盐酸伊托必利与多潘立酮片联合治疗功能性消化不良效果观察

目的探讨伊托必利与多潘立酮片联合治疗功能性消化不良的治疗效果。方法将200例功能性消化不良患者随机分成治疗组100例和对照组100例。治疗组每次口服盐酸伊托必利50mg＋多潘立酮片10mg,对照组口服多潘立酮片10mg,两组均每日3次,餐前30min服用;两组均治疗1个月,3个月后随访,观察有效率和不良反应发生率。结果治疗1个月后,治疗组的有效率高于对照组（P〈0．05）,不良反应发生率显著低于对照组（P〈0．05）,两组的复发率无显著性差异。结论盐酸伊托必利与潘立酮片联合治疗功能性消化不良的效果优于单用多潘立酮片。     

四磨汤联合多潘立酮治疗极低出生体重儿喂养不耐受的疗效

【目的】探讨四磨汤联合多潘立酮治疗极低出生体重儿（VLBWI）喂养不耐受的疗效。【方法】将74例出现喂养不耐受VLBWI随机分为三组,在常规治疗基础上,四磨汤组（A组,22例）给予四磨汤口服液每次1．5mL／kg,每日3次鼻饲;多潘立酮组（B组,22例）给予多潘立酮混悬液0．3mg／kg,每日3次鼻饲;联合治疗组（C组,30例）随机分为C1组和C2组同时给予四磨汤和多潘立酮,剂量同前,每日3次鼻饲,C2组在给药满5d后停药;A组、B组和C,则连续用药10d。【结果】C组胃排空时间、腹胀及胃潴留消失时间、足量胃肠营养日龄以及住院时间与A组和B组比较有显著差异（P〈0．01）。【结论】中药四磨汤联合多潘立酮治疗VLBWI喂养不耐受有显著疗效,明显优于单用四磨汤或多潘立酮治疗,且未见明显不良反应。     

乳果糖加莫沙必利治疗老年便秘90例疗效分析

目的：了解乳果糖加莫沙必利治疗老年便秘的疗效。方法：90例病人分为三组，A组单用乳果糖，B组单用莫沙必利，C组乳果糖加莫沙必利口服，疗程2周。结果：A组与C组在总有效率有显著差异（P＜0．01），B组与C组在排便率有显著差异（P＜0．05），结论：乳果糖与莫沙必利合用，可显著提高疗效。     

莫沙必利联合甲钴胺治疗老年糖尿病胃轻瘫效果观察

目的探讨莫沙必利联合甲钴胺治疗老年糖尿病胃轻瘫的临床效果。方法选择72例2012-06—2015-06在抚顺矿务局总医院干一病房就诊的糖尿病胃轻瘫患者,将所有病例随机分为观察组与对照组,每组各36例,给予对照组患者莫沙必利5 mg/次,餐前30 min口服,3次/d。在对照组治疗方法的基础上给予观察组甲钴胺0.5 mg/次,餐后口服,3次/d。两组治疗时间均为6周。观察两组患者治疗前后的胃排空率及治疗疗效。结果治疗前,两组患者胃排空率接近,差异无统计学意义,具有可比性(P0.05),经过6周治疗,两组患者胃排空率均有明显提高,但是观察组平均胃排空率为(90.31±7.52)%,明显高于对照组的(77.25±6.31)%,组间比较差异具有统计学意义(P0.05);经过治疗观察组总有效率为91.7%(33/36),明显高于对照组的77.8%(28/36),组间比较,差异具有统计学意义(P0.05)。结论莫沙必利联合甲钴胺治疗老年糖尿病胃轻瘫能有效提高胃排空率,效果显著。     

枸橼酸莫沙必利联合羟苯磺酸钙治疗糖尿病胃轻瘫38例

目的:观察枸橼酸莫沙必利联合羟苯磺酸钙治疗糖尿病胃轻瘫的疗效.方法:75例糖尿病胃轻瘫患者分为治疗组38例和对照组37例.治疗组给予枸橼酸莫沙必利5 mg,每日3次,餐前15～30 min服用,口服羟苯磺酸钙0.5 g,每日3次.对照组给予吗丁啉10 mg,每日3次,餐前15～30 min服用.两组疗程均为4周.结果:治疗组38例患者中显效15例,有效20例,无效3例,总有效率92.1%.对照组37例患者中显效6例,有效21例,无效10例,总有效率73.0%.治疗组与对照组总有效率比较,治疗组效果明显优于对照组(X2=4.65,P＜0.05).结论:枸橼酸莫沙必利联台羟苯磺酸钙治疗糖尿病胃轻瘫疗效明显,用药安全,服药方便.     

