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It is only for medical professionals to read and refer to different patients with constipation.
What should I pay attention to when taking medicine? With changes in dietary structure, faster pace of life and the influence of social and psychological factors, the prevalence of constipation at different ages is gradually increasing.
According to the survey, constipation has seriously affected the quality of human life and even mental health! Therefore, the prevention and treatment of constipation requires clinical attention! Case sharing: A 65-year-old male patient was admitted to the hospital due to "constipation and anorexia for 2 months".
Past history: 3 years of history of anxiety disorders.
Due to anxiety, the patient developed dry stools after taking the antidepressant venlafaxine 2 months ago.
The patient had regular bowel movements, had a history of chronic gastritis, and had no history of other digestive tract diseases.
According to the clinical situation of the patient, considering the adverse reaction caused by the drug, venlafaxine was stopped and lactulose was given symptomatic treatment.
A few days later, the patient's constipation symptoms improved and was discharged from the hospital.
This case is constipation caused by drug factors.
Did the clinician choose the correct drug? How should it be handled correctly? Case analysis For this case, it is appropriate for clinicians to choose lactulose to treat constipation.
First of all, the drug is a disaccharide composed of galactose and fructose, which can be decomposed into lactic acid and acetic acid after entering the intestines, which can promote the growth of physiological bacteria.
It is a commonly used clinical drug for the treatment of constipation (level of evidence II, level of recommendation B) ).
Second, the recommendation of lactulose is suitable for patients over 6 months of age.
This case is an elderly person and suitable for the population.
Third, constipation is a common adverse reaction of antidepressants.
Clinicians stopped the suspicious drugs in time and then treated them symptomatically.
The pharmacist's treatment suggestion added: For this patient, it is not recommended to use venlafaxine again.
When treating constipation, attention should be paid to drug interactions: lactulose may aggravate the loss of potassium caused by drugs such as thiazides, steroids and amphotericin B, and it is not recommended to use them in combination.
Adjuvant treatment: Patients can also increase dietary fiber intake, drink more water and exercise properly, so that the combined drug treatment will have a better effect! Summary of constipation medications In addition to lactulose, you also need to understand the characteristics of other constipation medications! Table 1: Clinical tips for constipation medication for different groups of people with characteristics of drug treatment! The pharmacist specially reminds: For some special groups in the clinic need special clinical care, do not use drugs at will! ▎Elderly 1.
Change lifestyle (diet: increase fiber and water intake, recommended daily intake of dietary fiber 25-35g; drinking water: drink at least 1.
5-2L of water per day; moderate exercise: for long-term sleep, exercise Few elderly patients are beneficial; good defecation habits: try to defecate within 2 hours of getting up in the morning or after a meal, and concentrate during defecation to reduce the interference of external factors); 2.
Discontinue suspicious constipation drugs; 3.
After "1,2" "It hasn't improved yet.
It is recommended to use osmotic laxatives (polyethylene glycol) and lactulose (but there are adverse reactions such as bloating and flatulence); 4.
Stool is still difficult to discharge, add stimulant laxatives.
▎Children 1.
Reasonable diet; 2.
Sufficient drinking and moderate exercise; 3.
Children's education; 4.
Medication: polyethylene glycol (scholars recommend the first choice of treatment drugs), wheat cellulose granules and lactulose; oral microbial ecology The preparation can be used as an adjuvant treatment for functional constipation (but further evidence-based evidence is needed for safety); 5.
For fecal impaction, glycerol preparation (generic name Kaisailu) or warm sodium chloride solution can be used Enema.
▎Pregnant women 1.
Increasing dietary fiber, drinking more water, and exercising appropriately are the main treatment measures for such patients; 2.
Drug treatment: Drug treatment is selected when the "1" treatment is ineffective.
Short-term or occasional use of osmotic and stimulating laxatives to avoid dehydration or electrolyte imbalance in pregnant women.
Volumetric laxatives, lactulose, and polyethylene glycol are safe and can be used.
Bisacodyl has rarely been reported as teratogenic, but it can cause intestinal cramps.
The use of anthraquinone laxatives and castor oil should be avoided.
▎Diabetic patients 1.
Lifestyle changes; 2.
Drug therapy: volumetric laxatives, osmotic laxatives and stimulant laxatives (recommended only for short-term use as a remedy).
