症状缓解：有高质量的证据显示对于慢性便秘比沙可啶是一种有效且耐受性好的治疗，可以改善肠道功能、便秘相关症状和疾病相关的生活质量。[69]Kamm MA, Mueller-Lissner S, Wald A, et al. Oral bisacodyl is effective and well-tolerated in patients with chronic constipation. Clin Gastroenterol Hepatol. 2011 Jul;9(7):577-83.http://www.ncbi.nlm.nih.gov/pubmed/21440672?tool=bestpractice.com
系统评价或者受试者＞200名的随机对照临床试验（RCT）。
症状缓解：有高质量的证据显示对于慢性便秘比沙可啶是一种有效且耐受性好的治疗，可以改善肠道功能、便秘相关症状和疾病相关的生活质量。[69]Kamm MA, Mueller-Lissner S, Wald A, et al. Oral bisacodyl is effective and well-tolerated in patients with chronic constipation. Clin Gastroenterol Hepatol. 2011 Jul;9(7):577-83.http://www.ncbi.nlm.nih.gov/pubmed/21440672?tool=bestpractice.com
症状缓解：有高质量的证据显示利那洛肽治疗慢性便秘可显著减少肠道和腹部症状且显著改善自主排便、粪便性状、排便费力、腹部不适、胀气、全面评估和生活治疗。[73]Ford AC, Suares NC. Effect of laxatives and pharmacological therapies in chronic idiopathic constipation: systematic review and meta-analysis. Gut. 2011 Feb;60(2):209-18.http://www.ncbi.nlm.nih.gov/pubmed/21205879?tool=bestpractice.com[76]Lembo AJ, Schneier HA, Shiff SJ, et al. Two randomized trials of linaclotide for chronic constipation. N Engl J Med. 2011 Aug 11;365(6):527-36.http://www.ncbi.nlm.nih.gov/pubmed/21830967?tool=bestpractice.com[77]Rao S, Lembo AJ, Shiff SJ, et al. A 12-week, randomized, controlled trial with a 4-week randomized withdrawal period to evaluate the efficacy and safety of linaclotide in irritable bowel syndrome with constipation. Am J Gastroenterol. 2012 Nov;107(11):1714-24.http://www.nature.com/ajg/journal/v107/n11/full/ajg2012255a.htmlhttp://www.ncbi.nlm.nih.gov/pubmed/22986440?tool=bestpractice.com[78]Chey WD, Lembo AJ, Lavins BJ, et al. Linaclotide for irritable bowel syndrome with constipation: a 26-week, randomized, double-blind, placebo-controlled trial to evaluate efficacy and safety. Am J Gastroenterol. 2012 Nov;107(11):1702-12.http://www.nature.com/ajg/journal/v107/n11/full/ajg2012254a.htmlhttp://www.ncbi.nlm.nih.gov/pubmed/22986437?tool=bestpractice.com[79]Lee N, Wald A. Linaclotide: evidence for its potential use in irritable bowel syndrome and chronic constipation. Core Evid. 2012;7:39-47.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3396047/http://www.ncbi.nlm.nih.gov/pubmed/22807692?tool=bestpractice.com[80]Quigley EM, Tack J, Chey WD, et al. Randomised clinical trials: linaclotide phase 3 studies in IBS-C - a prespecified further analysis based on European Medicines Agency-specified endpoints. Aliment Pharmacol Ther. 2013 Jan;37(1):49-61.http://onlinelibrary.wiley.com/doi/10.1111/apt.12123/fullhttp://www.ncbi.nlm.nih.gov/pubmed/23116208?tool=bestpractice.com 然而，需要进一步的研究评价利那洛肽治疗慢性便秘的长期风险和受益。[76]Lembo AJ, Schneier HA, Shiff SJ, et al. Two randomized trials of linaclotide for chronic constipation. N Engl J Med. 2011 Aug 11;365(6):527-36.http://www.ncbi.nlm.nih.gov/pubmed/21830967?tool=bestpractice.com
系统评价或者受试者＞200名的随机对照临床试验（RCT）。