熊去氧胆酸联合多潘立酮或莫沙必利治疗原发性胆汁反流性胃炎的疗效分析

目的比较熊去氧胆酸联合多潘立酮或联合莫沙必利治疗原发性胆汁反流性胃炎(PBRG)的疗效。方法选取2017年5月—2018年8月收治的PBRG患者86例,随机分为A组与B组各43例。A组采用熊去氧胆酸联合多潘立酮治疗,B组采用采用熊去氧胆酸联合莫沙必利治疗。治疗1个月后,比较2组临床疗效、临床症状评分以及不良反应发生情况。结果 A组总有效率为83. 72%,高于B组的76. 74%,差异无统计学意义(P 0. 05)。治疗1个月后,2组腹痛、饱胀、恶心、呕吐等临床症状评分较治疗前明显下降,且A组上述症状评分均低于B组,但差异无统计学意义(P 0. 05)。A组不良反应发生率为9. 30%,低于B组的13. 95%,差异无统计学意义(P 0. 05)。结论熊去氧胆酸联合多潘立酮或莫沙必利治疗PBRG患者安全有效,能明显改善患者胃部不适症状,且不良反应较少且轻微。     

莫沙必利联合六味安消胶囊治疗慢性传输型便秘的疗效观察

目的:探讨莫沙必利联合六味安消胶囊治疗慢性传输型便秘的疗效.方法:将2010年5月～2011年5月来我院消化内科就诊的便秘患者选择性地进行结肠传输功能试验和肠镜检查,从中筛选出63例诊断为慢性传输型便秘患者,入院后给予焦虑自评量表(SAS)和抑郁自评量表(SDS)测量并记录评分结果,所有患者随机分为A、B、C组,每组21例.A组单用莫沙必利,每次5 mg,3次/d,餐前30 min口服;B组单用六味安消胶囊,每次2 g,3次/d,口服;C组莫沙必利联合六味安消胶囊治疗,服法、疗程同A、B组.三组患者治疗期间均配合综合护理措施,治疗2周后再次对三组患者进行SAS、SDS测评和结肠传输功能试验.结果:通过2周合理用药以及配合系统护理干预后,A、B、C组患者SAS、SDS评分值与入院时相比较,均有明显降低,有显著性差异(P＜0.05).A组和B组患者结肠传输试验与入院时相比较,肠内存留标记物数目差异无统计学意义(P＞0.05),C组患者治疗2周后与入院时相比较有显著性差异(P＜0.05).结论:莫沙必利联合六味安消胶囊能有效改善慢性传输型便秘患者结肠蠕动功能,缩短粪便存留肠道内时间;期间实施综合护理措施,能明显改善便秘患者因长期排便障碍产生的忧郁、焦虑、强迫及神经衰弱等精神神经症状.     

生长抑素与垂体后叶素联合心得安治疗肝硬化并发上消化道出血的疗效比较

目的观察肝硬化门静脉高压引起上消化道出血患者分别应用生长抑素与垂体后叶素联合心得安的疗效比较。方法86例患者随机分成两组：A组43例,给予生长抑素250μg缓慢静脉推注,继以250mg／h微泵持续静脉滴注维持48～72h;B组43例,给予垂体后叶素0．2U／min静脉滴注维持72h,心得安20mg,每日3次口服。结果A、B两组止血有效率分别为90．4％和89．9％,P〉0．05,差异无统计学意义。结论垂体后叶素联合心得安治疗肝硬化并发上消化遭出血的临床疗效与生长抑素相似,说明其是治疗肝硬化并发上消化道出血的经济实用的方法。     

