枸橼酸莫沙必利分散片（新络纳）对功能性消化不良患者近端胃舒张和胃排空功能影响的研究

目的 探讨枸橼酸莫沙必利分散片(新络纳)对功能性消化不良(FD)患者近端胃舒张和胃排空功能的影响.方法 FD患者和健康志愿者各20例,以实时B超检查测定饮用500 ml纯净水后不同时间点近端胃容积的变化,对:FD患者服用枸橼酸莫沙必利分散片(新络纳)后于同一时间点再次以实时超声测定近端胃容积的变化.结果 FD组和对照组之间胃底气体评分有显著差异.FD组在服用枸橼酸莫沙必利分散片后与服用之前同一时间点的近端胃容积有显著性差异,与对照组之问有显著性差异.结论 FD患者近端胃舒张功能受损,枸橼酸莫沙必利分散片(新络纳)能改善胃舒张功能并加快FD患者的胃排空.     

功能性消化不良行枸橼酸莫沙必利分散片联合黛力新治疗的临床疗效

目的探讨功能性消化不良采用枸橼酸莫沙必利分散片联合黛力新治疗的临床效果。方法将103例功能性消化不良患者随机分为两组,对照组50例予以枸橼酸莫沙必利分散片治疗,观察组53例在对照组的基础上联合黛力新治疗,对比两组临床治疗效果、治疗前后胃固体排空时间及症状积分变化情况、复发率等。结果观察组治疗总有效率为92.5%,复发率为4.1%,与对照组的74.0%、24.3%比较差异显著(P0.05);治疗后观察组胃固体排空时间、症状积分均低于对照组(P0.05)。结论功能性消化不良采用枸橼酸莫沙必利分散片联合黛力新治疗能有效改善患者临床症状及体征,促进患者胃肠运动,缩短胃排空时间,降低复发率,提高患者生活质量,临床应用价值高。     

体重指数对枸橼酸莫沙必利分散片治疗糖尿病性胃轻瘫的影响

糖尿病性胃轻瘫(diabetic gastroparesis,DGP)是糖尿病患者常见并发症之一,主要有胃排空延缓,出现反酸嗳气、早饱、恶心呕吐、腹胀及厌食等临床表现,在糖尿病患者中有研究报道其发病率为50%[1].枸橼酸莫沙必利分散片是新一代胃肠动力药,在治疗DGP方面具有较好的效果[2].本文通过回顾性分析方法,观察不同体重指数(BMI)对枸橼酸莫沙必利分散片治疗DGP患者的影响.     

仁术健脾理气方对功能性消化不良大鼠胃排空功能及Ghrelin、5-HT、CGRP的影响

[目的]研究仁术健脾理气方对碘乙酰胺（iodoacetamide,IA）诱导的功能性消化不良（FD）大鼠胃排空功能及胃促生长素（Ghrelin）、5-羟色胺（5-HT）、降钙素基因相关肽（CGRP）的影响,初步探讨仁术健脾理气方治疗FD的机制.[方法]雄性10日龄SD幼鼠100只,随机分为正常组（30只）和造模组（70只）.采用0.1％ IA灌胃诱导大鼠FD模型.大鼠8周龄时进行模型评定,将造模成功的70只大鼠随机分为模型组（30只）、中药低剂量组（10只）、中药中剂量组（10只）、中药高剂量组（10只）和阳性药组（10只）5组.正常组与模型组予以0.9％氯化钠溶液1 ml/100 g灌胃,中药低、中、高剂量组分别给予生药含量0.477 5 g/ml、0.955 5 g/ml、1.911 g/ml的中药煎剂1 ml/100 g灌胃,阳性药组给予0.3 mg/ml多潘立酮溶液1 ml/100 g灌胃.采用苏木精-伊红染色观察大鼠胃组织病理变化.采用放射免疫法检测大鼠胃组织髓过氧化物酶（MPO）活性以及血清中Ghrelin、5-HT、CGRP的含量.[结果]胃排空结果显示,中药高剂量组和阳性药组大鼠3h摄食量和胃排空率显著高于模型组（P＜0.05）,而3h后胃内食物残余量显著低于模型组（P＜0.05）.血清学结果显示,中药各剂量组和阳性药组FD大鼠血清中Ghre-lin和5-HT的含量均不同程度地升高（均P＜0.05）,且高剂量组与阳性药组比较差异无统计学意义;中药各剂量组和阳性药组FD大鼠血清中CGRP的含量均不同程度地降低（均P＜0.05）,且高剂量组与阳性药组比较差异无统计学意义.[结论]仁术健脾理气方对IA诱导的FD大鼠具有加快胃排空、降低胃肠感觉过敏的作用,其机制可能与外周血 Ghrelin、5-HT含量升高、CGRP含量降低有关.     