症状缓解：有高质量的证据显示利那洛肽治疗慢性便秘可显著减少肠道和腹部症状且显著改善自主排便、粪便性状、排便费力、腹部不适、胀气、全面评估和生活治疗。[73]Ford AC, Suares NC. Effect of laxatives and pharmacological therapies in chronic idiopathic constipation: systematic review and meta-analysis. Gut. 2011 Feb;60(2):209-18.http://www.ncbi.nlm.nih.gov/pubmed/21205879?tool=bestpractice.com[76]Lembo AJ, Schneier HA, Shiff SJ, et al. Two randomized trials of linaclotide for chronic constipation. N Engl J Med. 2011 Aug 11;365(6):527-36.http://www.ncbi.nlm.nih.gov/pubmed/21830967?tool=bestpractice.com[77]Rao S, Lembo AJ, Shiff SJ, et al. A 12-week, randomized, controlled trial with a 4-week randomized withdrawal period to evaluate the efficacy and safety of linaclotide in irritable bowel syndrome with constipation. Am J Gastroenterol. 2012 Nov;107(11):1714-24.http://www.nature.com/ajg/journal/v107/n11/full/ajg2012255a.htmlhttp://www.ncbi.nlm.nih.gov/pubmed/22986440?tool=bestpractice.com[78]Chey WD, Lembo AJ, Lavins BJ, et al. Linaclotide for irritable bowel syndrome with constipation: a 26-week, randomized, double-blind, placebo-controlled trial to evaluate efficacy and safety. Am J Gastroenterol. 2012 Nov;107(11):1702-12.http://www.nature.com/ajg/journal/v107/n11/full/ajg2012254a.htmlhttp://www.ncbi.nlm.nih.gov/pubmed/22986437?tool=bestpractice.com[79]Lee N, Wald A. Linaclotide: evidence for its potential use in irritable bowel syndrome and chronic constipation. Core Evid. 2012;7:39-47.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3396047/http://www.ncbi.nlm.nih.gov/pubmed/22807692?tool=bestpractice.com[80]Quigley EM, Tack J, Chey WD, et al. Randomised clinical trials: linaclotide phase 3 studies in IBS-C - a prespecified further analysis based on European Medicines Agency-specified endpoints. Aliment Pharmacol Ther. 2013 Jan;37(1):49-61.http://onlinelibrary.wiley.com/doi/10.1111/apt.12123/fullhttp://www.ncbi.nlm.nih.gov/pubmed/23116208?tool=bestpractice.com 然而，需要进一步的研究评价利那洛肽治疗慢性便秘的长期风险和受益。[76]Lembo AJ, Schneier HA, Shiff SJ, et al. Two randomized trials of linaclotide for chronic constipation. N Engl J Med. 2011 Aug 11;365(6):527-36.http://www.ncbi.nlm.nih.gov/pubmed/21830967?tool=bestpractice.com
完全自主排便的增加：有高质量的研究证实吡苯氧磺钠与完全自主排便的增加有关，其可使排便增加至3.4次/周而安慰机组为1.7次/周。 大约70%的患者在首剂24小时内出现完全自主排便。[116]Mueller-Lissner S, Kamm MA, Wald A, et al. Multicenter, 4-week, double-blind, randomized, placebo-controlled trial of sodium picosulfate in patients with chronic constipation. Am J Gastroenterol. 2010;105:897-903.http://www.ncbi.nlm.nih.gov/pubmed/20179697?tool=bestpractice.com
系统评价或者受试者＞200名的随机对照临床试验（RCT）。
完全自主排便的增加：有高质量的研究证实吡苯氧磺钠与完全自主排便的增加有关，其可使排便增加至3.4次/周而安慰机组为1.7次/周。 大约70%的患者在首剂24小时内出现完全自主排便。[116]Mueller-Lissner S, Kamm MA, Wald A, et al. Multicenter, 4-week, double-blind, randomized, placebo-controlled trial of sodium picosulfate in patients with chronic constipation. Am J Gastroenterol. 2010;105:897-903.http://www.ncbi.nlm.nih.gov/pubmed/20179697?tool=bestpractice.com
