六昧安消胶囊治疗功能性消化不良的临床研究

目的 :评价六味安消胶囊治疗功能性消化不良的疗效及安全性。方法 :30例功能性消化不良患者随机分为两组 ,给以治疗组六味安消胶囊 3粒 ,1日 3次 ,对照组莫沙比利 5mg ,1日 3次 ,疗程均为 2wk。治疗前存在胃排空延迟者 ,治疗后用小钡条法复查固体食物胃排空。结果 :两组治疗 2wk后均可明显改善功能性消化不良患者上腹胀、早饱、腹痛、食欲不振及嗳气等症状 ,与治疗前相比 ,有显著性差异 (P <0 0 5 ) ;治疗组治疗前症状总积分为 19 7± 5 1,治疗后为 3 9± 3 3,有显著性差异 (P <0 0 5 ) ;治疗组上腹胀、早饱、腹痛、食欲不振及嗳气等症状的有效率分别为 6 1 2 7% ,6 7 2 4 % ,5 6 84 % ,6 5 % ,5 8 2 6 % ,对照组治疗前症状总积分为 2 0 4± 9 5 ,治疗后为 5 3± 3 7,有显著性差异 (P <0 0 5 ) ;对照组上腹胀、早饱、腹痛、食欲不振及嗳气等症状的有效率分别为 6 3 15 % ,6 0 33% ,6 8 2 5 % ,5 5 7% ,5 3 6 %。两组治疗前后的症状总积分及症状有效率比较 ,均无显著性差异 (P >0 0 5 )。两组均可改善胃排空延迟患者的胃排空率 ,均无显著性差异 (P >0 0 5 )。两组患者治疗后均未发现严重不良反应。结论 :六味安消胶囊治疗功能性消化不良安全、有效     

西沙比利治疗老年人功能性消化不良的疗效

607例门诊老年功能性消化不良患者随机分为治疗组和对照组.治疗组(317例)中po西沙比利5mp tid×4wk;对照组(290例)po多福立酮10mgtid×4wk.结果:西沙比利对餐后饱胀、上腹胀满、恶心及呕吐等症状的缓解作用明显优于多潘立酮(P<0.01).治疗组总有效率为86.1%,对照组为77.6%,差异有显著性.西沙比利的主要不良反应为腹泻、肠鸣和腹痛,但患者可以耐受.结果表明西沙比利对老年人功能性消化不良有良好的疗效.     

疏肝和胃汤治疗功能性消化不良

功能性消化不良(FD)是一组以上腹胀痛不适、餐后腹胀、恶心呕吐等消化不良症状为主要表现的临床综合征.已经证实本病存在对固体食物和不消化固体的排空延迟,提示胃肠动力减慢是FD的主要发病因素.现代医学多以多潘立酮(吗丁林)、西沙比利等胃肠动力药治疗.笔者十余载来,每以自拟疏肝和胃汤施治,兹报告如下.     

柴胡枳实合剂治疗运动障碍样型功能性消化不良的临床研究

目的 通过对柴胡枳实合剂治疗运动障碍样型功能性消化不良患者疗效的观察及用药前后胃排空时间的检测 ,探讨柴胡枳实合剂治疗该病的机制。 方法 选择健康志愿者 30名 ,功能性消化不良患者 42名 ,通过B超法测定胃排空时间 ,以胃排空时间超过正常对照组 x± 1 96s者为运动障碍样型 ,共 30例 ,询问其症状并记分 ,应用柴胡枳实合剂一周后重复上述过程。 结果 功能性消化不良患者胃排空时间较对照组显著延长 ,胃排空延迟的发生率为 71 4% ;运动障碍样型功能性消化不良患者以腹胀、早饱症状为主 ,用药后症状除呕吐外均有显著改善 ,胃排空时间显著缩短。　结论 柴胡枳实合剂可有效治疗运动障碍样型功能性消化不良 ,是通过促进胃排空的机制而达到的     

