枳实消痞丸方及其拆方对大鼠胃排空及血浆胃动素的影响

目的：研究枳实消痞丸及其拆方和不同剂型对大鼠胃排空及血浆胃动素（MOT）水平的影响。方法：大鼠分为标准组、正常对照组、西沙必利组、枳实消痞丸方饮片组（全方）、消法组、补法组、和法组、全方合煎冲剂组、全方分煎冲剂，共九组，分别用生理盐水及各组药物灌胃4周后利用蛋白胨法测定胃排空；另分5组，放免法测定血浆胃动素水平。结果：除和法组外，各用药组的胃排空率均显快于正常对照组（P＜0．001，0．05），而补法组和分煎冲剂组胃排空率又较全方组及西沙必利组为慢（P＜0．05），其余各组两两间无显差异。枳实消痞丸方具有促进MOT释放的作用，拆方研究表明方可消法组的药物起主要作用（P＜0．05）。结论：枳实消痞丸方能显促进大鼠胃排空及损害其血浆胃动素水平，拆方研究表明其中的消法组药物（枳实、厚朴、麦芽）可能起主要作用。未能发现冲剂和水煎剂之间的作用差别。但分煎冲剂作用较弱。     

枳实消痞丸方及其拆方对大鼠胃排空及血浆胃动素的影响

目的 :研究枳实消痞丸及其拆方和不同剂型对大鼠胃排空及血浆胃动素 (MOT)水平的影响。方法 :大鼠分为标准组 ,正常对照组 ,西沙必利组 ,枳实消痞丸方饮片组 (全方 ) ,消法组 ,补法组、和法组 ,全方合煎冲剂组 ,全方分煎冲剂组 ,共 9组 ,分别用 0 .9% Na Cl溶液及各组药物灌胃 4周后利用蛋白胨法测定胃排空 ;另分 5组 ,放免法测定血浆 MOT水平。结果 :除和法组外 ,各用药组的胃排空率均显著快于正常对照组 (P<0 .0 1,<0 .0 5 ) ,而补法组和分煎冲剂组胃排空率又较全方组及西沙必利组为慢 (P<0 .0 5 ) ,其余各组两两间差异无显著性意义。枳实消痞丸方具有促进 MOT释放的作用 ,拆方研究表明方中消法组的药物起主要作用 (P<0 .0 5 )。结论 :枳实消痞丸方能显著促进大鼠胃排空及提高其血浆 MOT水平 ,拆方研究表明其中的消法组药物 (枳实、厚朴、麦芽 )可能起主要作用。未发现冲剂和水煎剂之间的作用差别 ,但分煎冲剂作用较弱。     

枳实消痞丸联合枸橼酸西沙必利治疗慢传输型便秘的疗效观察

[目的]探讨枳实消痞丸联合枸橼酸西沙必利治疗慢传输型便秘的作用。[方法]将138例患者随机分为2组,均予枸橼酸西沙比利治疗基础上,对照组加服四磨汤口服液,治疗组加服枳实消痞丸。对2组患者治疗2周、4周及治疗结束后2周的治愈率、总有效率、无效率,治疗前后便秘主要症状积分进行比较。[结果]治疗组治疗2周、4周及治疗结束后2周的总有效率分别为91．66％、95．83％及86．11％,对照组分别为81．58％、81．58％及65．79％;2组比较差异有统计学意义（P〈0．01）;2组治疗前、后便秘主要症状积分比较差异均有统计学意义（P〈0．05）,2组间治疗后积分比较差异有统计学意义（P〈0．01）。[结论]枳实消痞丸联合枸橼酸西沙必利治疗慢传输型便秘效果好,复发率低,优势明显。     

疏肝健脾法对功能性消化不良血浆胃动素和生长抑素的影响

[目的]观察中医疏肝健脾法治疗肝郁脾虚型功能性消化不良（FD）的临床疗效及对血浆胃动素（MOT）和生长抑素（SS）水平的影响。[方法]选择确诊为FD患者120例，按2：1比例随机分为2组，治疗组（疏肝健脾方治疗）80例，对照组（莫沙必利治疗）40例，并设正常组40例。采用放射免疫法测定2组患者治疗前、后空腹血浆MOT和SS水平，并与正常组测得值对比。[结果]治疗组临床症状总有效率为92．5％，对照组为90．0％，差异无统计学意义，但前者显效率为85．0%，明显高于对照组的60．0%（P〈0．05）。治疗组MOT及SS治疗前后比较差异均有统计学意义（均P〈0．01）。[结论]中医疏肝健脾法治疗FD患者疗效显著，能升高血浆MOT及降低SS水平，推动胃肠蠕动，促进胃肠道排空，达到改善患者临床症状的目的。     

