复方阿嗪米特治疗功能性消化不良、慢性胆囊炎、胆结石、肝硬化腹胀的疗效观察

目的观察复方阿嗪米特肠溶片对功能性消化不良、慢性胆囊炎、胆结石及肝硬化所致腹胀的疗效。方法将功能性消化不良、慢性胆囊炎、胆结石、肝硬化患者各20例纳入本研究。分别予以复方阿嗪米特肠溶片2粒，每日3次，疗程4周。观察治疗前后腹胀症状积分改变。功能性消化不良及慢性胆囊炎、胆结石患者治疗前后进行水负荷试验。结果复方阿嗪米特肠溶片可明显改善功能性消化不良、慢性胆囊炎、胆结石及肝硬化患者腹胀症状，治疗2周及4周腹胀症状积分均明显下降（P〈0．01）。治疗后功能性消化不良及慢性胆囊炎、胆结石患者最大饮水量明显增加（P〈0．01），其对腹胀的总有效率为80％～85％。治疗过程中无不良反应发生。结论阿嗪米特肠溶片是治疗功能性消化不良，慢性胆囊炎、胆结石及肝硬化患者腹胀症状安全、有效的药物。     

复方阿嗪米特治疗消化不良的自身对照多中心临床研究

目的 观察复方阿嗪米特肠溶片治疗消化不良的疗效和安全性.方法 观察北京8家医院消化科门诊的180例多潘立酮(10 mg/次,3次/d)治疗2周症状积分下降<30%的消化不良患者,根据引起消化不良症状的基础疾病分成胃肠疾病相关的消化不良(A组)和胆系疾病相关的消化不良(B组),使用复方阿嗪米特肠溶片治疗(2片/次,3次/d)2周,观察治疗前、后上腹胀、上腹痛或不适、食欲不振积分变化,计算有效率,同时观察记录不良事件.结果 A、B两组患者治疗后上腹胀、上腹痛或不适、食欲不振积分及总症状积分明显下降(P<0.01),各单项症状及总症状有效率均在84.9%和92.5%以上.1例患者于复方阿嗪米特治疗14 d时出现皮疹伴有瘙痒,3 d后皮疹消退,未遗留其他不适及检验异常.结论 复方阿嗪米特肠溶片可以有效缓解多潘立酮治疗无效的消化不良患者的上腹胀、上腹痛或不适、食欲不振症状,且安全性较好.     

马来酸曲美布汀联合复方阿嗪米特治疗功能性消化不良疗效观察

目的观察马来酸曲美布汀联合复方阿嗪米特肠溶片治疗功能性消化不良的疗效。方法将确诊为功能性消化不良的患者120例分成3组,观察组（A 组）40例,给予马来酸曲美布汀、复方阿嗪米特肠溶片口服;对照组（B 组）40例,单用马来酸曲美布汀口服;对照组（C 组）40例,单用复方阿嗪米特肠溶片口服,疗程均为4周。观察患者治疗前后腹胀及上腹部不适症状的改善情况。结果3组患者治疗后腹胀及上腹部不适症状改善均有统计学意义（P ＜0．05）,观察组较对照组症状改善明显。结论马来酸曲美布汀和复方阿嗪米特肠溶片联合治疗消化不良,疗效优于单用马来酸曲美布汀和复方阿嗪米特肠溶片。     

复方阿嗪米特肠溶片对胆囊炎患者外科治疗后消化不良的影响

目的:探讨复方阿嗪米特肠溶片对胆囊炎患者外科治疗后消化不良的影响.方法:选取在浙江省江山贝林医院就诊的胆囊炎外科手术后消化不良的患者60例,随机分为研究组和对照组,每组30例.研究组口服复方阿嗪米特肠溶片,对照组服用安慰剂,150 mg/次,3次/d,连续服用4 wk.比较治疗前后两组患者消化不良症状积分、消化不良的总疗效率和两组患者的SF-NDI量表总评分.结果:两组患者治疗前消化不良积分及症状总积分情况比较,差异不具有统计学意义(P0.05),研究组患者在治疗第28天食欲不振、早饱、嗳气、腹痛或腹部不适及症状总积分明显低于对照组,差异具有统计学意义(P0.05);两组患者在治疗后1 wk,消化不良的总有效率差异不具有统计学意义(P0.05),研究组中患者于治疗后2、3、4 wk消化不良的总有效率显效高于对照组,差异具有统计学意义(P0.05);两组患者于治疗前、治疗后第7、14天的SF-NDI量表总评分差异不具有统计学意义(P0.05),研究中患者于治疗后第21天及治疗后第28天的SFN D I量表总评分低于对照组,差异具有统计学意义(P0.05).结论:复方阿嗪米特肠溶片可有效的改善胆囊炎患者外科手术后消化不良的症状,提高患者的生活质量.     

