针刺足阳明经穴对兔胃粘膜损伤前后胃运动功能的影响

目的 :通过针刺足阳明经穴对兔胃粘膜损伤前后胃运动的观察 ,进一步探讨足阳明经与胃的相关规律。方法 :对 40只大耳白兔运用无水乙醇灌胃 ,造成胃粘膜损伤模型 ,然后观察针刺对胃粘膜损伤前后胃运动功能的影响。结果 :胃粘膜损伤造模前后 ,胃运动振幅指数百分率比较差异有显著性意义 ,造模后振幅指数显著下降 ,与造模前比较 P <0 .0 1,针刺四白、足三里穴能增强胃运动 ,针刺后比刺前胃运动振幅指数显著升高 (P <0 .0 1) ,尤以四白穴最为显著 ,且在胃粘膜损伤后 ,同样能增强胃的运动。结论 :胃粘膜损伤后 ,胃运动振幅指数显著下降 ,针刺足阳明经穴后可使胃运动振幅指数上升 ,提示足阳明经与胃具有相关性。     

针刺足阳明经穴对大鼠胃运动及脑肠肽的影响

目的：探讨针刺足阳明经穴对胃运动的调整作用与脑肠肽的关系。方法：以乙醇灌胃造成大鼠胃粘膜损伤模型,气囊法测量胃运动频率和波幅的变化率,采用放免分析法（RIA）检测大鼠胃窦及延髓内P物质（SP）、胃动素（MTL）及胃泌素（GAS）含量。结果：模型组胃运动频率和波幅呈抑制状态,针刺四白、天枢、足三里穴可促进胃运动恢复,与此同时胃窦、延髓内SP、MTL、GAS含量出现相应变化。三穴比较：四白主要影响胃窦MTL含量,天枢主要影响胃窦SP及延髓GAS含量,足三里穴对SP、MTL及GAS均有影响。结论：推测针刺足阳明经对胃运动的调整作用有脑肠肽参与,但上述三穴对胃运动的影响所涉及的脑肠肽不完全一致。     

针刺足阳明经穴对健康人血浆胃动素及胃泌素含量的影响

目的：进一步探讨足阳明经与胃运动内在联系的物质基础,方法：对50例健康人针刺前后各采用5ml,采用放射免疫分析法测量血浆胃动素,胃泌素的含量,结果：针刺四白,足三里穴后,血浆胃动素的含量明显升高,与针前相比差异有显著意义（P＜0．05）,针刺四社对照点后血中胃泌素明显升高,与针刺前相比差异有显著性意义（P＜0．05）,结论：针刺足阳明经穴位可使血浆胃动素含量上升,与胃运动增强呈平行关系,提示胃运动增强有胃动素的参与。     

针刺足阳明经穴对健康人血浆胃动素及胃泌素含量的影响

进一步探讨足阳明经与胃运动内在联系的物质基础。方法对50例健康人针刺前后各采血5ml,采用放射免疫分析法测量血浆胃动素、胃泌素的含量。结果针刺四白、足三里穴后,血浆胃动素的含量明显升高,与针前相比差异有显著性意义(P＜0.05),针刺四白旁对照点后血中胃泌素明显升高,与针刺前相比差异有显著性意义(P＜0.05)。结论针刺足阳明经穴位可使血浆胃动素含量上升,与胃运动增强呈平行关系,提示胃运动增强有胃动素的参与。     

针刺足阳明经特定穴治疗功能性消化不良30例

目的:分析针刺足阳明经特定穴治疗功能性消化不良(FD)的临床疗效,探讨针刺足阳明经特定穴对FD的经穴效应特异性.方法:将60例FD患者随机分到治疗组(A)和对照组(B)各30例.治疗组针刺足阳明经特定穴,对照组针刺非经非穴.两组均每日针刺1次,每次0.5 h,每周5次为1个疗程,治疗4个疗程.分别于治疗前、治疗完成、治疗后1 mo由受试者填写尼平消化不良指数(NDI),包括症状指数(NDSI)和生活质量指数(NDLQI),消化不良症状积分(FDI),健康相关生活质量评分(SF-36).统计与分析所获资料.结果:治疗组各种症状的疗效高于对照组.治疗组各症状上腹饱胀不适、早饱、上腹痛、上腹烧灼感的总有效率分别为85.72%、78.26%、94.11%、60.00%,明显高于对照组(19.23%、20.00%、6.25%、7.69%),差异有统计学意义(P<0.01);治疗完成和1 mo随访时,两组相对治疗前NDSI,FDI均显著降低,NDLQI,SF-36均显著增加(均P<0.01);且同期比较治疗组NDSI,FDI明显低于对照组,NDLQI,SF-36明显高于对照组(均P<0.01).结论:针刺足阳明经特定穴与非经非穴治疗FD都是有效的治疗方法,但前者治疗FD近期疗效(治疗完成)和远期疗效(治疗后1 mo)都明显优于后者.     