枳实消痞丸加减治疗胃实痞证的临床观察

[目的]观察枳实消痞丸治疗胃实痞证的临床疗效.[方法]以枳实消痞丸为基本方,临床辨证论治,随证化裁,治疗胃痞实患者77例,并通过治疗前、后症状评分变化进行比较分析,评价枳实消痞丸的临床疗效.[结果]临床治愈24例,显效20例,有效17例,无效16例,总有效率为79.22％.[结论]枳实消痞丸能够有效改善胃实痞患者的主要临床症状,且治疗效果满意.     

平胃消导胶囊对功能性消化不良模型大鼠胃电活动和胃肠激素的影响

[目的]观察平胃消导胶囊对情志刺激引起的功能性消化不良（FD）模型大鼠胃电活动和胃肠激素水平的影响,探讨其可能的作用机制。[方法]将实验大鼠随机分为6组：空白对照组,模型组,多潘立酮药物对照组,平胃消导胶囊大、中、小剂量组。除空白对照组外,其余各组用夹尾激怒法复制FD大鼠模型,观察和对比各组大鼠胃窦消化间期综合肌电（IMC）活动,检测血浆胃动素（MOT）和血管活性肠肽（VIP）水平,并以此评价药物疗效。[结果]与模型组相比,平胃消导胶囊治疗组IMC周期缩短（P〈0．05,〈0．01）、Ⅲ相时程延长（P〈0．01）、Ⅲ相发生率增高（P〈0．05,〈0．01）,血浆MOT水平升高（P〈0．05,〈0．01）,VIP水平降低（P〈0．01）。[结论]平胃消导胶囊可增强FD模型大鼠胃电活动,恢复性调节MOT、VIP）水平,表现出良好的整体调节和促进胃排空作用。加大剂量治疗效果更好,是治疗FD疗效确切的中药制剂。     

胃胀舒合剂对功能性消化不良大鼠胃排空及血浆胃肠激素水平的影响

[目的]观察胃胀舒合剂对功能性消化不良（FD）大鼠胃排空和胃肠激素的影响，探讨其可能的作用机制。[方法]采用不规则进食加稀盐酸喂养以及劳倦过度的复合因素制作大鼠FD模型。随机分成胃胀舒合剂高、低剂量（高、低剂量）组、多潘立酮组、正常对照（正常）组、模型对照（模型）组共5组，连续给药14d后，放免法检测血浆胃动素（MOT）和生长抑素（SS）水平，以酚红法观察胃排空。[结果]与正常组相比，模型组胃排空和血浆MOT水平显著降低，SS显著升高（均P〈0．05），与模型组相比，高、低剂量及多潘立酮组胃排空和血浆MOT显著升高，SS显著降低（均P〈0．05）。[结论]胃胀舒合剂具有促进内源性MOT及抑制SS释放和促进胃排空作用，是其治疗FD机制之一。     

小陷胸汤治疗功能性消化不良的实验研究

[目的]探讨小陷胸汤对功能性消化不良（FD）模型大鼠的作用机制。[方法]采用不规则喂养配合夹尾刺激法建立FD大鼠模型，予以小陷胸汤水煎液灌胃治疗。观测大鼠胃固体排空率，检测胃组织内一氧化氮（NO）及血浆胃动素（MOT）水平，并与空白对照组、模型对照组和多潘力酮组进行比较。[结果]小陷胸汤能明显升高胃排空率（P〈0．05），与多潘力酮等效（P〉0．05）；能显著降低胃组织NO水平，且优于多潘力酮（P〈0．01）；能明显升高血浆MOT水平（P〈0．05），与多潘力酮等效（P〉0．05）。[结论]小陷胸汤能提高FD大鼠胃固体排空率；减轻NO对胃排空的抑制；增强MOT水平，促进胃排空。在降低胃组织NO方面明显优于多潘力酮。     

