比较莫沙必利和安慰剂治疗糖尿病胃轻瘫的疗效

目的比较莫沙必利和安慰剂治疗糖尿病胃轻瘫的疗效。方法选取2010年11月至2012年10月期间我院收治120例糖尿病胃轻瘫患者。随机分为观察组和治疗组,各60例,观察组采用莫沙必利,对照组采用安慰剂,观察两组的治疗效果。结果①观察组的总有效率（83．3％）明显高于对照组的总有效率（71．7％）（x^2=6．142,P〈0．05）;②两组糖尿病胃轻瘫患者治疗前的胃排空时间相比无明显差异;观察组治疗后的胃排空时间（60．22±3．41）min明显低于对照组的胃排空时间（97．20±4．63）vain（f=1．615,P〈0．05）。结论莫沙必利治疗糖尿病胃轻瘫疗效要好于安慰剂,可以明显改善患者的胃功能。     

长期口服多潘立酮治疗胃轻瘫

胃轻瘫（gastroparesi）是一种慢性胃动力疾病，表现为冒对固体或液体食物的排空延缓，伴恶心、呕吐、脱水，基至出现营养不良。多潘立酮（domperidone）是一种多巴胺桔抗剂，文中评价了本品治疗胃轻瘫的长期疗效。17例胃轻瘫病人进入研究，胃轻瘫的病因包括特发性（12例），糖尿病性（3例）和手术后胃轻瘫（2例）。所有病人均经钡剂和（或）内窥镜检查排除了其它原因的胃排空或梗阻疾病。本组病人中100％伴恶心，94％伴呕吐和腹痛、59％伴腹胀。治疗前后均进行冒排空检查。整个研究时间为48个月，平均随访23．3个月（6～48个月）。本品用量…     

糖尿病胃排空数学模型

糖尿病（ＤＭ）胃轻瘫固体排空障碍的报道较多,但是否还存在液体排空障碍仍有争议。在此报告８９ 例糖尿病患者超声胃液体排空检测结果,通过建立胃排空数学模型来研究ＤＭ 患者的胃运动功能。利用胃排空数学模型和胃排空速度方程,可求出任意时刻的胃排空率和胃排空速度,为评判胃运动功能取得了科学的数据。结果显示,ＤＭ 组有５１ 例（５７．３％ ）胃液排空延缓,３８ 例（４２．７％ ）排空正常,ＤＭ 胃排空延缓组各时相平均胃排空率、胃排空速度都明显低于对照组,两组有显著性差异（Ｐ＜ ０．００１）。研究结果表明,ＤＭ 组５７．３％ 有不同程度的胃液体排空障碍,胃排空数学模型定量地反映了胃排空率、胃排空速度与排空时间的动态关系,将医学上一惯性的定性分析定量化。胃排空数学模型是深入研究胃动力障碍性疾病的科学方法与工具     

Ghrelin能够增加胃轻瘫糖尿病病人的胃排空率

根据英国研究人员的报道，胃肽ghrelin（Ⅰ）能够增加胃轻瘫糖尿病病人的胃排空率。在一项随机的交叉试验中，十名有胃轻瘫症状的糖尿病病人接受5pmol／kg／分的（Ⅰ）输注或接受生理盐水输注，共120分钟。然后，在另外一天交换输注。     

噬菌体生物扩增法快速测定结核分枝杆菌对异烟肼和利福平的药物敏感性应用价值

目的探讨噬菌体生物扩增法（PhaB）快速测定结核分枝杆菌对异烟肼（INH）和利福平（褂甲）的药物敏感性在临床应用价值。方法选择初治肺结核病患者留痰后培养获得的结核分枝杆菌菌株69株和复治患者留痰后培养获得的结核分枝杆菌菌株98株。均经改良罗氏培养基培养并进行菌型鉴定,证实为结核分枝杆菌（MTB）。分别采用PhaB法和改良罗氏比例法检测其对INH和RFP的耐药性,将2种方法的结果进行敏感度、特异度和符合率比较。结果（1）初治结核分枝杆菌69株中,与改良罗氏比例法比较,PhaB法检测INH的敏感度、特异度和符合率分别为80％（4／5）、90．6％（58／64）和89．9％（62／69）;PhaB法检测趾11P的敏感度、特异度和符合率分别为100％（3／3）、95．5％（63／66）和95．7％（66／69）。（2）复治结核分枝杆菌98株中,与改良罗氏比例法比较,PhaB法检测INH的敏感度、特异度和符合率分别为89．7％（35／39）、88．1％（52／59）和88．7％（87／98）;PhaB法检测肿的敏感度、特异度和符合率分别为97．1％（34／35）、93．7％（59／63）和94．9％（93／98）。结论噬菌体生物扩增法同改良罗氏比例法比较有较高的敏感度、特异度和符合率,可快速、准确地检测结核分枝杆菌对INH和RFP的耐药性。     

