胃肠动力中药的作用机制研究进展

胃肠动力疾病是目前消化内科的研究热点，随着胃肠动力理论基础的发展，对胃肠动力疾病的研究也逐渐深入，特别是中药对胃肠动力疾病的治疗，由于疗效确切，不良反应小，临床应用广泛，正越来越受到关注。     

针刺足三里调控胃肠动力机制的实验研究

目的探讨针刺足三里调控家兔胃肠动力的机制。方法选择健康成年实验用家兔30只，分为对照组、针刺足三里穴组及针刺非穴位组。在针刺前后多点（针刺前及针刺后15、30、45、60min）采血测定胃动素含量，并在针刺1h后处死动物，取胃和空肠组织进行胆碱酯酶染色、一氧化氮合酶染色并电镜观察神经末梢囊泡。结果针刺足三里穴后家兔血浆胃动素含量增多，并在针刺后45min达高峰。胃及近端空肠平滑肌组织内的胆碱酯酶活性在针刺足三里穴组明显增高，与对照组比较差异有统计学意义[胃：（15571±2876）像素点比（9081±801）像素点，近端空肠：（18588±4909）像素点比（11703±2050）像素点，P〈0．01]。一氧化氮合酶活性在针刺足三里穴组明显降低，与正常组比较差异有统计学意义（胃：1．38±0．74比4．71±1．06，近端空肠：2．10±0．94比4．81±1．08，P〈0．01）。针刺足三里穴后，胃肠道平滑肌组织神经末梢内含乙酰胆碱递质的无颗粒囊泡数目明显减少，与正常对照组比较差异有统计学意义（胃：31．12±9．99比57．45±9．18，近端空肠：21．89±4．35比56．70±9．35，P〈0．05）。结论胃动素、胆碱能神经及非肾上腺素能非胆碱能神经参与了针刺足三里穴对胃肠道运动的调节机制。     

胃炎丸调整胃肠动力的临床与实验研究

为探讨胃炎丸治疗慢性胃炎在改善胃肠动力方面的作用，对33例慢性胃炎患者进行临床观察，并选择胃肠墨汁推进试验及胃酚红排空试验进行了动物实验。研究结果胃炎丸能明显改善症状，提高血清胃动素水平（P＜0．05）．促进胃排空，治疗前、后胃排空率分别为（20．1±6.1）％、（30．3±7．6）％（P＜0．05），从而有利于胃粘膜的修复。动物实验也证实胃炎丸具有提高小鼠胃肠墨汁推进运动及加快大鼠酚红的排空作用。提示胃炎丸能调整胃肠动力，改善胃的内环境，从而对慢性胃炎具有较好的治疗效果。     

胃肠动力检测方法及原理研究进展

功能性胃肠病是临床常见病,诊断常较困难.胃肠动力即消化道的自主运动力,包括肠的收缩运动、张力、顺应性、转运、室壁运动、室壁张力,它们协同作用完成:①推进功能,②混和功能,③储存功能,④防逆流功能.     

胃肠神经系统与胃肠动力药物

体内胃肠道是唯一由中枢神经、肠神经和自主神经系统共同支配的系统，有感觉神经纤维和运动神经纤维。胃肠动力与胃肠神经系统密切相关。1993年巴塞罗那第二届欧洲消化周专题会上估计因消化不良而就诊的病人占门诊病人的30％，与我国康信强统计发现人群中消化不良发病率达20％～40％吻合。李增然等调查发现消化不良病人中73％属运     

胃肠动力的影响因素

2002年2月世界胃肠病大会提出了胃肠动力疾病的新分法,并将胃肠动力异常的概念从单纯的运动障碍扩展到运动及感知异常。于是,胃肠动力的研究再一次受到了广大学者的关注,而胃肠动力的影响因素也得到了广泛的重视。胃肠动力是消化系统生理功能的重要组成部分。胃肠动力主要由平滑肌细胞介导,通过消化道管壁的纵行肌和环形肌使食物和消化道充分混合,最后将未被吸收的废物以粪便形式排出体外。胃肠动力的基础研究是治疗胃肠动力障碍性疾病的基础,受多种因素的影响,如胃肠激素、胃肠激素受体、一氧化氮     

氧化应激在糖尿病胃肠动力障碍中的作用

糖尿病胃肠动力障碍是糖尿病常见的并发症,其机制尚未明确。近年来,越来越多的证据表明,氧化应激与糖尿病及其并发症的发生、发展密切相关。本文就氧化应激在糖尿病胃肠动力障碍中的作用作一概述。     

胃肠电刺激和胃肠动力紊乱研究进展

胃肠电刺激治疗消化道运动障碍性疾病方面的研究已经取得可喜的成果.此文就胃肠电刺激的分类和作用机制及其在胃轻瘫、肥胖、大便失禁、便秘及慢性假性肠梗阻中临床应用的研究成果进行综述.     