金双歧联合莫沙必利治疗功能性消化不良的疗效及对患者胃动力指标的影响

目的探讨金双歧联合莫沙必利治疗功能性消化不良(FD)的疗效及对患者胃动力指标的影响。方法将112例FD患者随机分为研究组和对照组各56例。研究组予以金双歧+莫沙必利治疗,对照组予以多潘立酮治疗。比较2组患者疗效,比较2组治疗前后胃排空率、血浆胃动素(MTL)水平、乙酰胆碱酯酶(Ach E)水平、胃电图指标[平均收缩波频率(MFC)、收缩波幅值(AC)],记录2组不良反应发生情况。结果研究组治疗总有效率显著高于对照组(P 0. 05);治疗4周后,2组患者胃排空率、血浆MTL及Ach E水平、空腹MFC及AC均较治疗前显著升高,且研究组显著高于对照组(P 0. 05);2组患者不良反应发生率比较,差异无统计学意义(P 0. 05)。结论金双歧联合莫沙必利治疗FD疗效优于多潘立酮,其能有效升高血浆MTL、Ach E水平,促进胃收缩,提高胃排空率,且不增加不良反应。     

硫酸镁对离体大鼠缺血-再灌流心脏的保护作用

目的　研究硫酸镁对缺血 再灌流心肌损伤的治疗作用 ,探讨更有效减轻再灌流心肌损伤的治疗措施。方法　采用Langendorff离体大鼠心脏灌流模型 ,心脏缺血 (停灌 ) 30min、再灌流 12 0min ,2 4只大鼠随机分成 3组 ,A组 :给Krebs-Henseleix (NKH)灌注液为对照组 ;B组 :再灌流开始至结束给予硫酸镁 ( 1 5mM)治疗 ;C组 :缺血前 5min及再灌流全程给予硫酸镁( 1 5mM)治疗。结果　B组、C组心脏功能 (LV +dp/dtmax,LV -dp/dtmax,LVDP)恢复显著优于A组 (P <0 0 5 ) ;C组再灌流后 2h心肌梗死范围减小 ,C组为 ( 2 8 75± 5 0 1) %、A组为( 38 98± 9 0 8) % ,P <0 0 5 ;C组肌酸激酶 (CK)活性增加 ,C组为 ( 1 0 1± 0 31)IU/mg蛋白、A组为 ( 0 75± 0 0 9)IU/mg蛋白 ,P <0 0 5 ;此外心律失常发生C组亦明显减少 ,C组 ( 0 81±0 5 3)次、A组 ( 2 31± 1 5 5 )次 ,P <0 0 5。结论　硫酸镁对缺血 再灌流损伤有保护作用 ,并与给药时间密切相关     

不同类型功能性消化不良患者胃排空的超声观察与分析

目的 探索胃肠超声造影检查并计算胃排空率用于评估功能性消化不良（functional dyspepsia, FD）的价值。方法 选择我院就诊的FD患者128例,记为FD组并进一步分为上腹痛综合征（epigastric pain syndrome, EPS）亚组68例和餐后不适综合征（postprandial discomfort syndrome, PDS）亚组60例。同期选择健康成年人65例作对照组。测量所有研究对象禁食时、0min（试餐结束即刻）、30min、60min、90min、120min时全胃腔容积（TGCV）并计算胃排空率。治疗结束后再次检查并计算FD患者的胃排空率。分析不同临床类型以及不同严重程度FD患者胃排空超声观察结果。结果 餐后FD组和对照组TGCV均呈下降趋势,但相同时间段内对照组TGCV变化幅度明显大于FD组（均P<0.05）。FD组的胃排空率在30min、60min、90min和120min时均较对照组低,两组胃排空率均随着时间的增长而呈上升趋势,但每个时间点上FD组的胃排空率均低于对照组（均P<0.05）。治疗前EPS亚组患者120min胃排空率显著大于PDS亚组,轻度患者显著大于重度患者,治疗后PDS亚组患者显著大于EPS亚组,差异有统计学意义（均P<0.05）,轻度患者与重度患者差异无统计学意义（P＞0.05）。结论 超声胃肠造影检查并计算TGCV和胃排空率是一种有效的诊断FD的方法。     