复方阿嗪米特联合盐酸伊托必利治疗老年功能性消化不良疗效及安全性观察

目的探讨复方阿嗪米特联合盐酸伊托必利治疗老年功能性消化不良的临床疗效及安全性。方法将92例老年功能性消化不良患者随机分为两组。观察组47例给予复方阿嗪米特肠溶片和盐酸伊托必利片治疗,对照组45例仅给予盐酸伊托必利片治疗。比较两组临床疗效及安全性。结果观察组治疗2周、4周后腹胀、餐后不适、食欲不振等改善程度均明显优于对照组(P0.05);观察组治疗2周、治疗4周总有效率分别为68.1%、89.4%,均明显高于对照组的46.7%、66.7%(P0.05)。治疗期间两组均未出现明显的不良反应。结论复方阿嗪米特联合盐酸伊托必利能显著改善老年功能性消化不良的症状,提高临床疗效,且安全性较高。     

复方阿嗪米特肠溶片联合四逆散加减治疗功能性消化不良的临床研究

目的探讨复方阿嗪米特肠溶片联合四逆散加减治疗功能性消化不良的疗效。方法选取我院2013年10月~2015年3月收治的功能性消化不良患者229例,将其随机分为观察组115例和对照组114例。对照组采取复方阿嗪米特肠溶片治疗,观察组在此基础上联合四逆散加减治疗。比较两组疗效和生活质量评分。结果观察组总有效率为95.65%,高于对照组的78.95%,生活质量评分较对照组高,差异均有统计学意义(P0.05)。结论复方阿嗪米特肠溶片联合四逆散加减治疗功能性消化不良的疗效显著,值得临床推广。     

中西医结合治疗功能性消化不良的临床研究

目的观察复方阿嗪米特肠溶片联合四逆散加减治疗功能性消化不良的疗效。方法将257例功能性消化不良患者随机分为治疗组129例和对照组128例。对照组给予复方阿嗪米特肠溶片治疗,治疗组在此基础上给予四逆散加减治疗,2个疗程结束后观察两组患者的疗效,随访1年。结果治疗组总有效率为94.57%显著高于对照组的77.34%,其差异有统计学意义(P0.05)。结论复方阿嗪米特肠溶片联合四逆散加减治疗功能性消化不良,可显著的改善患者的临床症状,促进患者的康复,且在停药后降低其复发率,值得临床推广应用。     

肠溶片治疗胆道结石术后消化不良影响

目的探讨复方阿嗪米特肠溶片对治疗胆道结石术后消化不良的影响.方法取2013-10/2016-12苍南县人民医院普外科收治胆道术后消化不良患者90例,电脑抽取随机数字法分为对照组(n=45)和观察组(n=45).对照组采用复方消化酶胶囊治疗,观察组采用复方阿嗪米特肠溶片治疗,比较2组临床疗效及安全性.结果观察组治疗后食欲不振时间(1.28 d±0.21 d)、腹胀消失时间(2.04 d±0.35 d)、嗳气消失时间(1.98 d±0.38 d)及腹痛等症状消失时间(2.13 d±0.41 d),均短于对照组(P0.05);观察组不良反应发生率为13.33%,对照组为20.00%,2组治疗2 wk药物不良反应发生率比较,差异有统计学意义(P0.05).结论胆道结石术后消化不良患者采用复方阿嗪米特肠溶片治疗效果理想,安全性高,值得推广应用.     

调中颗粒联合复方阿嗪米特对糖尿病胃轻瘫疗效观察

[目的]观察调中颗粒联合复方阿嗪米特治疗糖尿病胃轻瘫的临床效果.[方法]选择糖尿病胃轻瘫患者60例,随机分为治疗组30例,对照组30例;治疗组予调中颗粒联合复方阿嗪米特治疗,对照组单用复方阿嗪米特治疗,2组疗程均为4周.[结果]治疗组、对照组临床疗效总有效率分别为86.7％、60.o％,组间临床疗效比较及症状积分,差异有统计学意义(P＜0.05).[结论]调中颗粒联合复方阿嗪米特能显著缓解糖尿病胃轻瘫患者的消化道临床症状,改善胃排空.     