胃肠动力药的进展和评价

胃肠动力疾病的病理生理研究是临床药物研制的基础。近年研究证实,胃肠动力障碍性疾病的发生可能与中枢神经系统（CNS）、自主神经系统（ANS）、肠肌间伸经丛（ENS）、胃肠道平滑肌等每一水平或相互间的功能障碍有     

A Gastrointestinal Endoscopic Study on Secondary Amyloidosis Complicating Rheumatoid Arthritis

Abstract: Biopsy specimens endoscopically obtained from the stomach, duodenum, sigmoid colon and rectum of 58 patients with rheumotoid arthritis (RA) were examined for amyloid deposition by light microscopy. Six cases (10.3%) were diagnosed as being amyloidosis. In cases with more than moderate amyloid deposition, amyloid was most notable in the lamina propria mucosae. In cases with slight amyloid deposition, amyloid was seen in the blood vessel walls of the lamina muscularis mucosae and tela submucosa. On the whole, amyloid deposition was most marked in the duodenum. Endoscopically, whitish, irregular, partially nodular thickening of mucosa was characteristic in the sites with severe amyloid deposition. A fine granular appearance was observed in the sites with moderate amyloid deposition. No particular abnormal findings were noticed in the sites with slight amyloid deposition. Erosions, redness and a tendency for easy mucosal bleeding appeared frequently in the sites with more than moderate amyloid deposition. The endoscopic abnormal findings were most remarkable in the duodenum, and mildest in the recto-sigmoid colon. It was suggested that these abnormal findings were correlated with the degree of amyloid deposition especially in the lamina propria mucosae. All the amyloidosis cases were in advanced anatomical stages of RA. The degree of anemia was more severe, and total protein, albumin and total cholesterol values were lower in the amyloidosis cases than in non-amyloidosis cases. It is clear that when endoscopic examinations of RA patients are done to rule out amyloidosis, a biopsy should be taken from a depth including the submucosa even if the endoscopic finding is normal.     

Prevalence and Determinants of Gastrointestinal Manifestations in Patients with Selected Rheumatologic Diseases

Background: Many rheumatic diseases may cause gastrointestinal manifestations. The goal of this study was to analyze the prevalence and predictors of gastrointestinal involvement in patients with rheumatic disorders.Methods: A retrospective chart review was performed for patients with systemic lupus erythematosus, rheumatoid arthritis, and systemic sclerosis who have consulted due to gastrointestinal symptoms. The relationship between clinical symptoms, gastroscopic/colonoscopic findings, and histopathological results with current drugs and disease duration was evaluated.Results: A total of 364 patients with rheumatic disorders and 740 people as control group were included in the study. Abdominal bloating followed by abdominal pain, regurgitation, and heartburn were reported as the main complaints by more than half of the patients. Most of the patients had gastric mucosal changes expressed as Lanza score, and the presence of major polypharmacy was the most important factor affecting Lanza score (odds ratio: 10, 95% CI: 1.882-54.111, P < .007) followed by disease duration (odds ratio: 1.559, 95% CI: 1.369-1.775, P < .001) and age (odds ratio: 1.069, 95% CI: 1.030-1.109, P < .001). In general, approximately 30% of the patients were positive for Helicobacter pylori infection and 35% showed intestinal metaplasia in histopathological examination. Most of the colonoscopic findings were associated with colonic polyps (n = 81). In multivariate analysis, disease duration was the only factor that affected the presence of colonic lesions (Area Under the Receiver Operating Characteristic (ROC) Curve (AUROC): 0.871, 95% CI: 0.824-0.918, P < .001).Conclusion: Patients with rheumatologic diseases frequently have gastrointestinal manifestations. The most encountered gastrointestinal symptom was abdominal bloating, followed by abdominal pain. Being aware of gastrointestinal manifestations and their determinants may help physicians manage and follow patients with rheumatologic disorders.     

Gastrointestinal symptoms in Chinese patients with Type 2 diabetes mellitus.