西沙比利联合帕罗西汀治疗功能性消化不良86例临床观察

目的探讨西沙比利联合帕罗西汀治疗功能性消化不良（FD）的临床疗效。方法将门诊172例FD患者随机分成治疗组和对照组，均予以西沙比利治疗和生活指导，治疗组加用帕罗西汀口服治疗。结果治疗4周后统计结果，治疗组显效45．4％，有效39．5％，总有效率为84．9％，对照组总有效率为51．2％，两组相比差异有统计学意义（P〈0．05）。结论西沙比利联合帕罗西汀治疗功能性消化不良，疗效显著提高，值得临床推广应用。     

莫沙必利治疗功能性消化不良多中心双盲对照研究

目的 :观察莫沙必利治疗功能性消化不良的有效性及安全性。方法 :采用双盲随机对照研究 ,2 55名功能性消化不良病人。随机分为 2组 :莫沙必利组 12 7例 (男性 58例 ,女性 6 9例 ,年龄 4 0a±s 12a)用莫沙必利 5mg ,po ,tid ;多潘立酮组 12 8例(男性 6 1例 ,女性 6 7例 ;年龄 39a± 12a)用多潘立酮 10mg ,po ,tid。疗程均为 4wk。结果 :莫沙必利治疗 4wk ,上腹疼痛、上腹饱胀、嗳气、进食减少及早饱等症状的总有效率分别为 77.8% ,86 .6 % ,82 .5% ,87.3% ,87.2 %。明显高于多潘立酮的6 3.5% ,75.0 % ,6 9.6 % ,74 .1% ,74 .5%。莫沙必利组治疗后胃半排空时间缩短 15min± 13min ,明显高于多潘立酮组 5min± 16min。结论 :莫沙必利是一种新型安全有效的治疗功能性消化不良的药物。     

西沙比利试验预示促动力剂对功能性消化不良疗效的初步研究

目的 观察促动力剂治疗功能性消化不良的效果.方法 设计西沙比利试验,将功能性消化不良患者依照其胃电图及对短暂西沙比利治疗的反应分为EGG正常组、西沙比利试验阳性组和西沙比利试验阴性组.三组患者接受同样剂量、同样疗程的西沙比利治疗,并分别设有对照组,比较相互间的疗效.结果 西沙比利试验阳性FD患者的疗效显著高于西沙比利试验阴性FD患者及EGG正常的FD患者;治疗后胃电图节律紊乱率亦较阴性FD患者为低.结论 西沙比利试验可在一定程度上预示促动力剂对功能性消化不良的疗效.     

六味能消胶囊治疗功能性消化不良的临床研究

目的 :评价六味能消胶囊治疗功能性消化不良 (FD)的疗效及安全性。方法 :78例FD患者随机分为两组 :治疗组和对照组。治疗组六味能消胶囊 0 .9g ,每日 3次 ,口服 ;对照组多潘立酮 10mg,每日 3次 ,口服 ,疗程均 4周。结果 :治疗组有效率 84 .3% ,明显高于对照组 6 0 .4 % (P <0 .0 5 )。治疗组治疗前症状积分 2 0 .9± 6 .1,治疗后为 5 .6± 3.1,有显著差异 (P <0 .0 1)。两组均可改善胃排空延迟患者的胃排空率 ,并有显著性差异 (P <0 .0 5 )。两组患者治疗后均未发现严重不良反应。结论 :六味能消胶囊治疗FD安全、有效。     

不透X线标志物测定功能性消化不良患者的胃排空

目的:探讨功能性消化不良患者的症状与不消化固体胃排空的关系。方法:采用不透X线标志物检查30例功能性消化不良患者的胃排空情况。结果:功能性消化不良患者中有63.33%存在不消化固体,胃排空延迟;7种功能性消化不良症状出现率与胃排空延迟或正常无差异。症状总分比较也未发现症状轻重与胃排空有直接关系。结论:功能性消化不良有胃窦功能异常;对功能性消化不良的分型诊断和治疗应以胃运动功能检查为依据;不透X线标志物法是研究胃排空功能较准确而简便的方法。     