枳实消痞方联合雷火灸治疗功能性消化不良寒热错杂证152例

[目的]观察枳实消痞方联合雷火灸法治疗功能性消化不良寒热错杂证的疗效。[方法]将2008年12月~2013年12月在本院脾胃病门诊就诊的152例患者按就诊序号随机分为2组,治疗组76例给予枳实消痞方联合雷火灸法治疗,对照组76例给予奥美拉唑联合多潘立酮片治疗,疗程均为4周。[结果]治疗组临床总有效率及治疗前后症状积分改善情况均优于对照组（P〈0.05）;2组治疗后随访1年,治疗组复发率明显低于对照组（P〈0.01）。[结论]枳实消痞方联合雷火灸法治疗功能性消化不良寒热错杂证临床疗效显著,且复发率低。     

健脾消痞汤治疗功能性消化不良的胃动力学超声改变及其机制探讨

[目的]观察中药治疗对功能性消化不良(FD)患者的胃动力学变化,并探讨其作用机制。[方法]将40例FD患者用健脾消痞汤加减治疗1个疗程,观察对比治疗前后的胃动力学改变以及胃动素(MOT)、生长抑素(SS)的分泌情况。[结果]治疗后总有效率达97.5%;超声胃动力学指标:胃窦收缩幅度(△V)为(518.45±160.40)mm2、胃窦收缩频率(F)为(2.80±0.70)次/min、胃窦运动指数(MI)为(1 450.66±538.75)、胃窦半排空时间(T1/2)为(29.93±0.14)min、胃窦排空时间(T)为(46.35±13.82)min。△V较治疗前提高(P0.05),F较治疗前增加(P0.05)、MI较治疗前显著改善(P0.01),T1/2、T均较治疗前明显缩短(P0.01);患者空腹MOT较治疗前明显增高(P0.01)、SS较治疗前明显减低(P0.01)。[结论]健脾消痞汤治疗FD疗效满意,能够改善胃的排空功能,其作用机制可能是通过神经-体液调节各种胃肠激素的分泌所致。     

柴枳朴槟汤原方及拆方对大鼠血浆胃动素水平的影响

[目的]观察柴枳朴槟汤原方及拆方对大鼠血浆胃动素(MOT)水平的影响。[方法]取大鼠随机分成对照组、理气A组、理气B组、活血A组、活血B组、理气活血A组、理气活血B组、甘草组8组,灌胃14 d后进行血浆MOT水平的检测。[结果]理气活血B组(柴枳朴槟汤原方)、理气A组、活血A组MOT水平明显增高,与对照组比较差异均有统计学意义(P<0.05,<0.01);甘草组MOT水平降低,与对照组比较差异有统计学意义(P<0.05);理气B组、活血B组、理气活血A组与对照组比较差异均无统计学意义。[结论]柴枳朴槟汤原方及拆方对大鼠血浆MOT水平的影响各不同,推测可能方中理气药、活血药能升高大鼠血浆MOT水平,而甘草抑制其水平。3组药物配伍后能协同作用。     

替勃龙与西沙必利对绝经期功能性消化不良患者胃肠动力的影响

目的　比较替勃龙和西沙必利对绝经期功能性消化不良 (MPFD)患者胃肠动力的影响。方法　 5 3例MPFD和 31例伴胆汁反流的MPFD患者随机分为 3组 ,分别给予替勃龙、西沙必利及替勃龙 +西沙必利治疗 4周。观察胃排空、血浆胃动素和胃内胆汁变化。结果　 3组治疗后胃 30min排空率均增加 (P <0 0 5 ) ,组间差异无显著性。 3组空腹血浆胃动素治疗前后及组间差异无显著性 ;替勃龙和西沙必利均减少胆汁反流 ,两者联合无增强。结论　替勃龙和西沙必利均能改善MPFD患者胃排空 ,减少胆汁反流     