舒肝解郁胶囊联合马来酸曲美布丁胶囊、复方阿嗪米特肠溶片治疗功能性消化不良疗效观察

目的 观察舒肝解郁胶囊联合马来酸曲美布丁、复方阿嗪米特肠溶片治疗功能性消化不良的疗效及安全性.方法 将确诊为功能性消化不良的120例患者随机分为2组,每组60例.治疗组给予口服舒肝解郁胶囊2粒,bid,马来酸曲美布丁胶囊100 mg,tid,复方阿嗪米特肠溶片100 mg,tid;对照组给予口服马来酸曲美布丁胶囊100...     

The efficacy of Combizym in the treatment of Chinese patients with dyspepsia: a multicenter,randomized, placebo‐controlled and cross‐over study

OBJECTIVE: To evaluate the efficacy and safety of Combizym treatment in Chinese patients with dyspepsia. METHODS: In this multicenter, randomized, placebo‐controlled cross‐over study, a total of 151 patients (76 men and 75 women, mean age: 44.67 ± 6.46 years, range: 22–67 years) with dyspepsia whose symptoms were not relieved by placebos were recruited. They were randomly divided into group A (79 patients, 2 weeks of Combizym treatment, two tablets post‐meal, t.i.d.; then 1 week of wash‐out, followed by 2 weeks of placebo treatment, two tablets post‐meal, t.i.d.) or group B (72 patients, 2 weeks of placebo treatment, two tablets post‐meal, t.i.d. then one week of wash‐out, followed by 2 weeks of Combizym treatment, 2 tablets post‐meal, t.i.d.). The index of severity of the dyspepsia symptoms was evaluated before and after each treatment phase with Combizym or the placebo. RESULTS: Compared with the placebo, 2 weeks of Combizym treatment decreased the severity index of dyspepsia symptoms significantly (27.64 ± 1.77 to 9.72 ± 1.33 vs 23.99 ± 1.28 to 22.03 ± 1.40, P < 0.01). The efficacy rates of Combizym and the placebo on dyspepsia were 89.63% and 21.68%, respectively (P < 0.01). According to the improvement of symptoms index, individual dyspepsia symptoms that could be attenuated by Combizym therapy were anepithymia, abdominal distension, belching, diarrhea, abdominal pain, epigastric burning. None of patients reported adverse events during the study. CONCLUSION: Combizym treatment effectively ameliorates dyspepsia symptoms in Chinese patients, with satisfactory safety and compliance.     

复方阿嗪米特联合莫沙必利对老年胃肠疾病相关性消化不良的疗效探讨

[目的]探讨复方阿嗪米特联合莫沙必利治疗老年胃肠疾病相关性消化不良的效果以及安全性。[方法]采用临床随机对照试验,将128例门诊就医的老年胃肠疾病相关性消化不良患者纳入本研究并分为复方阿嗪米特联合莫沙必利组(治疗组,66例),莫沙必利组(对照组,62例),2组疗程均为4周,观察2组治疗前后消化不良症状的改善以及药物副作用的情况。[结果]2组药物对改善消化不良症状均有疗效,治疗组疗效优于对照组(P0.01),2组均未观察到严重的药物相关性不良反应。[结论]复方阿嗪米特联合莫沙必利治疗老年胃肠疾病相关性消化不良疗效明显,安全性好,可在临床上推广使用。     

Does Helicobacter pylori infection increase gastric sensitivity in functional dyspepsia?

The role of Helicobacter pylori infection in the pathogenesis of functional dyspepsia is debated. It is known that a substantial fraction of dyspeptic patients manifest a low discomfort threshold to gastric distension. This study investigated the symptomatic pattern in 27 H pylori positive and 23 H pylori negative patients with chronic functional dyspepsia, and potential relations between infection and gastric hyperalgesia. Specific symptoms (pain, nausea, vomiting, bloating/fullness, early satiety) were scored from 0 to 3 for severity and frequency (global symptom scores: 0-15). The mechanical and perceptive responses to gastric accommodation were evaluated with an electronic barostat that produced graded isobaric distensions from 0 to 20 mm Hg in 2 mm Hg steps up to 600 ml. Gastric compliance (volume/pressure relation) and perception (rating scale: 0-10) were quantified. Standard gastrointestinal manometry and recorded phasic pressure activity at eight separate sites during fasting and postprandially were also assessed. H pylori positive and H pylori negative patients manifested similar severity and frequency of specific symptoms and global symptom scores (mean (SEM)) (severity: 9.5 (2.0) v 9.0 (2.1); frequency: 10.8 (2.0) v 9.7 (2.2)). No differences were seen either in gastric compliance (53 (4) ml/mm Hg v 43 (3) ml/mm Hg) or in gastric perception of distension (slope: 0.50 (0.05) v 0.53 (0.06)). Postprandial antral motility was significantly decreased in H pylori positive patients (two hours motility index: 10.4 (0.6) v 12.6 (0.5); p < 0.05). It is concluded that H pylori infected patients with functional dyspepsia present no distinctive symptoms by comparison with H pylori negative counterparts and H pylori infection is associated with diminished postprandial antral motility but it does not increase perception of gastric distension.     