枸橼酸莫沙必利片联合奥美拉唑治疗脑卒中后鼻饲患者胃食管反流病疗效观察

目的观察枸橼酸莫沙必利片联合奥美拉唑治疗脑卒中后鼻饲患者胃食管反流病(gastroesophageal reflux dis-ease,GERD)的临床效果。方法脑卒中后鼻饲合并GRED患者60例,按随机数字表法分为观察组和对照组各30例。观察组给予枸缘酸莫沙必利片口服,5 mg/次,3次/天;奥美拉唑口服,20 mg/次,1次/天。对照组给予多潘立酮口服,10 mg/次,3次/天;铝碳酸镁咀嚼片口服,1.0 g/次,3次/天。两组均治疗4周,采用调查量表评定的形式观察临床症状改善情况。结果治疗前观察组仅呃逆积分高于对照组,差异有统计学意义(P<0.01),其余各项积分差异均无统计学意义(P>0.05)。治疗后各项积分比较,观察组均低于对照组,差异有统计学意义(P<0.01)。两组患者均未发生明显不良反应。结论枸橼酸莫沙必利联合奥美拉唑能够显著改善脑卒中后鼻饲患者GRED临床症状。     

三维超声对非溃疡性消化不良患者胃排空功能的初步研究

目的 探讨三维超声对服用疏肝和胃冲剂的非溃疡性消化不良(NUD)患者胃排空功能的诊断价值.方法 60例NUD患者随机分为疏肝和胃冲剂治疗组(中药组)和吗丁啉治疗组(西药组)各30例,应用三维超声技术测量胃排空时间和胃窦容积,分别给予疏肝和胃冲剂和吗丁啉治疗4周后复查胃排空功能,观察药物对患者胃排空功能的影响.结果 经药物治疗后,两组患者胃排空时间均较治疗前缩短,胃窦容积缩小.中药组胃半排空和胃全排空时间分别为(37.6±11.4)min和(78.9±14.6)min,西药组胃半排空和胃全排空时间分别为(39.2±14.0)min和(82.1±13.7)min;中药组治疗前15 min胃窦容积为(44.5±5.7)ml,治疗后15 min为(41.5±4.8)ml,治疗前105 min为(17.2±2.2)ml,治疗后105 min为(10.2±1.3)ml,西药组治疗前15 min胃窦容积为(45.1±5.8)ml,治疗后15 min为(39.4±4.5)ml,治疗前105 min为(15.3±2.3)ml,治疗后105 min为(9.3±1.0)ml,两组胃窦容积均呈逐渐减小趋势.结论 疏肝和胃冲剂对NUD患者胃排空功能有一定程度改善,为临床提供了一种疗效确切、无毒副作用的治疗NUD的新药.三维超声可有效检测NUD患者的胃排空功能,可临床应用推广.     

胃三维容积超声造影与上消化道碘水造影评价经口内镜下幽门肌切开术疗效的价值

目的探讨胃三维容积超声造影与上消化道碘水造影在经口内镜下幽门肌切开术(G-POEM)疗效评估中的价值。方法选取确诊为胃轻瘫且需行G-POEM的患者94例,随机分为胃三维容积超声检查组48例(A组)和X线碘水造影检查组46例(B组),A组口服超声造影剂后5 min、15 min、30 min、60 min及90 min分别行超声检查,B组口服碘水造影剂后于上述相同时间点行上腹部平片检查,于G-POEM前后各测量一次,获得三维容积超声造影和X线碘水造影估测的胃容积,分析手术前后胃排空时间和胃排空率的差异,评估G-POEM后的胃排空改善情况。结果①A组胃三维容积超声造影检查的成功率97.9%(47/48),B组上消化道碘水造影检查的成功率97.8%(45/46),两组比较差异无统计学意义;②A、B组分别有31例患者的术后胃排空时间较术前明显减少(均P<0.05);③A组16例患者术前及术后胃排空时间均为90 min,90 min时间点测得胃排空率较术前明显改善者8例,差异均有统计学意义(均P<0.05),胃排空率无明显改善者8例,与术前比较差异均无统计学意义。B组14例患者术前及术后胃排空时间均为90 min,90 min时间点测得胃排空率较术前明显改善者5例,差异均有统计学意义(均P<0.05),胃排空率无明显改善者9例,与术前比较差异均无统计学意义;④A组47例超声造影患者中,31例胃排空情况较术前显著改善,8例有一定改善,余8例患者无明显改善;B组45例碘水造影患者中,31例胃排空情况较术前显著改善,5例有一定改善,余9例无明显改善。两组胃排空改善率比较差异无统计学意义(83%vs.80%)。结论胃三维容积超声造影和上消化道碘水造影均可有效评估G-POEM前后的胃排空情况,临床可首选胃三维容积超声造影评估G-POEM前后的胃排空情况和术后胃排空功能的改善效果,上消化道碘水造影可作为补充方法,为临床提供客观的影像学信息。     

