多潘立酮在增强结肠运动中的作用

Objective To observe the prokinetic effect of domperidone on colon and compare with that of mosapride and cisapride.Methods ① In viva experiment:forty rats were divided into control,domperidone,mosapride,and cisapride groups with 10 in each group.Stran gauges were planted both in proximal and distal colons and colonic motor activities were recoded in conscious rats.② In vitro experiment:the prokinetics effects of dopamine or dopamine combined with domperidone on the contraction of isolated rat colon strips were recorded by tone-transducers in the thermostatic muscle bath.Results In viva experiments:① in the interdigestive period of resting,activities of rhythimic phasic contraction were recoded in colon at conscious rats,and ② it had been showed that dornperidone significantly enhanced the contraction of colon in dose-dependent manner.Compared with control group,the mean contraction amplitude of proximal colon and distal colon increased by 84.61% ± 7.26% and 76.37 % ± 8.47% in domeridone group,respectively,which was higher than those in mosapride group (50.32%±8.16% and 45.13%±7.16%,respectively),but as same as those in cisapride group (92.55% ± 8.37% and 81.27% ± 9.95%,respectively).In vitro experiments:① perfusion of dopamin (40 mg/ml) could significantly decrease the contraction of isolated colon strip by 91.56% ± 10.24% in comparison with Krebs-Ringer solution,and ① domperidone could block the relaxant effect of dopamin on the isolated colon strip.Conclusions Domperidone can significantly enhance the colonic motor activities via antidopaminergic action.The effects of domperidone are similar as eisapride and greater than mosapride.     

多潘立酮在增强食管和下食管括约肌运动的作用

目的 观察多潘立酮对食管和下食管括约肌(LES)的促动力作用,并与莫沙必利及西沙必利比较.方法 在体实验:将40只大鼠分为对照组、多潘立酮组、莫沙必利组和西沙必利组.在各组大鼠近端食管体、远端食管体和LES埋植应力传感器,记录清醒大鼠食管体和LES运动.离体实验:在恒温灌流肌槽中,采用张力传感器测定多潘立酮、莫沙必利、西沙必利对大鼠离体食管体及LES肌条的收缩活动.结果 在体实验:①清醒大鼠在消化间期的静息状态下,食管体呈现轻微的收缩运动.LES则出现典型的消化间期移行性复合运动(MMC)Ⅰ、Ⅱ、Ⅲ、Ⅳ相,其收缩强度大于食管体.②多潘立酮可明显增加食管体及LES的收缩运动.使近端食管体与远端食管体及LES平均振幅分别比对照组增加63.24%±7.17%,75.54%±5.27%和85.81%±6.02%,并呈剂量-效应关系.同等剂量的莫沙必利对近端食管体和远端食管体及LES平均振幅分别比对照组增加29.71%±4.15%,40.15%±3.30%和35.24%±5.36%.莫沙必利对食管和LES的促动力作用大大低于多潘立酮.而同等剂量的西沙必利对近端食管体和远端食管体及LES平均振幅分别比对照组增加59.84%±6.55%,70.11%±5.62%,75.13%±5.10%,其促动力作用与多潘立酮相同.离体实验:①灌流多潘立酮可明显刺激离体食管体肌条和LES肌条收缩,分别较Krebs-Ringer液对照组增加87.74%±7.65%和92.44%±7.17%.同等剂量的莫沙必利平均振幅分别较对照组Kreha-Ringer液增加35.42%±5.02%和31.12%±4.32%.莫沙必利的促动力作用大大低于多潘立酮.而同等剂量的西沙必利对离体食管和LES促动力作用与多潘立酮相同.②阿托品与河豚毒素均可阻断多潘立酮刺激食管及LES的动力作用.结论 多潘立酮可明显刺激食管体收缩及明显增强LES动力,上述作用均明显优于莫沙必利并与西沙必利作用相同.多潘立酮增强食管与LES动力的作用机制,除已知阻断多巴胺受体外,还可能通过肠神经系统内胆碱能神经介导.     