Ranitidine bismuth citrate or omeprazole-based triple therapy for Helicobacter pylori eradication in Helicobacter pylori- infected non-ulcer dyspepsia

AIM: To test the eradication rate of Helicobacter pylori by ranitidine bismuth citrate-based triple therapy, and evaluate the symptomatic response of Helicobacter pylori eradication therapy for non-ulcer dyspepsia. METHODS: A total of 59 consecutive Helicobacter pylori infected non-ulcer dyspepsia patients were randomly selected to receive either one of two triple therapy regimens, including metronidazole, amoxycillin plus ranitidine bismuth citrate (RAM group) or omeprazole (OAM group). To determine the success of eradication, patients underwent the 13C-urea breath test, 6 weeks and one year after treatment. The dyspeptic symptom scores were also assessed at the time of enrolment, 6 weeks and one year after treatment. RESULTS: Per-protocol and intention-to-treat eradication rates were 77.7% and 70% in RAM group and 83.8% and 68.9% in OAM group (p = non significant). At both the 6th week and at the first year after treatment, the mean symptom scores were lower than pre-treatment scores in the study population, regardless of whether treatment was successful or not. However, patients, whether eradicated successfully or not-eradicated, presented similar 6-week and 1-year scores. CONCLUSIONS: One-week RAM triple therapy, which is cheaper than the OAM regimen, is a relatively effective alternative regimen for Helicobacter pylori eradication in Taiwanese. Triple therapy for Helicobacter pylori eradication was not the whole management for the relief of dyspeptic symptoms of non-ulcer dyspepsia patients.     

Role of duodenal lipid and cholecystokinin A receptors in the pathophysiology of functional dyspepsia

BACKGROUND/AIMS: We aimed to evaluate the role of fat and cholecystokinin (CCK) in the pathophysiology of functional dyspepsia (FD) by investigating symptoms and plasma CCK levels following increasing doses of duodenal lipid during gastric distension, and the effect of CCK-A receptor blockade. SUBJECTS/METHODS: In study A, six FD patients were studied on three occasions during duodenal infusion of saline or lipid (1.1 (L-1) or 2 kcal/min (L-2)) and proximal gastric distensions. Six healthy subjects were also studied as controls during L-2 only. In study B, the effect of the CCK-A antagonist dexloxiglumide (5 mg/kg/h) on L-2 induced symptoms was studied in 12 FD patients. Changes in gastric volume at minimal distending pressure and plasma CCK (study A) were assessed, gastric distensions were performed using a barostat, and dyspeptic symptoms were monitored. RESULTS: Lipid increased gastric volume compared with saline (DeltaV (ml): saline 15 (20), L-1 122 (42), L-2 114 (28)) in patients and even more so in controls (221 (37); p<0.05). During distensions, symptoms were greater during L-2 than during saline or L-1, and greater in patients than in controls, while gastric compliance was smaller in patients than in controls (p<0.05). Lipid increased plasma CCK levels in patients and controls (p>0.05). Dexloxiglumide abolished the increase in gastric volume (DeltaV (ml): dexloxiglumide 17 (9), placebo 186 (49)) and dyspeptic symptoms (sum of scores: dexloxiglumide 24 (7), placebo 44 (19)) during duodenal lipid infusion. Dexloxiglumide also reduced gastric compliance (ml/mm Hg: dexloxiglumide 51 (7), placebo 72 (11)) and symptoms (sum of scores: dexloxiglumide 101 (17), placebo 154 (21)) during gastric distension. CONCLUSION: CCK-A receptors are involved in the generation of dyspeptic symptoms by duodenal lipid during gastric distension.     