多塞平、西沙比利联合治疗功能性消化不良

目的观察多塞平、西沙比利联合治疗功能性消化不良(FD)的疗效.方法将88例FD患者随机分为治疗组和对照组各44例,均给西沙比利5 mg,tid,餐前15～30 min,po,治疗组加多塞平12.5 mg,qn,po,疗程为4 wk.结果治疗组总有效率84.08%;对照组总有效率为59.09%,2组比较差异有显著性(P<0.01).结论多塞平与西沙比利联合应用可提高治疗FD的疗效.     

Long-term cisapride treatment improves diabetic gastroparesis but not glycaemic control

BACKGROUND: In patients with diabetic gastroparesis, delayed food delivery to the intestine may become a major obstacle to post-prandial glycaemic control. AIM: To investigate whether cisapride accelerates gastric emptying in the long term or improves diabetes control in patients with diabetic gastroparesis. METHODS: Eighty-five patients with long-standing insulin-dependent diabetes mellitus (glycosylated haemoglobin (HbA1c) > 7.0%), dyspepsia and diabetic neuropathy were tested for impaired gastric emptying of solids by the 13C-octanoate breath test. Nineteen of these patients with severe diabetic gastroparesis (i.e. t1/2 > 170 min) were randomly treated with 10 mg cisapride t.d.s. (n=9) or placebo (n=10) for 12 months. Thereafter, the breath test, dyspeptic symptoms and HbA1c values were reassessed. RESULTS: Half emptying times in nine patients with diabetic gastroparesis were significantly shortened by cisapride (175 +/- 46 min vs. 227 +/- 40 min; P < 0.03). Half emptying times in the 10 patients taking placebo did not change (205 +/- 37 min vs. 211 +/- 36 min, P=0.54). Cisapride significantly reduced dyspepsia (score: 4.1 +/- 1.6 vs. 2.0 +/- 0.5, P=0.002). HbA1c values after 12 months of treatment were not different (cisapride: 7.7 +/- 0.4% vs. 7.6 +/- 0.9%, P=0.76; placebo: 7.5 +/- 0.6% vs. 7.6 +/- 1.5%, P=0.89). CONCLUSIONS: Prokinetic treatment with cisapride accelerates gastric emptying of solids and improves dyspeptic symptoms in diabetic gastroparesis. Glycaemic control, however, is not affected by cisapride.     

The eflects of levosulpiride on gastric and gall-bladder emptying in functional dyspepsia

Background: 50 % of patients with functional dyspepsia have delayed gastric emptying. Levosulpiride is an orthopramide drug that stimulates gastrointestinal motility. Aim of our study was to evaluate the effect of levosulpiride on symptoms and gastric and gall-bladder emptying, in dyspeptic patients. Methods: Thirty adult patients, treated for 20 days with levosulpiride (75 mg/day) or placebo, were evaluated in a randomized double-blind study. Symptoms were assessed by a cumulative index and overall intensity (visual analogue line). Gastric and gall-bladder emptying were evaluated by epigastric impedance (liquid meal) and real-time ultrasonography (mixed meal). Results: Levosulpiride, with respect to placebo, accelerated the mean gastric half-emptying time of liquids (P < 0.05), gastric emptying (P < 0.001 at 180 min; P < 0.05 at 240 min), and gall-bladder emptying (P < 0.05 at 60 and 120 min) emptying after a solid-liquid mixed meal. Both the mean cumulative index (P < 0.05) and the overall intensity (P < 0.025) of dyspeptic symptoms were reduced significantly by levosulpiride. Conclusions: Our results showed that levosulpiride can be usefully employed in patients affected by functional dyspepsia.     