糖尿病胃轻瘫患者异常胃肌电活动的观察与分析

目的通过胃电图检查研究糖尿病胃轻瘫患者异常胃肌电活动，探讨胃动力异常在糖尿病胃轻瘫发生中的作用。方法67例糖尿病胃轻瘫患者行餐前和餐后体表胃电图检查，对正常胃慢波百分比和胃电主功率两项参数进行分析。结果本组糖尿病性轻瘫患者中胃电节律正常占41．8％、胃动过缓占32．8％、胃动过速占7．5％和混合性胃电节律紊乱占17．9％。在胃电节律正常的糖尿病胃轻瘫患者中，10例（35．7％）存在餐后／餐前胃电主功率比异常。结论胃动力异常在糖尿病胃轻瘫发病机制中起有重要作用。     

粮尿病性胃轻瘫的诊断与治疗

糖尿病患者血糖控制不良,可并发自主神经病变导致胃轻瘫。血糖水平与胃排空呈负相关,高血糖可抑制胃运动,延迟胃排空,干扰胃消化间期移行性复合运动(IMMC)周期活动和胃肠道激素分泌。诊断本病需做胃运动功能检查如:双核素胃排空和胃电图。糖尿病性胃轻瘫的治疗需联合应用降糖药和促胃动力药物。多潘立酮(吗丁啉)和西沙必利都可促进胃蠕动,加快胃排空,改善胃轻瘫,但在使用西沙必利时应严格掌握其适应证、禁忌证和药物剂量,忌与红霉素联用。     

糖尿病性胃轻瘫的诊断与治疗

糖尿病患者血糖控制不良,可并发自主神经病变导致胃轻瘫。血糖水平与胃排空呈负相关,高血糖可抑制胃运动,延迟胃排空,干扰胃消化间期移行性复合运动(IMMC)周期活动和胃肠道激素分泌。诊断本病需做胃运动功能检查如：双核素胃排空和胃电图。糖尿病性胃轻瘫的治疗需联合应用降糖药和促胃动力药物。多潘立酮(吗丁啉)和西沙必利都可促进胃蠕动,加快胃排空,改善胃轻瘫,但在使用西沙必利时应严格掌握其适应证、禁忌证和药物剂量,忌与红霉素联用。     

枳芍健脾汤治疗糖尿病胃轻瘫50例临床分析

目的运用对照法观察枳芍健脾汤治疗糖尿病胃轻瘫的疗效。方法将糖尿病胃轻瘫患者100例随机分为治疗组50例采用枳芍健脾汤加减辩证施治与对照组50例采用多潘立酮口服,观察患者胃轻瘫症状及胃排空率情况,进行疗效对比观察。结果治疗组患者总有效率为80.0%,对照组总有效率为56.0%,治疗组治疗结果与对照组治疗结果比较,P<0.05,两组之间数据差异有统计学意义。治疗组50例患者胃轻瘫症状的缓解明显优于对照组,胃排空率亦明显优于对照组。结论应用枳芍健脾汤治疗糖尿病胃轻瘫疗效好。     

核素显像对功能性消化不良患者胃排空功能的研究

为了探讨功能性消化不良（ＦＤ）患者胃排空状况，采用固体试验餐和放射性核素显像法对符合诊断标准的ＦＤ患者１８例，正常（对照）组１６例进行了胃排空检查。结果显示，ＦＤ患者胃排空前的延迟时间，即延迟期（ＬＰ），较对照组明显延长（Ｐ＜０．０５）；胃半排空时间（ＧＥＴ１／２）亦明显延长（Ｐ＜０．０１）；从餐后１５分起，各时段的胃排空率（ＧＥＲ）均明显低于对照组（Ｐ＜０．０１）。以对照组ｘ±２ｓ为诊断标准，则ＦＤ组７２．２％患者的ＬＰ延长，６６．７％患者的 ＧＥＴ １／２延长，５５．６％患者的 ６０分 ＧＥＲ减低。因此，核素胃排空显像能很好地反映胃的运动功能，对ＦＤ的诊断和疗效判断有一定的临床价值。     

pH及胃排空率对早产儿胃食道反流的诊断价值

目的：探讨早产儿胃食道反流（ＧＥＲ）的早期实用诊断和预防方法。方法：利用２４小时ｐＨ值自动记录仪测定４０例早产儿的食道下端ｐＨ值，当ｐＨ〈４、持续时间〉１５秒为１闪反流，同时应用Ｂ超检测胃排空率，观察与ＰＨ计的相关性。结果：４０例早产儿中ＧＥＲ阳性率为８２．５％，其中和８０％为无症状型。当患儿头抬高３０度时或日龄≥１５天者，ＧＥＲ发生率逐步下降且ＰＨ及各项参数降低。ＧＥＲ的参数与喂奶后６０分的胃排     