胃三维容积超声造影与上消化道碘水造影在G-POEM手术疗效评估中的价值分析

目的 探讨胃三维容积超声造影与上消化道碘水造影在G-POEM手术疗效评估中的价值,从而为临床选择更合适的影像学检查方法。 方法 经东南大学附属中大医院消化科医生确诊胃轻瘫且需要进行G-POEM手术的患者共93例,根据胃排空检查方法的不同分为A组（超声胃三维容积检查）和B组（X线碘水造影检查）,其中A组48例、B组共46例,A组口服超声造影剂后在5min、15min、30min、60min及90min时间点时进行超声测量,B组在口服碘水造影剂后在上述相同时间点进行上腹部平片,上述方法在G-POEM手术前、后各测量一次,分别得到三维超声造影方法及碘水造影方法估测的G-POEM手术前、后的胃容积,从而各自评估G-POEM手术的有效后的胃排空改善情况,并进行比较分析。 结果1、完成A组胃三维超声造影方法检查的成功率为97.9%,完成B组上消化道碘水造影检查的成功率为97.8%,两组检查成功率没有统计学差异（P＞0.05）;2、A组检查中胃排空时间明显减少的有效例数为31例,胃排空时间由术前的90（90,90）min减少至术后的30（15,60）min（P＜0.05）,B组检查中胃排空时间明显减少的有效例数为31例,胃排空时间由术前的90（90,90）min减少至术后的30（15,60）min（P＜0.05）。3、A组术前及术后排胃空时间均为90min的16例患者中,90min时间点测量时胃排空率较术前明显改善的有效例数为8例,由术前的61.6%（55.9%,73.6%）增加至术后的78.1%（74.1%,91.6%）（P＜0.05）,胃排空无明显改善的例数为8例（P＞0.05）, B组术前及术后排空时间均为90min的14例患者中,90min时间点测量时胃排空率较术前明显改善的有效例数为5例,由术前的25.0%（25.0%,50.0%）增加至术后的75.0%（70.0%,90.0%） (P＜0.05),胃排空无明显改善的例数为9例（P＞0.05）。4、A组47例超声造影患者中有39例患者的胃排空情况得到了改善（P＜0.05）,其中31例患者的胃排空情况较术前显著改善,8例患者的胃排空情况得到了改善,另8例患者的胃排空情况没有得到改善（P＞0.05）;B组45例碘水造影患者中有36例患者的胃排空情况得到了改善（P＜0.05）,其中31例患者的胃排空情况有明显的改善,5例患者的胃排空情况得到了改善,另9例患者的胃排空情况没有得到改善（P＞0.05）。A、B两组影像学检查评估结果的G-POEM手术后胃排空改善有效率分别为83.0%、80.0%,两组影像学检查结果没有明显差异(P＞0.05)。 结论 胃三维超声容积测定方法及上消化道碘水造影方法均可以对G-POEM前后的胃排空情况进行评价,两种方法的成功率及评估G-POEM手术后的胃排空改善率符合率没有明显差异性,那么由于超声的独特优势（无辐射/操作简便/患者接受度高等）,临床可首选超声胃三维容积检查方法评估G-POEM手术前后的胃排空情况,从而评价G-POEM手术后胃排空功能的改善效果,上消化道碘水造影检查方法作为补充方法,为临床提供客观的影像学数据。     

Delayed gastric emptying in ventilated critically ill patients: measurement by 13 C-octanoic acid breath test