莫沙必利分散片治疗餐后不适综合征的近期疗效观察

背景：餐后不适综合征（PDS）是临床常见的功能性胃肠病,胃肠动力障碍为其重要病理生理机制之一。莫沙必利是一种胃肠促动力药．已用于胃肠动力障碍的治疗。目的：观察莫沙必利分散片治疗PDS的近期疗效。方法：60例符合罗马mPDS诊断标准的患者随机分成M组（接受铝碳酸镁1000mg加莫沙必利分散片5mg tid治疗）和P组（接受铝碳酸镁1000mg加安慰剂tid治疗）。疗程均为2周。于治疗前后行患者总体PDS症状评分并检测胃排空功能。结果：两组治疗后总体PDS症状评分较治疗前均显著降低（P〈0．001）,其中M组评分又显著低于P组（P〈0．01）。M组治疗有效率为83．3％,显著高于P组（40．0％）（P〈0．001）。两组治疗前胃3h排空钡条数无明显差异,均显著少于正常对照组（P〈0．001）。M组治疗后胃排空钡条数较治疗前和P组治疗后显著增多（P〈0．001）,P组治疗后与治疗前相比则无明显差异。结论：莫沙必利分散片能明显改善PDS患者的胃排空功能,对缓解餐后饱胀和早饱症状近期疗效满意。     

阿米替林对功能性消化不良症状及胃动力的作用

研究功能性消化不良（ＦＤ）患者的胃排空和胃电特性以及阿米替林对ＦＤ的疗效。方法：用双同位素标记ＳＰＥＣＴ技术和体表胃电图检测４２例ＦＤ患者服用小剂量阿米替林前后胃运动功能的变化。结果：ＦＤ组和对照组液相排空曲线相似,半排空时间（Ｔ５０）差异无显著性;ＦＤ组固相Ｔ５０较对照组显著延长,胃电节律紊乱率及餐后振幅降低率较对照组显著增加。阿米替林治疗４周后,ＦＤ患者的临床症状显著改善,但胃排空异常率及胃电     

Eradication of Helicobacter pylori Restores the Inhibitory Effect of Cholecystokinin on Gastric Motility in Duodenal Ulcer Patients

Background: Increased gastric emptying and defective action of endogenous cholecystokinin (CCK), that is known to inhibit this emptying, have been implicated in the pathogenesis of duodenal ulcer (DU). The aim of this double blind study was to assess whether CCK and somatostatin participate in the impairment of gastric motility in active DU patients before and after Helicobacter pylori eradication. Methods: Tests were undertaken in 10 DU patients without or with elimination of the action of endogenous CCK using loxiglumide, a selective CCK-A receptor antagonist, before and 4 weeks after eradication of H. pylori with 1 week triple therapy that resulted in healing of all DUs tested. The gastric emptying rate after feeding was determined using the ¹³C-acetate breath test. Before each test, samples of gastric juice were obtained by aspiration using a nasogastric tube for determination of somatostatin using specific radioimmunoassay. Results: Prior to H. pylori     

功能性消化不良患者的胃液体排空和胃感觉阈异常

目的检测功能性消化不良(FD)患者的胃液体排空和胃感觉阈,以了解两者之间的联系.方法采用超声法测定68例FD患者和29例正常对照者饮水500ml后的胃体-底前后径变化,以了解胃液体排空情况;同时记录受检者摄入温水后出现上腹不适感觉时的饮水量以表示胃最小感觉容量(感觉阈).结果FD患者的胃液体半排空时间较正常人明显延迟(FD患者31.06min±10.29min,正常人24.63min±4.86min,P<0.001),胃感觉阈显著下降(FD患者412.50ml±94.47ml,正常人478.33m1±35.78m1,P<0.001),50%(34/68)的患者胃感觉过敏.胃感觉阈与胃液体半排空时间的相关分析表明,胃感觉阈越低,排空延迟越明显(P<0.05).结论FD患者不但存在胃排空延迟,还存在胃感觉过敏,两者有一定的相关性.     

Gastric Emptying of Realistic Meals With and Without Gluten in Patients with Coeliac Disease. Effect of Jejunal Mucosal Recovery

Background: Few data are available on disturbed gastric emptying in patients with coeliac disease. The aims of the study were to investigate (a) the presence of delayed gastric emptying; (b) the acute effect on gastric emptying of gliadin; and (c) the effect of jejunal recovery on gastric emptying of meals with or without gluten in such patients. Methods: We measured gastric emptying of two meals in 16 patients with coeliac disease; one meal contained gliadin. Results were compared with those obtained in 24 controls. In 12 patients, both measurements were repeated after mucosal recovery. Statistical analysis was performed using the analysis of variance for repeated measurements and Student's t     