Effects of sho-saiko-to (xiao chai hu tang), a Chinese traditional medicine, on the gastric function and absorption of tolbutamide in rats

This study was carried out to investigate the effects of Sho-saiko-to (Xiao Chai Hu Tang), a Chinese traditional medicine, on the gastric function including the gastric emptying rate (GER) and intragastric pH in rats. Additionally, the effects of the GER and intragastric pH on tolbutamide absorption after oral administration were examined. The GER measured at 40 min after dosing was reduced to about 70% by the pretreatment of Sho-saiko-to (500 mg/kg). The plasma tolbutamide concentration in the rats treated with a 250 mg/kg dose of Sho-saiko-to was significantly lower than that in the control group. Plasma tolbutamide concentrations increased along with the GER in the group co-administered Sho-saiko-to, and there were significant correlations between the GERs and plasma levels in both time points at 20 and 40 min after administration. In the study using pylorus-ligated rats, Sho-saiko-to significantly elevated the intragastric pH, but induced no change in the concentrations of tolbutamide dissolved in the gastric content. Additionally, Sho-saiko-to did not change the area under the plasma concentration-time curve (AUC) of tolbutamide up to 60 min after administration into the stomach loop, and gastric absorption has been considered to minimally contribute to whole absorption of tolbutamide in the gastrointestinal tract. These results indicate that Sho-saiko-to has an inhibitory effect on the function of gastric emptying in rats. The reduced gastric emptying could affect gastrointestinal absorption, resulting in the lower plasma concentration of tolbutamide after oral administration. Furthermore, it is suggested that Sho-saiko-to can raise the intragastric pH but affect neither the intragastric dissolution nor the gastric absorption of tolbutamide.     

润降利膈丸联合莫沙必利治疗糖尿病性胃轻瘫(胃阴不足型)的疗效及对胃肠激素、氧化应激反应的影响

目的:探讨润降利膈丸联合莫沙必利治疗糖尿病性胃轻瘫(diabetic gastroparesis,DGP)(胃阴不足型)的疗效及对胃肠激素、氧化应激反应的影响,为临床治疗提供参考。方法:将2018年1月至2019年10月石家庄市中医院内分泌科收治的DGP(胃阴不足型)患者117例纳入研究,采用随机数字表法分为研究组(63例)和对照组(54例)。两组患者均进行常规治疗,在此基础上,对照组患者给予莫沙必利,研究组患者给予润降利膈丸联合莫沙必利,总疗程为2周。比较两组患者治疗前后胃肠激素[胃动素(MOT)、胃泌素(GAS)]、氧化应激指标[超氧化物歧化酶(SOD)、活性氧(ROS)及丙二醛(MDA)]水平及胃排空情况的差异,观察两组患者临床疗效、不良反应发生情况及复发情况。结果:治疗后,两组患者MOT、GAS、SOD水平及胃排空率明显高于治疗前,ROS、MDA水平明显低于治疗前,差异均有统计学意义(P<0.05)。治疗后,研究组患者MOT、GAS、SOD水平及胃排空率明显高于对照组,ROS、MDA水平明显低于对照组,差异均有统计学意义(P<0.05)。研究组患者的总有效率为92.06%(58/63),明显高于对照组的74.07%(40/54),差异有统计学意义(P<0.05)。治疗期间,研究组患者未出现明显不良反应,对照组2例患者出现丙氨酸氨基转移酶水平升高;研究组患者无复发,对照组8例患者复发(复发率为14.81%)。结论:润降利膈丸联合莫沙必利治疗DGP(胃阴不足型)的疗效良好且安全性高,可有效促进胃动力并减轻患者体内氧化应激反应。     

A new method using flow cytometry to measure the effects of drugs on gastric emptying and gastrointestinal transit in mice