OBJECTIVE: To measure gastric emptying in ventilated critically ill patients with a new noninvasive breath test. DESIGN: Single-center, open study. SETTING: Combined medical and surgical intensive care unit of a university hospital. SUBJECTS: Thirty unselected mechanically ventilated critically ill patients receiving gastric feeding and 22 healthy volunteers. INTERVENTIONS: None. PATIENTS: After 4 hrs without feeding, intragastric infusion of 100 mL of a liquid meal (Ensure) labeled with 100 microL 13C-octanoic acid. End-expiratory breath samples were collected into evacuated tubes from the respirator circuit every 5 mins for the first hour, then every 15 mins for 3 hrs. End-expiratory breath samples were also collected from volunteers studied supine after an overnight fast following an identical infusion via a nasogastric tube. Breath 13CO2 was measured with an isotope ratio mass spectrometer. MEASUREMENTS AND MAIN RESULTS: Performance of the breath test posed no difficulty or interference with patient care. The CO2 level was >1% in 1297/1300 breath samples, indicating satisfactory end-expiratory timing. Data are median and interquartile range. Gastric emptying was slower in patients compared with volunteers: gastric emptying coefficient 2.93 (2.17-3.39) vs. 3.58 (3.18-3.79), p <.001 and gastric half emptying time, derived from the area under the 13CO2 curve, 155 min (130-220) vs. 133 min (120-145), p <.008. Fourteen of the 30 patients had a gastric emptying coefficient <95% of all volunteers and 11 had a gastric half emptying time longer than 95% of all volunteers. The Acute Physiology and Chronic Health Evaluation (APACHE II) score (median 22, range 13-43) either at admission or on the day of the study did not correlate with gastric emptying coefficient. CONCLUSION: Gastric emptying of a calorie-dense liquid meal is slow in 40% to 45% of unselected mechanically ventilated patients in a combined medical and surgical intensive care unit. The 13C-octanoic acid breath test is a novel and useful bedside technique to measure gastric emptying in these patients.     

Prevalence of delayed gastric emptying in diabetic patients and relationship to dyspeptic symptoms: a prospective study in unselected diabetic patients

OBJECTIVE: Data on the prevalence of abnormal gastric emptying in diabetic patients are still lacking. The relation between gastric emptying and dyspeptic symptoms assessed during gastric emptying measurement has not yet been investigated. The aim was to investigate the prevalence of delayed gastric emptying in a large cohort of unselected diabetic patients and to investigate the relation between gastric emptying and gastrointestinal sensations experienced in the 2 weeks before and during the test meal, prospectively. RESEARCH DESIGN AND METHODS: Gastric emptying was evaluated in 186 patients (106 with type 1 diabetes, mean duration of diabetes 11.6 +/- 11.3 years) using 100 mg (13)C-enriched octanoic acid added to a solid meal. RESULTS: Gastric emptying was significantly slower in the diabetic subjects than in the healthy volunteers (T(50): 99.5 +/- 35.4 vs. 76.8 +/- 21.4 min, P < 0.003; Ret(120 min): 30.6 +/- 17.2 vs. 20.4 +/- 9.7%, P < 0.006). Delayed gastric emptying was observed in 51 (28%) diabetic subjects. The sensations experienced in the 2 weeks before the test were weakly correlated with the sensation scored during the gastric emptying test. Sensations assessed during the gastric emptying test did predict gastric emptying to some extent (r = 0.46, P < 0.0001), whereas sensations experienced in the previous 2 weeks did not. CONCLUSIONS: This prospective study shows that delayed gastric emptying can be observed in 28% of unselected patients with diabetes. Upper gastrointestinal sensations scored during the gastric emptying tests do predict the rate of gastric emptying to some extent and sensation experienced during daily life does not.     

The effect of sildenafil on gastric emptying in patients with end-stage renal failure and symptoms of gastroparesis