胃痛娄对大鼠胃粘膜血流量及脾虚大鼠模型的影响

为深入探讨胃痛灵保护胃粘膜的作用机制，研究了胃痛灵（ＷＴＬ）对无水乙醇损伤大鼠胃粘膜血流量（ＧＭＢＦ）、脾虚大鼠Ｄ－木糖吸收率、胃壁结合粘液量以及胃酸分泌和胃蛋白酶活性的影响。结果显示ＷＴＬ能够明显增中大鼠ＧＭＢＦ、胃壁结合粘液量，提高脾虚大鼠Ｄ－木糖吸收率，增强胃粘膜防御机能，但对脾虚大鼠胃酸的分泌和胃蛋白酶均无明显影响，在体外也无中和胃酸的能力。     

胃痛灵对大鼠胃粘膜血流量及脾虚大鼠模型的影响

为深入探讨胃癌灵保护胃粘膜的作用机制，研究了胃痛灵（WTL）对无水乙醇损伤大鼠胃粘膜血流量（GMBF）、脾虚大鼠D-木糖吸收率、胃壁结合粘液量以及胃酸分泌和胃蛋白酶活性的影响。结果显示WTL能够明显增加大鼠GMBF（P＜0．05）、胃壁结合粘液量（P＜0．05），提高脾虚大鼠D-木糖吸收率（P＜0．05），增强胃粘膜防御机能，但对脾虚大鼠胃酸的分泌和胃蛋白酶活性均无明显影响。在体外也无中和胃酸的能力。     

B超显象观察针刺足阳明经下肢段穴位对胃窦面积的影响

目的通过B超显象观察针刺足阳明经下肢段穴位对胃窦面积的影响，而探讨足阳明经与胃的相关性．方法选用足阳明经下肢段伏兔、梁丘、足三里、上巨虚、冲阳、内庭6个穴组，每组15例，每例均接受经穴及左右旁开1cm对照点的观察．刺激方法为针刺手捻针，观察记录方法为B超显示屏上直接观察，同步用日产日立录像机记录，观察过程为针前记录3min,针刺中记录3min，将记录的信号输入到计算机中每Zs采样一次，6min共捕获图象180幅，以象素为单位，计算鲁窦的面积、上下径、前后径、统计学处理采用配对t检验，组间比较用方差分析及Q检验（方差不齐时采用秩和检验）结果针刺足三里、上巨虚、冲阳、内庭4个穴位后都能使胃窦面积明显增大，与针前比较P值分别＜0．05和0．01，而针刺穴位左右对照点则作用不明显．针刺足三里、冲阳2穴后能使胃窦上下径明显增大，与针前比较P＜0．05．对胃窦前后径的变化起作用的穴位只有足三里1穴．结论针刺足阳明经下肢段穴位对胃运动功能确有特异性影响     

Gastric Mucosal Blood Flow and Neutrophil Activation in Aspirin-Induced Gastric Mucosal Damage in Man

Konturek JW, Dembinski A, Stoll R, Konturek M, Domschke W. Gastric mucosal blood flow and neutrophil activation in aspirin-induced gastric mucosal damage in man. Scand J Gastroenterol 1993; 28:767-771.