▎Stimulating laxatives or combined osmotic laxatives or lubricating laxatives are recommended for end-stage patients.
It has been reported in the literature that the peripheral u opioid receptor antagonist methylnaltrexone and the secretagogue lubiprostone are effective for constipation caused by opioids.
Summary Pharmacists recommend safe, effective, and low-dependency drugs for treatment.
Follow the following treatment principles: The treatment of patients with constipation is mainly to relieve symptoms, restore normal intestinal motility and defecation physiological functions.
1.
Recommend a reasonable dietary structure; 2.
Establish correct bowel habits; 3.
Adjust the patient's mental and psychological state; 4.
Carry out etiological treatment for those with a clear cause; 5.
Avoid long-term use of laxatives for maintenance treatment Abuse of laxatives. References: 1.
Gallegos-Orozco JF, Foxx-Orenstein AE, Sterler SM, et al.
Chronic constipation in the elderly.
Am J Gastroenterol,2012,107:18-26.
2.
American College of Gastroenterology Chronic Constipation Task Force.
An evidence -based approach to the management of chronic constipation in North America.
Am J Gastroenterol.
2005;100 Suppl 1:S1-4.
3.
Polycarbophil calcium cooperative group.
Polycarbophil calcium treatment of constipation-type irritable bowel syndrome random , Double-blind, placebo-controlled multicenter clinical trial[J].
Chinese Journal of Digestion,2007,27(10):685-688.
4.
Yuan Yaozong.
Multicenter clinical trial of wheat cellulose granules in the treatment of functional constipation[J].
China Journal of Digestion, 2009, 29(4): 271-272.
5.
Tack J, Müller-Lissner S, Stanghellini V, Boeckxstaens G, Kamm MA, Simren M, Galmiche JP, Fried M.
Diagnosis and treatment of chronic constipation--a European perspective.
Neurogastroenterol Motil.
2011 Aug;23(8):697-710.
6.
Gastrointestinal Dynamics Group, Chinese Medical Association Gastroenterology Branch, Colorectal and Anal Surgery Group, Chinese Medical Association Surgery Branch.
Guidelines for the diagnosis and treatment of chronic constipation in China (2013,Wuhan)[J].
Chinese Journal of Digestion,2013,33(5):291-297.
7.
Yang Ting,Jiang Mizu.
Progress in diagnosis and treatment of functional constipation in children[J].
Chinese Journal of Pediatrics,2020,58(7) :611-614.
8.
Koppen I, Broekaert IJ, Wilschanski M,et al.
Role of polyethylene glycol in the treatment of functional constipation in children[J].
J Pediatr Gastroenterol Nutr,2017,65(4):361‑3639.
Trottier M,Erebara A,Bozzo P.
Treating constipation during pregnancy.
Can Fam Physician.
2012 Aug;58(8):836-8.
10.
Gastrointestinal Dynamics Group, Chinese Society of Gastroenterology, Chinese Medical Association, Functional Gastroenterology Collaboration Group, Chinese Society of Gastroenterology, Chinese Expert Consensus on Chronic Constipation ( 2019,Guangzhou)[J].
Chinese Journal of Digestion,2019,39(9):577-598.
11.
Attar A,Lémann M,Ferguson A,Halphen M,Boutron MC,FlouriéB,Alix E,Salmeron M,Guillemot F,Chaussade S,Ménard AM,Moreau J,Naudin G,Barthet M.
Comparison of a low dose polyethylene glycol electrolyte solution with lactulose for treatment of chronic constipation.
Gut.
1999 Feb;44(2):226-30.
Source of this article: Medical community digestion and liver disease channel author: This article polyphylla review: Deputy Director Yang Weisheng Jingdezhen City second people's hospital physician editor: Mary original copyright notice for reprint this article, please contact your authorized - End - posting / reprint / business cooperation, please contact : Xh@yxj.
org.
cnJ Pediatr Gastroenterol Nutr,2017,65(4):361-3639.
Trottier M,Erebara A,Bozzo P.
Treating constipation during pregnancy.
Can Fam Physician.
2012 Aug;58(8):836-8.
10.
Chinese Medical Association Digestion Gastrointestinal Dynamics Group of the Chinese Society of Digestive Diseases, Functional Gastroenterology Collaborative Group of the Chinese Society of Gastroenterology, Chinese Medical Association.
Expert consensus on chronic constipation in China (2019, Guangzhou)[J].