中华医学会消化病学分会2003年全国胃肠动力学术会议纪要

中华医学会消化病学分会2003年全国胃肠动力学术会议于2003年10月17～19日在天津举行，来自国内外的内、外、儿、中医科等近400名代表参加了会议。本次会议共有27个专题报告，收到论文172篇，其中12篇进行了大会发言交流。会议就胃肠动力疾病的基础与临床、回顾及展望均进行了热烈讨论。会议论文交流主要涉及以下几个方面。     

胃肠动力与相关受体

目前 ,胃肠学家们开始把注意力集中在胃肠动力上 ,因为维持人体生命活动的营养物质的吸收除靠消化液的作用外 ,更有赖于最佳的胃肠运动状态以实施混合、碾磨和运送食物的任务。当神经递质、肽类激素、单胺类物质以及生长因子等调节分子对平滑肌细胞动力发挥其作用时 ,首先要与靶细胞上的特异受体结合。调节胃肠道的受体种类之多是惊人的 ,这与胃肠道具有多种类型的细胞及这些细胞具有多种调节因子有关。空腹和餐后胃肠运动模式的多样性及神经与肽类调控的复杂性要通过神经元和神经纤维以及平滑肌细胞上的受体才能产生效应。现就几种主要受体…     

多潘立酮在增强结肠运动中的作用

Objective To observe the prokinetic effect of domperidone on colon and compare with that of mosapride and cisapride.Methods ① In viva experiment:forty rats were divided into control,domperidone,mosapride,and cisapride groups with 10 in each group.Stran gauges were planted both in proximal and distal colons and colonic motor activities were recoded in conscious rats.② In vitro experiment:the prokinetics effects of dopamine or dopamine combined with domperidone on the contraction of isolated rat colon strips were recorded by tone-transducers in the thermostatic muscle bath.Results In viva experiments:① in the interdigestive period of resting,activities of rhythimic phasic contraction were recoded in colon at conscious rats,and ② it had been showed that dornperidone significantly enhanced the contraction of colon in dose-dependent manner.Compared with control group,the mean contraction amplitude of proximal colon and distal colon increased by 84.61% ± 7.26% and 76.37 % ± 8.47% in domeridone group,respectively,which was higher than those in mosapride group (50.32%±8.16% and 45.13%±7.16%,respectively),but as same as those in cisapride group (92.55% ± 8.37% and 81.27% ± 9.95%,respectively).In vitro experiments:① perfusion of dopamin (40 mg/ml) could significantly decrease the contraction of isolated colon strip by 91.56% ± 10.24% in comparison with Krebs-Ringer solution,and ① domperidone could block the relaxant effect of dopamin on the isolated colon strip.Conclusions Domperidone can significantly enhance the colonic motor activities via antidopaminergic action.The effects of domperidone are similar as eisapride and greater than mosapride.     

多潘立酮增强胃运动作用的中枢机制

目的　多潘立酮 (Domperidone ,Domp)是一种抗呕吐的促胃肠动力药 ,其抗呕吐作用部位的延髓最后区 (Areapostrema ,AP)的促动力作用至今未见报导。本工作旨在研究多潘立酮对延髓最后区兴奋胃消化间期移行性复合运动 (MMC)的作用及其作用途径。方法　在清醒大鼠进行实验 ,在胃窦缝植应力传感器 ,通过电桥与自动平衡记录仪记录胃窦的MMC运动。AP注射部位根据脑定位图谱的AP位置埋藏不锈钢注射管 ,观察AP注入Domp对胃MMC运动的中枢作用。结果　 1 消化间期胃窦MMC运动 (n =10 )　胃窦MMC周期为 10 2 5± 1 32min ,其中Ⅰ相时程为 3…     

慢性激怒应激对大鼠胃动力和脑肠肽的影响及柴胡舒肝散的干预作用

目的探讨慢性激怒应激对大鼠胃窦平滑肌动力及下丘脑和血浆促肾上腺皮质激素释放激素(CRH)、促肾上腺皮质激素(ACTH)、瘦素、胃动素的影响,以及柴胡疏肝散的干预作用。方法将40只Wistar大鼠随机分为4组,每组10只,正常组不给任何刺激;模型组、柴胡舒肝散组、生理盐水组均给予夹尾刺激,每次30min,每天2次,连续刺激14天。柴胡舒肝散组、生理盐水组每次应激后分别立即灌胃2ml柴胡散[27.5g/(kg.d)]及生理盐水,每天2次。14天后检测各组大鼠胃窦肌条收缩活动,下丘脑及血浆CRH、ACTH、瘦素和胃动素水平。结果与正常组比较,模型组大鼠离体胃窦肌条收缩频率和振幅明显减少(P<0.01),下丘脑CRH、瘦素及血浆CRH、ACTH、瘦素浓度均明显增高(P<0.01),而下丘脑与血浆胃动素浓度则显著下降(P<0.01)。与模型组比较,柴胡舒肝散组胃窦肌条收缩频率和振幅显著增加(P<0.01),下丘脑和血浆CRH、ACTH及瘦素浓度显著降低(P<0.01),而下丘脑和血浆胃动素浓度则明显上升(P<0.01)。结论柴胡舒肝散可增加慢性激怒应激大鼠胃窦平滑肌动力,改善脑肠肽水平。     