Comparative effects of levosulpiride and cisapride on gastric emptying and symptoms in patients with functional dyspepsia and gastroparesis

BACKGROUND: The efficacy of several prokinetic drugs on dyspeptic symptoms and on gastric emptying rates are well-established in patients with functional dyspepsia, but formal studies comparing different prokinetic drugs are lacking. AIM: To compare the effects of chronic oral administration of cisapride and levosulpiride in patients with functional dyspepsia and delayed gastric emptying. METHODS: In a double-blind crossover comparison, the effects of a 4-week administration of levosulpiride (25 mg t.d.s.) and cisapride (10 mg t.d.s.) on the gastric emptying rate and on symptoms were evaluated in 30 dyspeptic patients with functional gastroparesis. At the beginning of the study and after levosulpiride or cisapride treatment, the gastric emptying time of a standard meal was measured by 13C-octanoic acid breath test. Gastrointestinal symptom scores were also evaluated. RESULTS: The efficacy of levosulpiride was similar to that of cisapride in significantly shortening (P < 0.001) the t1/2 of gastric emptying. No significant differences were observed between the two treatments with regards to improvements in total symptom scores. However, levosulpiride was significantly more effective (P < 0.01) than cisapride in improving the impact of symptoms on the patients' every-day activities and in improving individual symptoms such as nausea, vomiting and early postprandial satiety. CONCLUSION: The efficacy of levosulpiride and cisapride in reducing gastric emptying times with no relevant side-effects is similar. The impact of symptoms on patients' everyday activities and the improvement of some symptoms such as nausea, vomiting and early satiety was more evident with levosulpiride than cisapride.     

马来酸多潘立酮治疗功能性消化不良63例的Ⅱ期临床试验

目的:观察马来酸多潘立酮片治疗功能性消化不良(FD)的疗效和安全性。方法:采用随机、双盲、双模拟、阳性药对照、多中心设计。研究对象为141例FD病人,年龄18~65a,治疗组(63例)口服马来酸多潘立酮片,12.72mg,tid;对照组(69例)口服多潘立酮,10mg,tid,疗程均为4wk。评价指标有症状评分、胃排空功能、临床症状总积分以及不良反应等。结果:用药2,4wk后,2组病人主要症状积分均有显著下降(P<0.05或P<0.01)。治疗组用药后早饱、腹胀、恶心、呕吐、上腹部疼痛、食欲不振、烧心和嗳气等8项主要症状的有效率分别为85%,89%,90%,90%,86%,81%,81%和86%;对照组分别为87%,93%,91%,82%,66%,81%,92%和94%,2组比较均无显著差异(P>0.05),2组病人均无严重不良反应。结论:马来酸多潘立酮片治疗FD安全、有效。     

Influence of delaying gastric emptying on meal-related symptoms in healthy subjects

BACKGROUND: Although delayed gastric emptying is often found in functional dyspepsia, a causal role for delayed emptying in inducing symptoms has not been demonstrated. AIM: To investigate the influence of delaying gastric emptying rate in healthy volunteers on the occurrence of meal-related symptoms. METHODS: Fourteen healthy subjects (six men, mean age 23 +/- 1) underwent gastric emptying studies twice using the 14C octanoic acid and 13C glycin breath test after pre-treatment with saline or sumatriptan 6 mg s.c. Breath samples were taken before meal and at 15-min intervals for a period of 360 min postprandially. At each breath sampling, the subject was asked to grade the intensity (0-6) of four dyspeptic symptoms. RESULTS: Sumatriptan pre-treatment significantly delayed solid but not liquid gastric emptying (t1/2 respectively 159 +/- 11 vs. 112 +/- 9 min, P < 0.005 and 134 +/- 11 vs. 116 +/- 12 min, N.S.). Sumatriptan significantly decreased the mean cumulative symptom score (21.3 +/- 5.5 vs. 8.0 +/- 2.6, P = 0.01), as well as scores for each individual symptom. CONCLUSION: A moderate delay in gastric emptying in health is not associated with an increase of meal-related symptoms. This observation argues against a causal role for delayed gastric emptying in the pathogenesis of dyspeptic symptoms.     