Chinese Journal of Digestion,2019,39(9): 577-598.
11.
Attar A, Lémann M, Ferguson A, Halphen M, Boutron MC, Florié B, Alix E, Salmeron M, Guillemot F, Chaussade S, Ménard AM, Moreau J, Naudin G, Barthet M.
Comparison of a low dose polyethylene glycol electrolyte solution with lactulose for treatment of chronic constipation.
Gut.
1999 Feb; 44 (2):.
226-30 article source: medical digestion liver disease channel author: polyphylla review article: Yang Weisheng Jingdezhen City, the second Deputy Chief Physician of People's Hospital Editor: Mary Copyright Statement If you want to reprint the original article, please contact authorization-End-Contribution/reprint/business cooperation, please contact: xh@yxj.
org.
cnJ Pediatr Gastroenterol Nutr,2017,65(4):361-3639.
Trottier M,Erebara A,Bozzo P.
Treating constipation during pregnancy.
Can Fam Physician.
2012 Aug;58(8):836-8.
10.
Chinese Medical Association Digestion Gastrointestinal Dynamics Group of the Chinese Society of Digestive Diseases, Functional Gastroenterology Collaborative Group of the Chinese Society of Gastroenterology, Chinese Medical Association.
Expert consensus on chronic constipation in China (2019, Guangzhou)[J].
Chinese Journal of Digestion,2019,39(9): 577-598.
11.
Attar A, Lémann M, Ferguson A, Halphen M, Boutron MC, Florié B, Alix E, Salmeron M, Guillemot F, Chaussade S, Ménard AM, Moreau J, Naudin G, Barthet M.
Comparison of a low dose polyethylene glycol electrolyte solution with lactulose for treatment of chronic constipation.
Gut.
1999 Feb; 44 (2):.
226-30 article source: medical digestion liver disease channel author: polyphylla review article: Yang Weisheng Jingdezhen City, the second Deputy Chief Physician of People's Hospital Editor: Mary Copyright Statement If you want to reprint the original article, please contact authorization-End-Contribution/reprint/business cooperation, please contact: xh@yxj.
org.
cnExpert consensus on chronic constipation in China (2019, Guangzhou)[J].
Chinese Journal of Digestion,2019,39(9):577-598.
11.
Attar A,Lémann M,Ferguson A,Halphen M,Boutron MC,FlouriéB,Alix E, Salmeron M, Guillemot F, Chaussade S, Ménard AM, Moreau J, Naudin G, Barthet M.
Comparison of a low dose polyethylene glycol electrolyte solution with lactulose for treatment of chronic constipation.
Gut.
1999 Feb;44(2):226- 30.
This article source: medical digestion liver disease channel author: polyphylla review article: Yang Weisheng, deputy director of the Jingdezhen City second people's hospital physician editor: Mary original copyright notice for reprint this article, please contact your authorized - End - Submission / For reprinting/business cooperation, please contact: xh@yxj.
org.
cnExpert consensus on chronic constipation in China (2019, Guangzhou)[J].
Chinese Journal of Digestion,2019,39(9):577-598.
11.
Attar A,Lémann M,Ferguson A,Halphen M,Boutron MC,FlouriéB,Alix E, Salmeron M, Guillemot F, Chaussade S, Ménard AM, Moreau J, Naudin G, Barthet M.
Comparison of a low dose polyethylene glycol electrolyte solution with lactulose for treatment of chronic constipation.
Gut.
1999 Feb;44(2):226- 30.
This article source: medical digestion liver disease channel author: polyphylla review article: Yang Weisheng, deputy director of the Jingdezhen City second people's hospital physician editor: Mary original copyright notice for reprint this article, please contact your authorized - End - Submission / For reprint/business cooperation, please contact: xh@yxj.
org.
cnThis article Source: medical digestion liver disease Channel author: polyphylla review article: Yang Weisheng, deputy director of the Jingdezhen City Second People's Hospital Physician Editor: Mary original copyright notice for reprint this article, please contact your authorized - End - posting / reprint / For business cooperation, please contact: xh@yxj.
org.
cnThis article Source: medical digestion liver disease Channel author: polyphylla review article: Yang Weisheng, deputy director of the Jingdezhen City Second People's Hospital Physician Editor: Mary original copyright notice for reprint this article, please contact your authorized - End - posting / reprint / For business cooperation, please contact: xh@yxj.
org.
cn
What should I pay attention to when taking medicine? With changes in dietary structure, faster pace of life and the influence of social and psychological factors, the prevalence of constipation at different ages is gradually increasing.