The use of radiolabelled markers is considered to be a gold standard for assessing gastric emptying and gastrointestinal transit in mice and rats, but their use has increasingly been restricted due to health concern. Therefore, a new method using fluorescent polystyrene microbeads and flow cytometry was devised. Saline containing fluorescent markers (together with non-fluorescent microbeads) was infused into the stomach of each mouse and gastric emptying and gastrointestinal transit were calculated by measuring the quantity of the fluorescent microbeads in the gastrointestinal tract using flow cytometer. The effects of saline (as a control), morphine (CAS 52-26-6) and dexmedetomidine (CAS 113775-47-6) were tested. Both gastric emptying and gastrointestinal transit measured with this method (after i.p. injection of saline) were similar to those reported previously using the conventional radiolabelled methods. Morphine significantly inhibited both gastric emptying and gastrointestinal transit in a dose-dependent manner. Dexmedetomidine did not significantly inhibit gastric emptying but inhibited gastrointestinal transit. These results were also similar to those obtained using the conventional radiolabelled method. The method using fluorescent microbeads and flow cytometry may be a reliable alternative to the methods using radioisotope for studying the effects of drugs on gastric emptying and gastrointestinal transit.     

Delay in gastric emptying rate enhances bioavailability of sodium salicylates in rabbit

The effect of delay in gastric emptying rate (GER) caused by oil on the bioavailability of sodium salicylate was investigated. The bioavailability of sodium salicylate administered in aqueous, glycerin and oily vehicles was compared in rabbits. Glycerin (having no effect on GER and more viscous than oil) was used to eliminate the effect of viscosity of the oil on the bioavailability of the drug. Glycerin formulation was compared with both aqueous and oily formulations using a two-way crossover test in eight rabbits, in each study. The results indicate that the oily formulation gave a lower rate of absorption and a greater extent of absorption than the other formulations. No significant difference in the rate and extent of absorption was shown between the two vehicles having no effect on GER (aqueous and glycerin vehicles). In conclusion, Delaying effect of the oil on the GER enhances significantly the bioavailability of salicylate. This enhancement is due to the physiological effect of the oil on the GER and not due to its viscosity. Possible reasons for the differences are discussed with particular reference to the effects of oil on the gastric emptying rate (GER).     

The pharmacological effect of omeprazole on water gastric emptying: A study based on an impedance measure.

The present study was performed to validate the accuracy of a self-designed applied-potential tomograph (APT) in measuring the cross area of a studied object and to assess the effect of omeprazole premedication on water gastric emptying (GE), based on APT. Twelve electrodes were evenly placed in a circular array around the studied subjects. Ten electrodes in a rotated order recorded the electrical current injected into paired electrodes. Based on tomography, averaged signals of changed resistivity were constructed to display the area of interest and GE curve. Six beakers of various diameters were respectively placed into a cylindrical perspex tank which was filled with saline to measure their cross areas via computer-generated diagrams of APT. One hour after either omeprazole (20 mg) or placebo premedication, 15 healthy males were ordered to consume 500 ml of test water to assess emptying for 40 min. Within 3 days, a similar procedure was repeated using the counterpart premedication. The true cross areas of the 6 beakers are 2.01, 15.9, 18.8, 30.19, 38.48 and 63.61 cm(2), whereas those obtained by APT were 7.9 +/- 2.9, 16.7 +/- 3.3, 22.4 +/- 4.9, 28 +/- 4.8, 48.7 +/- 7.6 and 67 +/- 6.1 cm(2), respectively (r = 0.98, p < 0.001). Valid emptying data were obtained in 73.3 and 86.6% of subjects, following placebo and omeprazole, respectively (not significant). The half emptying times were 12.7 +/- 5.1 min for the placebo-treated group and 10.5 +/- 3.6 min for the omeprazole-treated group, respectively (p < 0.05). The areas under the emptying curve were 1,611.5 +/- 357.6 and 1,317.3 +/- 316.7 arbitrary units, respectively (p < 0.01). In conclusion, our APT system is accurate for large-area measurements; acid inhibition before APT measurement does not increase the success rate but enhances water emptying. The interpretation of impedance-obtained GE should consider the acid-inhibitory effect.     