Gastric and intestinal injury induced by nonsteroidal anti-inflammatory agents (NSAIDs) such as aspirin (ASA) is a common side effect of this class of drugs, but the mechanism by which these drugs act is not fully explained. In this study the effects of 3 days of continuous oral ASA administration (1 g twice daily) to eight healthy male volunteers were studied. To estimate the extent of mucosal damage, gastroscopy was performed before and after 3 days of ASA treatment, during which the mucosal blood flow was measured by means of laser-Doppler flowmetry. Before each endoscopy gastric microbleeding was measured. Since neutrophil activation has recently been suggested to be involved in the pathogenesis of ASA-induced gastric mucosal damage, we examined the influence of ASA treatment on the activation of leukocytes by determining their association with platelets in the blood. Aspirin-induced acute gastric damage reached about 3.5 in the endoscopic Lanza score. Mucosal blood flow increased significantly after ASA treatment, by about 50% in the oxyntic gland area and by 87% in the antral area. Gastric microbleeding rose from about 0.38 ml/day in the intact stomach to about 7.7 ml/day after ASA treatment. The platelet/neutrophil adherence increased significantly in both thrombin-unstimulated and thrombin-stimulated platelets. We conclude that acute 3 days' administration of ASA in man produces well-defined areas of gastric damage accompanied by a significant increase in gastric microbleeding and gastric blood flow and that ASA promotes platelet/neutrophil adhesion that may resemble the neutrophil/ endothelium interaction in the gastric mucosa.     

Effects of Ebrotidine on Aspirin-Induced Gastric Mucosal Damage and Blood Flow in Humans

Nonsteroidal anti-inflammatory agents (NSAIDs) such as aspirin (ASA) damage the gastric mucosa both in normal subjects and in arthritic patients. The aim of this study was to investigate the protective action of a new H₂-receptor antagonist, ebrotidine, in the prevention of ASA-induced acute mucosal injury in the stomach of healthy volunteers. In a double-blind randomized crossover study 10 male volunteers received treatment with either placebo plus ASA (500 mg) or ebrotidine (800 mg) plus ASA twice daily for 3 days with 10 days' washout period between treatments. The mean number of gastric erosions seen at endoscopy after treatment with ebrotidine plus ASA (2.0 ± 0.3) was significantly lower than that after placebo plus ASA (3.7 ± 0.2). This reduction in lesion core by ebrotidine was accompanied by a significant increase in gastric blood flow (by 15% in corpus and 26% in antrum), by a rise in transmucosal potential difference (by 12%), and by a decrease of mucosal microbleeding. Ebrotidine afforded substantial protection from ASA-induced injury to the gastric mucosa, and this was accompanied by increase of the mucosal blood flow. We conclude that ebrotidine provides mucosal protection for patients taking NSAIDs     

Preventive Effects of Rebamipide on NSAID-Induced Gastric Mucosal Injury and Reduction of Gastric Mucosal Blood Flow in Healthy Volunteers

The precise mechanisms of acute damage and the role of gastric mucosal blood flow in gastric mucosal injury induced by nonsteroidal anti-inflammatory drugs (NSAIDs) remain uncertain. The aim of this study was to evaluate the preventive effect of rebamipide on gastric mucosal injury and reduction of gastric mucosal blood flow (GMBF) after ibuprofen administration. Twenty healthy volunteers were randomized two groups. The rebamipide group took ibuprofen, 1800 mg/day, and rebamipide, 100 mg t.i.d., for 7 days. The placebo group took ibuprofen, 1800 mg/day. The numbers of gastric ulcer subjects were three in the placebo group and zero in the rebamipide group. The mean modified Lanza score after ibuprofen administration was significantly higher in the placebo group than the rebamipide group (2.9±1.7 vs. 1.3±1.0, respectively; P=0.032). The GMBF of the placebo group was significantly decreased at antrum from baseline, from 2.8±0.5 to 2.0±0.5 tissue perfusion units (P=0.005). There was no difference in GMBF change in the rebamipide group. Gastric mucosal injury was correlated with GMBF reduction in antrum (r=−0.677, P=0.001). In conclusion, it is suggested that the decrease in GMBF may have been associated with NSAID-induced gastric mucosal injury, and rebamipide may have prevented NSIAD-induced gastric mucosal injury by maintaining GMBF in healthy subjects.     

Effect of Acetyl Salicylic Acid and Cetraxate on Human Gastric Mucosal Blood Flow: Clinical Application of Laser Doppler Measurement

Abstract: The effects of acetyl salicylic acid and cetraxate on gastric mucosal blood flow (GMBF) were examined in human subjects. GMBF was determined endoscopically using a laser Doppler flowmeter. The normal value in 16 adults ranged from 1.7 ± 0.8 volts (mean ± SD) at the lesser curvature of the antrum to 3.72 ± 0.79 volts at the greater curvature of the body. In four normal volunteers, the time course of GMBF was measured after the oral intake of 0.5 g acetyl salicylic acid with or without cetraxate. GMBF was significantly lower after intake of acetyl salicylic acid at 15 min at the lesser curvature of the body (3.6 ± 1.0 to 2.3 ± 0.7, P<0.05) and at 20 min at the lesser curvature of the antrum (2.7 ± 0.6 to 1.4 ± 0.2, P<0.05), as compared with the values at 5 min. This adverse effect of acetyl salicylic acid on GMBF was inhibited by concomitant administration of 0.8 g cetraxate. It was concluded that cetraxate prevented the acetyl salicylic acid induced decrease in GMBF.     