According to the survey, constipation has seriously affected the quality of human life and even mental health! Therefore, the prevention and treatment of constipation requires clinical attention! Case sharing: A 65-year-old male patient was admitted to the hospital due to "constipation and anorexia for 2 months".
Past history: 3 years of history of anxiety disorders.
Due to anxiety, the patient developed dry stools after taking the antidepressant venlafaxine 2 months ago.
The patient had regular bowel movements, had a history of chronic gastritis, and had no history of other digestive tract diseases.
According to the clinical situation of the patient, considering the adverse reaction caused by the drug, venlafaxine was stopped and lactulose was given symptomatic treatment.
A few days later, the patient's constipation symptoms improved and was discharged from the hospital.
This case is constipation caused by drug factors.
Did the clinician choose the correct drug? How should it be handled correctly? Case analysis For this case, it is appropriate for clinicians to choose lactulose to treat constipation.
First of all, the drug is a disaccharide composed of galactose and fructose, which can be decomposed into lactic acid and acetic acid after entering the intestines, which can promote the growth of physiological bacteria.
It is a commonly used clinical drug for the treatment of constipation (level of evidence II, level of recommendation B) ).
Second, the recommendation of lactulose is suitable for patients over 6 months of age.
This case is an elderly person and suitable for the population.
Third, constipation is a common adverse reaction of antidepressants.
Clinicians stopped the suspicious drugs in time and then treated them symptomatically.
The pharmacist's treatment suggestion added: For this patient, it is not recommended to use venlafaxine again.
When treating constipation, attention should be paid to drug interactions: lactulose may aggravate the loss of potassium caused by drugs such as thiazides, steroids and amphotericin B, and it is not recommended to use them in combination.
Adjuvant treatment: Patients can also increase dietary fiber intake, drink more water and exercise properly, so that the combined drug treatment will have a better effect! Summary of constipation medications In addition to lactulose, you also need to understand the characteristics of other constipation medications! Table 1: Clinical tips for constipation medication for different groups of people with characteristics of drug treatment! The pharmacist specially reminds: For some special groups in the clinic need special clinical care, do not use drugs at will! ▎Elderly 1.
Change lifestyle (diet: increase fiber and water intake, recommended daily intake of dietary fiber 25-35g; drinking water: drink at least 1.
5-2L of water per day; moderate exercise: for long-term sleep, exercise Few elderly patients are beneficial; good defecation habits: try to defecate within 2 hours of getting up in the morning or after a meal, and concentrate during defecation to reduce the interference of external factors); 2.
Discontinue suspicious constipation drugs; 3.
After "1,2" "It hasn't improved yet.
It is recommended to use osmotic laxatives (polyethylene glycol) and lactulose (but there are adverse reactions such as bloating and flatulence); 4.
Stool is still difficult to discharge, add stimulant laxatives.
▎Children 1.
Reasonable diet; 2.
Sufficient drinking and moderate exercise; 3.
Children's education; 4.
Medication: polyethylene glycol (scholars recommend the first choice of treatment drugs), wheat cellulose granules and lactulose; oral microbial ecology The preparation can be used as an adjuvant treatment for functional constipation (but further evidence-based evidence is needed for safety); 5.
For fecal impaction, glycerol preparation (generic name Kaisailu) or warm sodium chloride solution can be used Enema.
▎Pregnant women 1.
Increasing dietary fiber, drinking more water, and exercising appropriately are the main treatment measures for such patients; 2.
Drug treatment: Drug treatment is selected when the "1" treatment is ineffective.
Short-term or occasional use of osmotic and stimulating laxatives to avoid dehydration or electrolyte imbalance in pregnant women.
Volumetric laxatives, lactulose, and polyethylene glycol are safe and can be used.
Bisacodyl has rarely been reported as teratogenic, but it can cause intestinal cramps.
The use of anthraquinone laxatives and castor oil should be avoided.
▎Diabetic patients 1.
Lifestyle changes; 2.
Drug therapy: volumetric laxatives, osmotic laxatives and stimulant laxatives (recommended only for short-term use as a remedy).
▎Stimulating laxatives or combined osmotic laxatives or lubricating laxatives are recommended for end-stage patients.