VB20B7, a Novel 5-HT-ergic Agent with Gastrokinetic Activity. II. Evaluation of the Gastroprokinetic Activity in Rats and Dogs*

The gastrokinetic activity of 2[l-(4-piperonyl)piperazinyl]benzothiazole (VB20B7), a new compound with 5-HT₄ receptor agonist and weak 5-HT₃ receptor antagonist properties has been studied in rats and dogs. The effects of VB20B7 were investigated in physiological conditions and in a model of gastroparesis induced by the α₂-adrenergic agonist UK-14304 and compared with cisapride. In rats, both VB20B7 and cisapride enhanced gastric emptying of indigestible solids (steel spheroids) and liquids (phenol red) at doses of 5–10 mg kg^?1 by mouth. Gastric emptying of solid radiopaque markers in fasted beagle dogs was enhanced significantly by VB20B7 (0.25–1 mg kg^?1 p.o.) whereas the effect of cisapride (0.5–2 mg kg^?1 p.o.) did not reach statistical significance. Similar results were found when the radiopaque markers were given to the dogs following a standard solid meal The delayed gastric emptying of indigestible solids and radiopaque markers by UK-14304 was reversed by oral administration of VB20B7 in both rats and dogs. Cisapride, however, was only effective in rats. In addition, gastric emptying of a digestible solid/liquid meal was assessed by quantitating the rate of appearance of the radioactive markers in the duodenum of dogs. VB20B7 (0.2–1 mg kg^?1, i.v.) enhanced gastric emptying of both solid and liquid phases while cisapride only enhanced emptying of the solid phase. The present study indicates that acute oral and intravenous administration of VB20B7 accelerates gastric emptying of both solids and liquids in different animal models.     

Variability of the 13C-octanoic acid breath test for gastric emptying of solids in healthy children

AIM: To assess the intra-individual variability of the 13C-octanoic acid breath test using non-dispersive infrared spectrometry for gastric emptying of solids in healthy children. METHODS: A 13C-octanoic acid breath test was performed at least two times in 19 healthy children (age 12.4 +/- 2.7 years) 2-7 days apart to measure gastric emptying of solids. Breath samples were taken before eating a 13C-octanoic acid-labelled pancake and at 15-min intervals for the following 240 min. Breath samples were analysed using non-dispersive infrared spectrometry; 13C-recovery was used to calculate values for gastric half-emptying time (t(1/2)), gastric lag phase (t(lag)) and gastric emptying coefficient. Intra-individual variability of the parameters t(1/2), t(lag) and gastric emptying coefficient were expressed as coefficient of intrasubject variation. RESULTS: The mean coefficient of intrasubject variation of t(1/2) was 13.3 +/- 7.9% (range 2.5-29.6%; interindividual range 99-204 min; intra-individual range 5-84 min for t(1/2)). The mean coefficient of intrasubject variation of t(lag) was 13.6 +/- 7.5% (range 0.8-27.8%) (interindividual range 65-146 min; intra-individual range 1-50 min for t(lag)). The mean coefficient of intrasubject variation of gastric emptying coefficient was 12.5 +/- 6.8% (range 3.4-30.2%; interindividual range 2.3-3.9; intra-individual range 0.17-1.4 for gastric emptying coefficient). The coefficient of intrasubject variations of t(1/2), t(lag) and gastric emptying coefficient were independent of the values of t(1/2), t(lag) and gastric emptying coefficient. CONCLUSIONS: Gastric emptying in healthy children is characterized by a large inter- and intra-individual variability and is concordant with the results obtained with other techniques.     

Comparative scintigraphic assessment of the intragastric distribution and residence of cholestyramine, Carbopol 934P and sucralfate

It has been demonstrated that orally administered cholestyramine is distributed throughout the stomach and provides prolonged gastric residence via mucoadhesion. Gamma scintigraphy was used to compare the gastric emptying and residence of this resin with two formulations known to exhibit retentive or bioadhesive properties, Carbopol 934P and sucralfate. Fasted normal subjects received a single radiolabelled dose and gastrointestinal transit was monitored for 6 h. The subjects were fed after 4 h to determine the effects of inducing a fed pattern of motility on the retention of the formulations. Initial gastric emptying was similar (Mean T50+/-S.E.M.: cholestyramine=66.93+/-9.39 min; Carbopol=56.57+/-11.96 min; sucralfate=48.33+/-11.07 min; P=0.548: n=10), however, the emptying of cholestyramine slowed beyond 2 h. This resulted in greater residence for cholestyramine (Mean AUC0-6+/-S.E.M. (relative units)=11516+/-686 versus 7657+/-1170 versus 6170+/-998; cholestyramine versus Carbopol versus sucralfate; P=0.004: n=10), with approximately 25% remaining in the stomach at 6 h compared to 3.84 and 2.65% of Carbopol and sucralfate, respectively. Cholestyramine was also distributed widely throughout the stomach whereas Carbopol and sucralfate were concentrated in the body and antrum. Thus, as cholestyramine had a comparable emptying time to Carbopol and sucralfate but greater gastric residence and wider distribution, it could provide a potential mucoadhesive drug delivery system targeting the gastric mucosa for treatment of conditions such as Helicobacter pylori infection.