AIMS: To examine and compare gastrointestinal (GI) symptoms in Hong Kong Chinese Type 2 diabetic outpatients and non-diabetic control subjects. METHODS: A total of 149 Chinese Type 2 diabetic patients (66 men and 83 women, age (mean +/- SD) 46.8+/-11.1 years) newly referred to the diabetes clinic of the Prince of Wales Hospital, Hong Kong were examined. Sixty-five age and sex-matched non-diabetic subjects were recruited from the community as controls (22 men and 43 women, age (mean +/- SD) 46.5+/-6.6 years, P = 0.820). All patients were interviewed regarding GI symptoms over the past year, using a questionnaire that covered 14 items. A scoring system from 0 to 4 was used to grade severity. RESULTS: Diabetic patients had higher blood pressure, fasting plasma glucose and glycated haemoglobin and were more often smokers than control subjects. Of the 149 diabetic subjects, 105 (70.5+/-45.8%) had GI symptoms while only 20 (30.8%) of the 65 control subjects had GI symptoms (P<0.001). The respective percentages of upper and lower GI symptoms in diabetic and normal subjects were 44.3% vs. 24.6% (P = 0.006) and 54.4% vs. 13.9% (P<0.001). The three commonest GI symptoms in diabetic patients were diarrhoea (34.9%), constipation (27.5%) and epigastric fullness (16.8%). After adjustment for age, sex, duration of diagnosed diabetes and smoking, patients with or without metformin had similar percentages or scores for GI symptoms. On multivariate analysis using age, body mass index, fasting plasma glucose, glycated haemoglobin, duration of diagnosed diabetes and presence of peripheral neuropathy as independent variables, duration of diabetes was the only independent parameter associated with total score for GI symptoms (beta = 0.116, P = 0.003), for upper GI symptoms (beta = 0.073, P = 0.005) and for lower GI symptom (beta = 0.043, P = 0.020). CONCLUSIONS: Up to 70% of the Chinese Type 2 diabetic outpatients have GI symptoms, which is a much higher rate than in non-diabetic control subjects. Duration of diabetes is the most important factor associated with the presence of such GI symptoms.     

Study on sensitivity and specificity of diagnostic criteria for early rheumatoid arthritis

Sensitivity and specificity were compared among the American College of Rheumatology (ACR) 1987 classification criteria, the Yamasaki diagnostic criteria, and the Japan Rheumatism Association (JRA) diagnostic criteria for early rheumatoid arthritis (RA). The study included 90 patients who consulted our department for the first time within 1 year after onset and were suspected of having RA (final diagnosis: RA 45 cases, non-RA 45 cases). We investigated whether physical and laboratory findings at the first examination met these three sets of criteria to determine the sensitivity and specificity of each set of diagnostic criteria. Moreover, the sensitivity and specificity of each item in the diagnostic criteria set were similarly determined. The sensitivity of the ACR 1987 classification criteria, the Yamasaki diagnostic criteria, and the JRA diagnostic criteria for early RA were 71.1%, 88.9%, and 95.6%, respectively, and their specificities were 100%, 93.3%, and 77.8%, respectively. In a study on each diagnostic item, observation for 1 week was considered to be sufficient for morning stiffness, swelling in three joint areas, and symmetrical swelling, while observation for a more prolonged period seemed to be necessary for swelling of the finger and hand joints. The Yamasaki diagnostic criteria are appropriate for the diagnosis of early RA, while the JRA diagnostic criteria are suitable for screening. Received: July 13, 1999 / Accepted: May 25, 2000     

正常国人胃液、十二指肠液、血浆胃动素水平及其关系研究

本文应用放免法测定５０名献血员空腹血浆胃动素（ＭＴＬ）和其中４３名胃液及２７名十二指肠液ＭＴＬ含量。均值分别为３８１±１３９ｎｇ／Ｌ、３６３±１２４ｎｇ／Ｌ、９８７±２２３ｎｇ／Ｌ。血浆ＭＴＬ浓度男高于女，Ｐ＜０．０１。十二指肠液ＭＴＬ浓度显著高于血浆及胃液，Ｐ＜０．０１。作相关分析显示：胃液及十二指肠液ＭＴＬ分别与血浆ＭＴＬ水平均有显著正相关关系。胃液ｐＨ值与胃液ＭＴＬ浓度呈显著负相关。研究结果首次证实了人的胃肠液中具有较高ＭＴＬ水平。并提示它可能由粘膜内Ｍｏ细胞直接向腔内释放所致。所释放量与Ｍｏ细胞分布稀密程度有关。并推测Ｍｏ细胞具有双向分泌作用。