It has been reported in the literature that the peripheral u opioid receptor antagonist methylnaltrexone and the secretagogue lubiprostone are effective for constipation caused by opioids.
Summary Pharmacists recommend safe, effective, and low-dependency drugs for treatment.
Follow the following treatment principles: The treatment of patients with constipation is mainly to relieve symptoms, restore normal intestinal motility and defecation physiological functions.
1.
Recommend a reasonable dietary structure; 2.
Establish correct bowel habits; 3.
Adjust the patient's mental and psychological state; 4.
Carry out etiological treatment for those with a clear cause; 5.
Avoid long-term use of laxatives for maintenance treatment Abuse of laxatives. References: 1.
Gallegos-Orozco JF, Foxx-Orenstein AE, Sterler SM, et al.
Chronic constipation in the elderly.
Am J Gastroenterol,2012,107:18-26.
2.
American College of Gastroenterology Chronic Constipation Task Force.
An evidence -based approach to the management of chronic constipation in North America.
Am J Gastroenterol.
2005;100 Suppl 1:S1-4.
3.
Polycarbophil calcium cooperative group.
Polycarbophil calcium treatment of constipation-type irritable bowel syndrome random , Double-blind, placebo-controlled multicenter clinical trial[J].
Chinese Journal of Digestion,2007,27(10):685-688.
4.
Yuan Yaozong.
Multicenter clinical trial of wheat cellulose granules in the treatment of functional constipation[J].
China Journal of Digestion, 2009, 29(4): 271-272.
5.
Tack J, Müller-Lissner S, Stanghellini V, Boeckxstaens G, Kamm MA, Simren M, Galmiche JP, Fried M.
Diagnosis and treatment of chronic constipation--a European perspective.
Neurogastroenterol Motil.
2011 Aug;23(8):697-710.
6.
Gastrointestinal Dynamics Group, Chinese Medical Association Gastroenterology Branch, Colorectal and Anal Surgery Group, Chinese Medical Association Surgery Branch.
Guidelines for the diagnosis and treatment of chronic constipation in China (2013,Wuhan)[J].
Chinese Journal of Digestion,2013,33(5):291-297.
7.
Yang Ting,Jiang Mizu.
Progress in diagnosis and treatment of functional constipation in children[J].
Chinese Journal of Pediatrics,2020,58(7) :611-614.
8.
Koppen I, Broekaert IJ, Wilschanski M,et al.
Role of polyethylene glycol in the treatment of functional constipation in children[J].
J Pediatr Gastroenterol Nutr,2017,65(4):361‑3639.
Trottier M,Erebara A,Bozzo P.
Treating constipation during pregnancy.
Can Fam Physician.
2012 Aug;58(8):836-8.
10.
Gastrointestinal Dynamics Group, Chinese Society of Gastroenterology, Chinese Medical Association, Functional Gastroenterology Collaboration Group, Chinese Society of Gastroenterology, Chinese Expert Consensus on Chronic Constipation ( 2019,Guangzhou)[J].
Chinese Journal of Digestion,2019,39(9):577-598.
11.
Attar A,Lémann M,Ferguson A,Halphen M,Boutron MC,FlouriéB,Alix E,Salmeron M,Guillemot F,Chaussade S,Ménard AM,Moreau J,Naudin G,Barthet M.
Comparison of a low dose polyethylene glycol electrolyte solution with lactulose for treatment of chronic constipation.
Gut.
1999 Feb;44(2):226-30.
Source of this article: Medical community digestion and liver disease channel author: This article polyphylla review: Deputy Director Yang Weisheng Jingdezhen City second people's hospital physician editor: Mary original copyright notice for reprint this article, please contact your authorized - End - posting / reprint / business cooperation, please contact : Xh@yxj.
org.
cnJ Pediatr Gastroenterol Nutr,2017,65(4):361-3639.
Trottier M,Erebara A,Bozzo P.
Treating constipation during pregnancy.
Can Fam Physician.
2012 Aug;58(8):836-8.
10.
Chinese Medical Association Digestion Gastrointestinal Dynamics Group of the Chinese Society of Digestive Diseases, Functional Gastroenterology Collaborative Group of the Chinese Society of Gastroenterology, Chinese Medical Association.
Expert consensus on chronic constipation in China (2019, Guangzhou)[J].