Gastric Mucosal Blood Flow Before and After TAE

Abstract: An evaluation of gastrointestinal complications after transcatheter arterial embolization (TAE) was conducted by endoscopy in order to investigate the pathogenesis of post TAE gastrointestinal complications. In addition, the gastric mucosal blood flow (GMBF) was evaluated by a laser doppler. The incidence of complications following the administration of a H₂–blocker was 34.1%, whereas the incidence following the administration of PGE1 and without medication were 2.3% (P >0.01) and 9.4%, respectively. In the group which did not receive medication, just after a TAE the GMBF decreased markedly in the lesser curvature of the gastric antrum (P >0.01), and in the lesser and greater curvature of the gastric body. This persisted from 1 to 7 days after the TAE with the GMBF showing a tendency to recover. On the other hand, in the group who received PGE1, the GMBF did not decrease in any site of the stomach following TAE. These findings suggested that the ischemia which occurred due to a decrease in the GMBF caused the gastrointestinal complications seen.     

丹参对肝硬变犬门脉压力及胃粘膜血流的影响

通过胆总管结扎法，制造犬肝硬变门脉高压模型，并直接测定丹参注射液对肝硬变犬门脉压力及胃粘膜血流（GMBF）的影响。结果表明，静注丹参注射液后，肝硬变犬的门脉压力（PpV）、嵌塞肝静脉压（WHVP）、肝静脉压力梯度（HVPG）显著下降（P＜0．01），平均动脉压（MAP）、心率（HR）无显著变化（P＞0．05）。给药后10min，肝硬变及正常犬的GMBF显著增加（P＜0．05）．用药后30min达最高值（P＜0．01），60min后GMBF稍有下降．但与用药前比较仍有显著差异（P＜0．05）。说明丹参在降低肝硬变犬门脉压力的同时改善GMBF，对血压、心率无显著影响。为副作用小，兼具降低门脉压力与保护胃粘膜作用的药物。     

氨水对大白鼠胃粘膜长期作用的影响：胃粘膜屏障功能的变化

本实验使用0.01％及0.02％的氨水,以自由饮水的形式经口长期喂养大白鼠,观察了氨水对胃粘膜血流、胃粘膜电位差及胃粘膜前列腺素E_2的影响。结果表明:由HP分泌的悄素酶所分解产生的氨长期作用于胃粘膜,可以导致大白鼠的胃粘膜血流和前列腺E_2减少,使胃粘膜电信差降低,破坏胃粘膜的防御机能,可能是HP导致慢性胃炎及胃溃疡的一个重要因素。     

Burn-Induced Gastric Mucosal Hemodynamic Disturbance in the Rat: Role of Platelet-Activating Factor

The role of platelet-activating factor (PAF) as a mediator of gastric damage associated with burn injury was examined in the rat. Gastric mucosal hemodynamics was recorded continuously by means of laser-Doppler flowmetry and reflectance spectrophotometry. Burn injury induced prolonged hypotension and rapid-onset and long-lasting gastric mucosal hemodynamic derangement—that is, ischemia with congestion. This hemodynamic disturbance was significantly inhibited by CV-6209, a specific PAF antagonist. Elevated tissue levels of thiobarbituric acid reactants and pathologic changes in the gastric mucosa subsequent to burn injury were also significantly alleviated by the preadministration of CV-6209. These results strongly suggest a role of PAF as an important mediator of gastric damage after burn injury through its potent vasoactive effect on gastric microcirculation.     

老年胃溃疡患者粘膜血流量和粘膜电位的变化

胃粘膜血流量(GMBF)在消化性溃疡的发生、发展和愈合过程中起着重要作用,胃粘膜电位(GMPD)为检测胃粘膜结构完整性的指标。我们于1988年1～6月对40例各期老年胃溃疡患者的GMBF和GMPD进行了检测,现报告如下。病例选择与方法一、病例选择 (一)老年胃溃疡组共40例,其中男性30例,女性10例,年龄60～75岁,平均64.5