复方阿嗪米特肠溶片联合多潘立酮治疗功能性消化不良的随机、双盲、安慰剂对照临床研究

目的 评估复方阿嗪米特肠溶片与促动力剂联合使用对功能性消化不良(FD)患者症状和生活质量的影响.方法 随机、双盲、安慰剂对照临床试验.卫生部北京医院门诊就诊的208例符合罗马Ⅲ诊断标准的FD患者,随机分为复方阿嗪米特肠溶片+多潘立酮组(A组,102例)和安慰剂+多潘立酮组(B组,106例)进行治疗.复方阿嗪米特肠溶片2片/次,3次/d;多潘立酮10 mg/次,3次/d,疗程均为4周.测定治疗前后改良消化不良严重程度评估(mSODA)分数的改变值,并计算有效率.结果 mSODA各项评分:(1)腹胀痛严重度评分,A组治疗前后改变值为-12.35±5.48,B组为-10.52±4.65(P=0.009);(2)非腹胀痛症状评分改变值,A组为-5.75±3.31,B组为-4.86±2.65(P=0.033);(3)生活满意度评分改变值,A组为7.09±3.78,B组为5.62±3.54(P=0.004).A组的治疗总有效率为89.2%,B组为76.4%,A组显著高于B组(P=0.015).两组均无严重不良事件发生.结论 复方阿嗪米特肠溶片与促动力剂联合使用较单用促动力剂可更有效缓解FD患者各种消化不良症状,并显著改善生活质量.

Abstract：

Objective To study the efficacy and safety of combined therapy of compound azintamide and domperidone in functional dyspepsia. Methods A randomised, double-blind, placebo-controlled trial.Two hundred and eight patients with functional dyspepsia were randomly grouped into group A (experimental group, 102 cases) and group B (control group, 106 cases). The patients in the group A were given 2 tablets of compound azintamide 3 times a day in addition to domperidone 10 mg 3 times per day for four weeks. The patients in the group B were only given domperidone 10 mg 3 times per day for 4 weeks. The therapeutic efficacy was evaluated by modified Severity of Dyspepsia Assessment (mSODA) and Global Patient Assessment (GPA). Results Subscore in mSODA:the change of bloating/pain intensity score in group A is -12.35±5.48 while group B is -10.52±4.65(P=0.009), the change of non-bloating/pain symptoms score in group A is -5.75±3.31 while group B is - 4. 86 ± 2.65 (P=0.033), and the change of satisfaction score in group A is 7. 09 ± 3. 78 while group B is 5.62 ± 3. 54 (P = 0. 004). The response rate in group A is 89. 2% which is significantly higher than 76.4% in group B (P=0. 015). Other symptoms for response assessment included loss of appetite, early satiety, fullness after meal, diarrhea. No severe side-effect was found in both groups. Conclusions Combined therapy of compound azintamide and domperidone may lead to bigger improvement in overall efficacy and health related quality of life in patients with functional dyspepsia than use of motility medicine alone. Potential mechanisms that may account for the efficacy of compound azintamide in functional dyspepsia include modulation of visceral sensitivity and/or gastrointestinal motility.     

Gallbladder contractility and volume characteristics in gallstone dyspepsia

AIM:It is difficult to differentiate gallstone dyspepsia and functional dyspepsia by clinical symptoms and signs. We hypothesized that gallstone dyspepsia was related to abnormal gallbladder motility. We aimed to differentiate gallstone dyspepsia from functional dyspepsia by measuring gallbladder motility.METHODS: We measured gallbladder volume changes in response to gastric distension (saline 500mL) and fatty meal in 10normal volunteers (controls) and 62 patients with gallstones and dyspepsia before cholecystectomy. Forty cholecystectomized patients were symptom free or had improvement (group I), while the remaining 22 patients had persistent dyspepsia (group Ⅱ). Gallbladder volume change and ejection fraction were analyzed and compared among the three groups.RESULTS:In group I, there were significant decreases in gallbladder volumes 5-25 rain after gastric distension,compared to fasting volumes. Compared to normal volunteers and group Ⅱ, group I had significantly decreased gallbladder volumes 10-20min after drinking 500mL of normal saline and 10 to 50min after eating fatty meal.CONCLUSION:Our results support the hypothesis that increased gallbladder contraction after gastric distension or fatty meal may be related to dyspeptic symptoms in uncomplicated gallstone disease. These findings may be useful in differentiating functional dyspepsia from gallstone dyspepsia, patients with the latter disease may benefit from laparoscopic cholecystectomy.