莫沙必利对阿司匹林致大鼠急性胃黏膜损伤的保护作用

研究显示促胃肠动力药物莫沙必利对胃黏膜损伤具有一定的保护作用。目的：研究不同剂量莫沙必利对阿司匹林致大鼠急性胃黏膜损伤的保护作用及其机制。方法：将50只大鼠随机分为阴性对照组、单纯损伤组以及不同剂量莫沙必利干预组（0．25mg／kg、0．50mg／kg、0．75mg／kg）。干预组大鼠以不同剂量莫沙必利灌胃行预处理,以150mg／kg阿司匹林灌胃制备急性胃黏膜损伤模型。实验第4d,处死大鼠。评估大鼠胃黏膜损伤指数和组织学变化,以免疫组化法检测Occludin蛋白分布,蛋白质印迹法检测Occludin、ZO．1以及磷酸化ERK（p-ERK）、磷酸化JNK（p-JNK）和磷酸化p38（p-p38）蛋白表达。结果：与单纯损伤组相比,各莫沙必利干预组胃黏膜损伤指数均明显降低（P〈0．05）;胃黏膜组织学明显改善;胃黏膜Occludin、ZO-1蛋白表达呈剂量依赖性升高（P〈0．05）;胃黏膜p-ERK、p-p38蛋白表达呈剂量依赖性降低（P〈0．05）;而胃黏膜p-JNK蛋白表达无明显差异。结论：莫沙必利对阿司匹林致大鼠急性胃黏膜损伤具有明显保护作用,其机制可能为降低MAPKs信号通路中ERK和p38蛋白磷酸化程度,并上调胃黏膜紧密连接蛋白Occludin和ZO-1表达,从而改善胃黏膜屏障的功能。     

Neural Mechanisms and Delayed Gastric Emptying of Liquid Induced Through Acute Myocardial Infarction in Rats

Background

In pathological situations, such as acute myocardial infarction, disorders of motility of the proximal gut can trigger symptoms like nausea and vomiting. Acute myocardial infarction delays gastric emptying (GE) of liquid in rats.

Objective

Investigate the involvement of the vagus nerve, α 1-adrenoceptors, central nervous system GABA_B receptors and also participation of paraventricular nucleus (PVN) of the hypothalamus in GE and gastric compliance (GC) in infarcted rats.

Methods

Wistar rats, N = 8-15 in each group, were divided as INF group and sham (SH) group and subdivided. The infarction was performed through ligation of the left anterior descending coronary artery. GC was estimated with pressure-volume curves. Vagotomy was performed by sectioning the dorsal and ventral branches. To verify the action of GABA_B receptors, baclofen was injected via icv (intracerebroventricular). Intravenous prazosin was used to produce chemical sympathectomy. The lesion in the PVN of the hypothalamus was performed using a 1mA/10s electrical current and GE was determined by measuring the percentage of gastric retention (% GR) of a saline meal.

Results

No significant differences were observed regarding GC between groups; vagotomy significantly reduced % GR in INF group; icv treatment with baclofen significantly reduced %GR. GABA_B receptors were not conclusively involved in delaying GE; intravenous treatment with prazosin significantly reduced GR% in INF group. PVN lesion abolished the effect of myocardial infarction on GE.

Conclusion

Gastric emptying of liquids induced through acute myocardial infarction in rats showed the involvement of the vagus nerve, alpha1- adrenergic receptors and PVN.     

A型肉毒毒素胃壁注射对大鼠胃排空和胃肌电的影响

背景：肥胖症是世界范围内的流行性疾病,以往非外科治疗手段的疗效甚微。近年研究发现A型肉毒毒素（BTX-A）胃壁注射治疗肥胖症的优势明显,是当前的研究热点。目的：研究BTX-A胃壁注射对大鼠胃排空和胃肌电的影响,以探索其用于肥胖症治疗的可能机制。方法：72只Wistar大鼠随机分为2周组、6周组和12周组,每组再分为正常对照组、BTX-A胃窦注射组、BTX-A胃底体注射组、BTX-A全胃多点注射组。记录大鼠进食量和体质量变化,测定胃固体半排空时间．描记胃肌电图。结果：各BTX-A注射组大鼠的进食量、体质量增加值均较正常对照组显著下降,胃固体半排空时间显著延长,胃肌电图表现为胃肌电过缓和节律不齐。上述改变以多点注射组最为显著,其次为胃底体组和胃窦组。随着时间的延长,各BTX-A注射组与正常对照组间各胃肌电相关参数的差异逐渐减小,至12周时部分指标差异无统计学意义。结论：BTX-A胃壁注射可致大鼠胃排空延迟．胃电节律紊乱,以多点注射作用最为显著．效果可维持12周。BTX-A胃壁注射致胃排空延迟和胃电节律紊乱可能是导致大鼠进食量减少和体质量增加值下降的机制之一。     

^13C-呼气试验检测胃排空的原理及其结果分析

随着稳定性核素^13C-呼气试验检测胃排空临床应用的普及,与其相关的问题也日益突出。作为一种间接测定胃排空的定量手段．理解试验原理和解读试验结果对临床工作者尤为重要。本文通过全面阐述^13C-呼气试验的原理、与其他胃排空检测方法的比较、试剂种类以及胃排空呼气试验底物^13C-辛酸和^13C-乙酸在体内的代谢以及^13C-的转运和分布规律,以期能帮助临床工作者理解^13C-呼气试验的原理并分析试验结果。