多潘立酮在增强结肠运动中的作用

Objective To observe the prokinetic effect of domperidone on colon and compare with that of mosapride and cisapride.Methods ① In viva experiment:forty rats were divided into control,domperidone,mosapride,and cisapride groups with 10 in each group.Stran gauges were planted both in proximal and distal colons and colonic motor activities were recoded in conscious rats.② In vitro experiment:the prokinetics effects of dopamine or dopamine combined with domperidone on the contraction of isolated rat colon strips were recorded by tone-transducers in the thermostatic muscle bath.Results In viva experiments:① in the interdigestive period of resting,activities of rhythimic phasic contraction were recoded in colon at conscious rats,and ② it had been showed that dornperidone significantly enhanced the contraction of colon in dose-dependent manner.Compared with control group,the mean contraction amplitude of proximal colon and distal colon increased by 84.61% ± 7.26% and 76.37 % ± 8.47% in domeridone group,respectively,which was higher than those in mosapride group (50.32%±8.16% and 45.13%±7.16%,respectively),but as same as those in cisapride group (92.55% ± 8.37% and 81.27% ± 9.95%,respectively).In vitro experiments:① perfusion of dopamin (40 mg/ml) could significantly decrease the contraction of isolated colon strip by 91.56% ± 10.24% in comparison with Krebs-Ringer solution,and ① domperidone could block the relaxant effect of dopamin on the isolated colon strip.Conclusions Domperidone can significantly enhance the colonic motor activities via antidopaminergic action.The effects of domperidone are similar as eisapride and greater than mosapride.     

柴胡疏肝散对功能性消化不良肝气郁结证患者胃动力及胃肠激素的影响

目的探讨功能性消化不良肝气郁结证患者可能的发病机制及柴胡疏肝散的干预作用。方法选择35例功能性消化不良肝气郁结证患者(治疗组)及20名健康志愿者(健康对照组),治疗组给予柴胡疏肝散治疗4周,观察治疗后中医症状总疗效,单项症状疗效及胃肠激素、胃排空、胃电图、饮水试验情况,并结合心理评估报告,同时与健康对照组比较。结果治疗组治疗前后总体评分比较均有统计学差异(P0.05)。若以单项有效率统计,上腹饱胀不适、早饱、上腹痛、上腹烧灼感、恶心、呕吐、嗳气、纳差、急躁易怒抑郁、口苦、头晕乏力、反酸及大便溏软13项症状均有改善(P0.05)。餐后不适综合征和上腹痛综合征两亚型间比较无统计学差异(P0.05)。治疗后胃排空延迟较治疗前好转(P0.05);胃电图餐前、餐后正常慢波有所提高;饮水量明显增加(P0.05);胃动素水平较治疗前升高,促肾上腺皮质激素释放激素(CRH)水平较治疗前下降,餐后瘦素水平较治疗前上升(P0.05);患者抑郁症状有所减轻,停药3个月后症状基本无反复。结论柴胡疏肝散能够很好地改善FD肝气郁结证患者临床证候,促进胃排空,改善胃电图,降低内脏敏感性,改善胃肠激素水平,改善抑郁症状。     

延髓最后区对犬消化间期移行性复合运动的调节作用

目的　探讨延髓最后区对胃肠消化间期移行性复合运动（MMC）及血浆胃动素水平的影响.方法　在8只犬的胃窦和十二指肠浆膜埋植应力传感器记录胃窦和十二指肠消化间期复合运动.在一侧股静脉内置慢性静脉插管供注射外源性胃动素.用RIA法测定血浆胃动素含量.观察：（1）消化间期正常MMC活动和血浆胃动素浓度变化；（2）电损毁延髓最后区对MMC活动和血浆胃动素水平的影响；（3）电损毁延髓最后区对外源性胃动素启动MMC Ⅲ相收缩作用的影响.结果　（1）正常犬消化间期出现典型的Ⅰ、Ⅱ、Ⅲ、Ⅳ相MMC.MMC Ⅲ相与血浆胃动素释放高峰同步发生.（2）电损毁延髓最后区后, 胃窦和十二指肠MMC的收缩运动明显抑制,MMC Ⅰ相延长,Ⅱ、Ⅲ相明显缩短,失去了损毁前MMC周期性﹑时相性和移行性的特点,血浆胃动素浓度明显降低,外源性静脉注射胃动素不能启动MMC Ⅲ相收缩.结论　延髓最后区对消化间期 MMC的周期发生和移行有重要的调控作用,其作用途径与胃动素介导有关.