recruiting time:

From 2025-08-15 00:00:00 To 2027-08-01 00:00:00

干预措施:

Interventions:

组别:

对照组

样本量:

106

Group:

control group

Sample size:

干预措施:

患者围术期常规处理

干预措施代码:

Intervention:

Routine perioperative management

Intervention code:

组别:

试验组

样本量:

106

Group:

Study group

Sample size:

干预措施:

在对照组基础上,患者术后第二天(48 小时)开始口服芦比前列酮胶囊(24 μg ,每日一次),直至术后第 14 天

干预措施代码:

Intervention:

In addition to the standard care in the control group, patients in the intervention group received oral lubiprostone capsules (24 μg once daily) starting from the second postoperative day (48 hours after surgery) until postoperative day 14.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

四川 

市(区县):

成都 

Country:

China

Province:

Sichuan

City:

Chengdu

单位(医院):

四川大学华西医院 

单位级别:

三级甲等 

Institution
hospital:

West China Hospital of Sichuan University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

宁夏回族自治区 

市(区县):

银川 

Country:

China

Province:

Ningxia Hui Autonomous Region

City:

Yinchuan

单位(医院):

宁夏医科大学总医院  

单位级别:

三级甲等 

Institution
hospital:

General Hospital of Ningxia Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

上海 

市(区县):

 

Country:

China

Province:

Shanghai

City:

单位(医院):

上海长征医院  

单位级别:

三级甲等 

Institution
hospital:

Shanghai Changzheng Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

湖北 

市(区县):

 

Country:

China

Province:

Hubei

City:

单位(医院):

华中科技大学同济医学院附属协和医院 

单位级别:

三级甲等 

Institution
hospital:

Union Hospital Affiliated to Tongji Medical College, Huazhong University of science and technology

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

四川 

市(区县):

 

Country:

China

Province:

Sichuan

City:

单位(医院):

西南医科大学附属医院 

单位级别:

三级甲等 

Institution
hospital:

Affiliated Hospital of Southwest Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

甘肃 

市(区县):

 

Country:

China

Province:

Gansu

City:

单位(医院):

兰州大学第二医院 

单位级别:

三级甲等 

Institution
hospital:

The Second Hospital of Lanzhou University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

苏州大学附属第一医院 

单位级别:

三级甲等 

Institution
hospital:

The First Affiliated Hospital of Suzhou University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

浙江 

市(区县):

 

Country:

China

Province:

Zhejiang

City:

单位(医院):

浙江大学附属第一医院 

单位级别:

三级甲等 

Institution
hospital:

The First Affiliated Hospital of Zhejiang University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

陕西 

市(区县):

 

Country:

China

Province:

Shaanxi

City:

单位(医院):

西安交通大学第二附属医院 

单位级别:

三级甲等 

Institution
hospital:

The Second Affiliated Hospital of Xi'an Jiaotong University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

青岛大学附属医院 

单位级别:

三级甲等 

Institution
hospital:

The Affiliated Hospital of Qingdao University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

北京 

市(区县):

 

Country:

China

Province:

Beijing

City:

单位(医院):

北京朝阳医院 

单位级别:

三级甲等 

Institution
hospital:

Beijing Chao-Yang Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

广西 

市(区县):

 

Country:

China

Province:

Guangxi

City:

单位(医院):

广西壮族自治区人民医院 

单位级别:

三级甲等 

Institution
hospital:

People's Hospital of Guangxi Zhuang Autonomous Region

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

江苏省人民医院 

单位级别:

三级甲等 

Institution
hospital:

Jiangsu Provincial People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

湖南 

市(区县):

 

Country:

China

Province:

Hunan

City:

单位(医院):

中南大学湘雅二医院 

单位级别:

三级甲等 

Institution
hospital:

The Second Xiangya Hospital of Zhongnan University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

自发性排便次数

指标类型:

主要指标

Outcome:

SBM

Type:

Primary indicator

测量时间点:

术后第 2 天到第 14 天

测量方法:

患者自报

Measure time point of outcome:

Measure method:

指标中文名:

便秘症状评估

指标类型:

次要指标

Outcome:

constipation Symptom Scale Assessment

Type:

Secondary indicator

测量时间点:

术后第 2 天到第 14 天

测量方法:

以下症状在基线(第 0 天)、术后第 2 天到第 14 天按 0(从不)到 4(总是)的 5 分制进行评分:恶心、腹胀、用力排便、腹痛

Measure time point of outcome:

Measure method:

指标中文名:

便秘发生率

指标类型:

次要指标

Outcome:

Constipation Incidence

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后使用开塞露和灌肠次数

指标类型:

次要指标

Outcome:

Number of Postoperative Glycerin Enema and Irrigation Uses

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后每天平均每次上厕所的时间

指标类型:

次要指标

Outcome:

Postoperative Mean Daily Time per Defecation Episode

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后每天平均排便未成功尝试的次数

指标类型:

次要指标

Outcome:

Postoperative Mean Daily Unsuccessful Defecation Attempts

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

住院时间

指标类型:

次要指标

Outcome:

Length of Hospital Stay

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

并发症发生率

指标类型:

次要指标

Outcome:

Incidence of Complications

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术中和术后的阿片类药物消耗量

指标类型:

次要指标

Outcome:

Intraoperative and Postoperative Opioid Consumption

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

None

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 40 years
最大 Max age 80 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

本研究采用随机数表法将212例符合标准的患者随机分为试验组和对照组(各106例)。具体实施过程如下:首先由课题统计员使用标准随机数表生成分配序列,采用区组长度为6的区组随机化方法确保组间平衡;然后将分组结果密封于编号的保密信封中,当患者完成知情同意和入组评估后,由专职研究护士按顺序拆阅信封执行分组。试验组在常规治疗基础上加用芦比前列酮24μg qd口服,对照组不给予便秘干预措施。整个随机化过程严格执行以下质控措施:(1)随机数表由独立统计人员保管;(2)分配信封采用双层不透光设计;(3)分组后立即登记备案。

Randomization Procedure (please state who generates the random number sequence and by what method):

This study used a random number table method to randomly allocate 212 eligible patients into an experimental group and a control group (106 cases each). The implementation process was as follows: First, the study statistician generated allocation sequences using a standard random number table, employing block randomization with a block size of 6 to ensure inter-group balance. The grouping results were then sealed in numbered confidential envelopes. After patients completed informed consent and enrollment assessments, dedicated research nurses opened the envelopes sequentially to execute group allocation. The experimental group received lubiprostone 24μg once daily orally in addition to standard treatment, while the control group received no constipation interventions. The randomization process strictly implemented the following quality control measures: (1) The random number table was maintained by independent statisticians; (2) Allocation envelopes used double-layer opaque design; (3) Immediate registration and record-keeping were performed after grouping.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

Blinding:

None

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

是Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

公开原始数据日期:试验完成后公开;公开内容:原始记录的数据和研究计划书;共享原始数据的方式:向研究者联系索取。

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

Date of release of raw data: released after the completion of the experiment; Public content: Original recorded data and research proposal; The way to share raw data: contact and request from researchers.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

本研究采用 EDC(eCRF)系统,此系统和支持系统的服务由合作的供应商提供。研究者必须保证完整和准确地填写电子病例报告表。每份电子病例报告表中只记录一个临床研究受试者的数据资料。 研究者应确保回答所有相关的疑问。如果一项检查或评价没有完成或无法完成,或者问题是不相关的(如不适用),需根据数据录入说明填写。 研究者必须确保所有信息与原始记录一致。研究者通过在eCRF上进行电子签名确认eCRF 和相关表格上信息的完整性和正确性。 参加临床试验的各中心,均应按照标准操作规程执行,以保证临床试验的质量控制和质量保证系统的实施。在正式试验开始前,对参加试验的有关医务人员和临床监查员同期进行临床方案的统一培训,保证eCRF中所有记录的内容均应与病程记录一致。

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

This study adopts the EDC (eCRF) system, and the services of this system and the supporting system are provided by cooperative suppliers. Researchers must ensure complete and accurate completion of electronic case report forms. Each electronic case report form only records the data of one clinical study subject. Researchers should ensure that all relevant questions are answered. If an inspection or evaluation is not completed or cannot be completed, or if the issue is unrelated (if not applicable), it should be filled in according to the data entry instructions. Researchers must ensure that all information is consistent with the original records. Researchers confirm the completeness and accuracy of information on eCRF and related forms by electronically signing on eCRF. Each center participating in clinical trials should follow standard operating procedures to ensure the quality control of clinical trials and the implementation of quality assurance systems. Before the formal trial begins, relevant medical personnel and clinical monitors participating in the trial shall receive unified training on the clinical protocol at the same time to ensure that all recorded contents in eCRF are consistent with the disease course records.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

无/No

注册人:

Name of Registration:

 2025-08-15 16:52:30