Prokinetic effect of gut-oriented hypnosis on gastric emptying

BACKGROUND: No data are available on the effect of hypnosis on gastric emptying. AIM: To determine the effect of a hypnosis session on gastric emptying and dyspeptic symptoms. METHODS: We studied emptying by ultrasonography and epigastric sensations in 11 healthy subjects and in 15 patients affected by functional dyspepsia under three conditions according to a fixed schedule: (a) basal, (b) after cisapride and (c) during a 90 min hypnotic trance. Eight healthy subjects repeated an emptying study listening to relaxing music. Statistical analysis was performed using the Friedman test or RM-ANOVA. RESULTS: In dyspeptics, the postprandial increase in the antral area was significantly smaller during the hypnosis trance than under the basal and the cisapride conditions. For the patients gastric emptying was significantly shortened by cisapride, and even more by hypnosis (basal 274 +/- 16.8 min; cisapride 227 +/- 13.2; hypnosis 150 +/- 9.7) whereas for healthy subjects it was shortened only by hypnosis. The repeated study in healthy subjects listening to relaxing music showed no significant difference compared with the basal. Epigastric sensations were improved in dyspeptics by hypnosis, but not by cisapride. CONCLUSIONS: Gut-oriented hypnosis is effective in shortening gastric emptying both in dyspeptic and in healthy subjects.     

莫沙必利治疗功能性消化不良及近端胃舒张和胃排空功能的临床疗效

目的：探讨莫沙必利治疗功能性消化不良及近端胃舒张和胃排空功能的临床治疗效果。方法：收集我院2013年9月～2015年4月入院的90例功能性消化不良患者随机分为两组。对照组给予口服吗丁啉多潘立酮片治疗,实验组口服莫沙必利治疗,比较两组胃排空率及近端胃容积变化情况。结果：实验组及对照组治疗前后胃排空率组内比较差异显著,存在显著差异,具有统计学意义（P＜0.01）;实验组治疗后胃排空率显著高于对照组,存在显著差异,具有统计学意义（P＜0.01）;实验组治疗后30min近端胃容积均显著小于对照组,存在显著差异,具有统计学意义（P＜0.01）。结论：莫沙必利治疗功能性消化不良及近端胃舒张和胃排空功能的临床疗效显著,具有借鉴意义。     

莫沙必利联合穴位注射对功能性消化不良患者近端胃舒张和胃排空功能的影响

目的 探讨莫沙必利片联合穴位注射对功能性消化不良(FD)患者近端胃舒张和胃排空功能的影响.方法 收集FD患者142例,随机分为对照组和联合组,每组71例.对照组给予枸橼酸莫沙必利片治疗,联合组在口服枸橼酸莫沙必利片治疗同时,给予穴位注射复方丹参注射液治疗.观察两组治疗前、后血清胃动素(MTL)、胃促生长素(Ghrelin)水平、胃底气体评分、胃排空率及饮水和显影剂后0、30、60 min时的近端胃容积变化,同时对比两组的临床疗效.结果 治疗后联合组的血清MTL、Ghrelin水平分别为(218.6±27.4) pg/ml、(3.8±1.6) ng/ml,明显高于对照组的(175.1±26.5) pg/ml、(3.2±1.5)ng/ml (P＜0.05);胃底气体评分为(0.4±0.2),明显低于对照组的(0.6±0.3);胃排空率为(75.8±19.4)％,明显高于对照组的(57.2±l6.6)％(P＜0.05);治疗后饮水和显影剂后60 min时,联合组近端胃容积为(12.4±4.6)ml,明显小于对照组的(22.6±5.2)ml(P＜0.05),联合组的显效率及总有效率分别为63.4％、87.3％,明显高于对照组的35.2％、63.4％ (P＜0.05).结论 枸橼酸莫沙必利片联合穴位注射能有效提高FD患者的MTL、Ghrelin水平,降低胃底气体评分,促进胃排空,改善近端胃舒张功能,提高临床疗效.