Chinese Journal of Digestion,2019,39(9): 577-598.
11.
Attar A, Lémann M, Ferguson A, Halphen M, Boutron MC, Florié B, Alix E, Salmeron M, Guillemot F, Chaussade S, Ménard AM, Moreau J, Naudin G, Barthet M.
Comparison of a low dose polyethylene glycol electrolyte solution with lactulose for treatment of chronic constipation.
Gut.
1999 Feb; 44 (2):.
226-30 article source: medical digestion liver disease channel author: polyphylla review article: Yang Weisheng Jingdezhen City, the second Deputy Chief Physician of People's Hospital Editor: Mary Copyright Statement If you want to reprint the original article, please contact authorization-End-Contribution/reprint/business cooperation, please contact: xh@yxj.
org.
cnJ Pediatr Gastroenterol Nutr,2017,65(4):361-3639.
Trottier M,Erebara A,Bozzo P.
Treating constipation during pregnancy.
Can Fam Physician.
2012 Aug;58(8):836-8.
10.
Chinese Medical Association Digestion Gastrointestinal Dynamics Group of the Chinese Society of Digestive Diseases, Functional Gastroenterology Collaborative Group of the Chinese Society of Gastroenterology, Chinese Medical Association.
Expert consensus on chronic constipation in China (2019, Guangzhou)[J].
Chinese Journal of Digestion,2019,39(9): 577-598.
11.
Attar A, Lémann M, Ferguson A, Halphen M, Boutron MC, Florié B, Alix E, Salmeron M, Guillemot F, Chaussade S, Ménard AM, Moreau J, Naudin G, Barthet M.
Comparison of a low dose polyethylene glycol electrolyte solution with lactulose for treatment of chronic constipation.
Gut.
1999 Feb; 44 (2):.
226-30 article source: medical digestion liver disease channel author: polyphylla review article: Yang Weisheng Jingdezhen City, the second Deputy Chief Physician of People's Hospital Editor: Mary Copyright Statement If you want to reprint the original article, please contact authorization-End-Contribution/reprint/business cooperation, please contact: xh@yxj.
org.
cnExpert consensus on chronic constipation in China (2019, Guangzhou)[J].
Chinese Journal of Digestion,2019,39(9):577-598.
11.
Attar A,Lémann M,Ferguson A,Halphen M,Boutron MC,FlouriéB,Alix E, Salmeron M, Guillemot F, Chaussade S, Ménard AM, Moreau J, Naudin G, Barthet M.
Comparison of a low dose polyethylene glycol electrolyte solution with lactulose for treatment of chronic constipation.
Gut.
1999 Feb;44(2):226- 30.
This article source: medical digestion liver disease channel author: polyphylla review article: Yang Weisheng, deputy director of the Jingdezhen City second people's hospital physician editor: Mary original copyright notice for reprint this article, please contact your authorized - End - Submission / For reprinting/business cooperation, please contact: xh@yxj.
org.
cnExpert consensus on chronic constipation in China (2019, Guangzhou)[J].
Chinese Journal of Digestion,2019,39(9):577-598.
11.
Attar A,Lémann M,Ferguson A,Halphen M,Boutron MC,FlouriéB,Alix E, Salmeron M, Guillemot F, Chaussade S, Ménard AM, Moreau J, Naudin G, Barthet M.
Comparison of a low dose polyethylene glycol electrolyte solution with lactulose for treatment of chronic constipation.
Gut.
1999 Feb;44(2):226- 30.
This article source: medical digestion liver disease channel author: polyphylla review article: Yang Weisheng, deputy director of the Jingdezhen City second people's hospital physician editor: Mary original copyright notice for reprint this article, please contact your authorized - End - Submission / For reprint/business cooperation, please contact: xh@yxj.
org.
cnThis article Source: medical digestion liver disease Channel author: polyphylla review article: Yang Weisheng, deputy director of the Jingdezhen City Second People's Hospital Physician Editor: Mary original copyright notice for reprint this article, please contact your authorized - End - posting / reprint / For business cooperation, please contact: xh@yxj.
org.
cnThis article Source: medical digestion liver disease Channel author: polyphylla review article: Yang Weisheng, deputy director of the Jingdezhen City Second People's Hospital Physician Editor: Mary original copyright notice for reprint this article, please contact your authorized - End - posting / reprint / For business cooperation, please contact: xh@yxj.
org.
cn