BACKGROUND: Delayed gastric emptying is a common disorder among patients with end-stage renal failure (ESRF). Pyloric relaxation, a major determinant of gastric emptying, is a nitric oxide (NO)-mediated process. NO-induced smooth muscle relaxation is mediated through its second messenger cyclic guanosine monophosphate, which is broken by tissue phosphodiesterases (PDEs). Thus the inhibition of cyclic guanosine monophosphate breakdown by PDE inhibitors can potentiate NO-mediated responses and facilitate pyloric relaxation. In an animal model of diabetes mellitus, treatment with sildenafil (a PDE-5 inhibitor) restored NO-mediated pyloric relaxation and improved gastric emptying. The aim of our study was to examine the hypothesis that sildenafil may improve gastric emptying in patients with ESRF and symptoms of gastric paresis. METHODS: We studied 12 patients with ESRF (6 men; age range, 54-80 years; 5 with diabetic nephropathy; 4 +/- 1 years receiving long-term renal replacement therapy) after either placebo or a 25-mg tablet of sildenafil (Viagra; Pfizer Inc). Gastric emptying of a solid meal (one medium-sized fried egg mixed with 37 MBq [1 mCi] technetium Tc 99m phytate plus 1 slice of bread and 150 mL of water at the end of the meal) was assessed 1 hour after dosing by use of a single-headed camera. Images were acquired every 30 seconds for 90 minutes immediately after patients ate. RESULTS: The gastric emptying rate was decreased at baseline (after placebo), to 33% +/- 6% (normal, > or =50%). Treatment with sildenafil had no effect on gastric emptying rates after 90 minutes (from 33% +/- 6% after placebo to 30% +/- 6% after sildenafil, P =.9). CONCLUSIONS: Sildenafil did not improve gastric emptying in patients with ESRF and gastric paresis. Sildenafil may have opposing effects on gastric peristalsis (causing gastric relaxation) compared with its effects on pyloric relaxation. Studies combining sildenafil with prokinetic drugs are of interest.     

Effect of motilin on gastric emptying in patients with diabetic gastroparesis

OBJECTIVES: Because disturbances of gastric emptying are a serious complication in insulin-dependent diabetic subjects with regard to the maintenance of good metabolic control, we wanted to assess the effectiveness of motilin as a potential treatment for gastric emptying disturbances. RESEARCH DESIGN AND METHODS: The intestinal hormone motilin has been shown to accelerate gastric emptying in healthy subjects. Therefore, we examined the effect of intravenous motilin on gastric emptying of a 99mTc colloid-labeled semisolid test meal in 9 insulin-dependent diabetic patients with diabetic gastroparesis. All patients had a significantly delayed gastric emptying rate compared with a group of 11 healthy control subjects. RESULTS: During the infusion of motilin, gastric emptying was accelerated, and it was no longer significantly different from control values. CONCLUSIONS: These data demonstrate that motilin and related compounds such as erythromycin derivatives could be useful for the treatment of disturbed gastric emptying in diabetic subjects.     

多潘立酮对功能性消化不良患者胃电图影响的临床研究

目的 研究多潘立酮对功能性消化不良(FD)患者的治疗效果,进一步探讨其治疗机制.方法 采用自身对照的研究方法,随机选取31例FD患者,停止应用影响胃酸分泌及胃动力的药物1周后,给予症状评分,并进行胃排空检测和餐前、餐后胃电图的检测;口服多潘立酮2周后,再次进行症状评分,并进行胃排空和餐前、餐后胃电图检测.结果 FD患者口服多潘立酮2周后,上腹痛、腹胀、早饱、嗳气等临床症状明显改善,治疗前症状积分48.20±21.71,治疗后症状积分19.00±11.03,治疗前后比较,差异有统计学意义(P<0.01);FD 患者治疗前后胃排空率检测比较:2、5 h胃总排空率均明显增加(17%与57%,56%与96%,均P<0.01);FD患者治疗后与治疗前胃电参数指标进行比较:①主频:实验组治疗前餐前主频值(2.57±0.60)cpm,餐后主频值(2.70±0.53)cpm;治疗后餐前主频值(3.00±0.26)cpm,餐后主频值(3.01±0.27)cpm;FD患者口服多潘立酮两周后主频与治疗前比较,餐前之间相比差异有统计学意义(P<0.05),餐后之间相比差异亦有统计学意义(P<0.05).②主功率:实验组治疗前餐前主功率值(55.36±8.46)μV,餐后(72.30±10.35)μV;实验组治疗后餐前主功率值(75.06±13.13)μV,餐后(112.27±17.27)μV,主功率显著增加(P<0.05);③正常胃电慢波百分比显著增多(54.8%→93.4%)(P<0.01);胃动过缓百分比显著减少(19.4%→3.2%)(P<0.01);胃动过速百分比显著减少(25.8%→3.2%)(P<0.01).结论 多潘立酮可显著改善FD患者的上腹痛、腹胀、早饱、嗳气等主要症状,增强胃电活动及胃排空,增加胃电可见图的主频及主功率,使紊乱的胃电节律趋于正常.