布拉氏酵母菌联合三联疗法对中老年幽门螺杆菌阳性消化性溃疡患者胃泌素和血浆胃动素的影响

[目的]探讨布拉氏酵母菌联合三联疗法对中老年幽门螺杆菌阳性消化性溃疡患者胃泌素和血浆胃动素的影响.[方法]选择我院2013年1月～2014年3月收治的120例幽门螺杆菌阳性消化性溃疡的中老年患者,随机分为观察组和对照组,观察组采用布拉氏酵母菌联合三联疗法,对照组仅采用常用的三联疗法,对比分析2组患者的血清胃泌素和胃动素的水平.[结果]治疗后与对照组相比,观察组的有效率显著升高,差异有统计学意义（x2—11.791,P=0.000）;治疗前,观察组和对照组的胃泌素和胃动素水平差异无统计学意义;治疗后,2组的胃泌素水平在治疗1d、5d、10 d后均有显著下降（P＜0.01）,其中与对照组相比,观察组治疗1d、5d、10 d后均有显著下降,差异有统计学意义（t=10.461、10.312、9.874,P=0.001、0.000、0.001）;观察组和对照组的胃动素水平在治疗1d、5d、10 d后均有显著升高（P＜0.01）,其中与对照组相比,观察组也有显著上升,差异有统计学意义（t=12.554、16.361、18.754,P=0.000、0.000、0.001）.[结论]布拉氏酵母菌联合三联疗法对恢复中老年幽门螺杆菌阳性消化性溃疡患者的胃泌素和血浆胃动素的水平有更好的疗效.     

Effect of Mental Stress and Cisapride on Autonomic Nerve Functions in Functional Dyspepsia

Background: Disordered autonomic nerve function is frequently present in patients with functional dyspepsia (FD). In this study we investigated whether the prokinetic cisapride, which acts via acetylcholine receptors, and stress may modulate these abnormalities. Methods: Nineteen patients (6 men, 13 women) with FD and 10 healthy subjects (3 men, 7 women) were studied after 3 days' treatment with 10 mg cisapride three times daily and placebo in a crossover design. Mental stress was induced with a videogame. Sympathetic and vagal nerve functions were assessed noninvasively by skin conductance and respiratory sinus arrythmia, respectively. Results: Vagal tone was significantly lower in FD patients than in controls both before and after mental stress (P &lt; 0.001). Sympathetic tone was higher in patients with FD than in controls (P &lt; 0.03). Generally, stress scores were increased by mental stress in both groups (P &lt; 0.001). In FD patients, but not in controls, cisapride significantly increased the sympathetic tone both before (P &lt; 0.05) and after stress (P &lt; 0.05). Conclusions: Patients with FD have lower vagal tone and higher sympathetic tone than healthy controls. Treatment with cisapride increased sympathetic tone in the patient group but had no effect on vagal tone.     

Effect of Cisapride on Gastric Emptying of Indigestible Solids and Plasma Motilin Concentration in Diabetic Autonomic Neuropathy

To investigate the role of motilin in diabetic gastroparesis, we evaluated gastric emptying and plasma concentrations of motilin in diabetic patients. Gastric emptying of radiopaque marker was significantly delayed in the diabetics with autonomic neuropathy (n = 14) compared with the healthy controls (n = 6) ( p < 0.01). Mean plasma motilin concentrations were significantly higher in the diabetics with autonomic neuropathy compared with the healthy controls ( p < 0.01). A positive correlation was observed between gastric emptying and plasma motilin concentrations in the healthy controls ( r = 0.955, p < 0.01), whereas these values were inversely correlated in the diabetics ( r = -0.620, p < 0.01). Oral administration of cisapride (15 mg/day 14 day) significantly accelerated gastric emptying without an effect on plasma motilin concentration ( p = 0.03). These observations suggest that gastric emptying in the diabetics with autonomic neuropathy is delayed despite elevated levels of motilin, and that cisapride accelerates gastric emptying, independent of the plasma motilin concentration.     

益气活血方对慢性萎缩性胃炎患者血浆胃动素及促胃液素的影响

[目的]探讨益气活血方对慢性萎缩性胃炎(CAG)患者血浆促胃液素(GAS)、胃动素(MOT)的影响.[方法]将200例CAG患者随机分为治疗组120例及对照组80例.治疗组服用益气活血方,对照组采用猴头菌提取物(谓葆),对幽门螺杆菌阳性者加用西药三联综合疗法治疗,疗程均为3个月.治疗前后,应用放射免疫法批量检测2组病例的血浆GAS、MOT水平,进行自身前后对照与组间对照统计学分析.[结果]2组患者治疗后血浆GAS、MOT平均水平较治疗前明显升高(P＜0.05或＜0.01),且治疗组水平明显高于对照组(P＜0.05).[结论]益气活血方具有提高CAG患者血浆GAS、MOT水平,促进其胃肠功能的作用.     

Treatment of functional dyspepsia with serotonin agonists: a meta-analysis of randomized controlled trials

BACKGROUND: Functional dyspepsia (FD) is often treated with serotonin agonists; however, the efficacy of such agents has recently been questioned. The aim of this study was to perform a meta-analysis of randomized controlled trials (RCTs) comparing serotonin agonists with other types of prokinetics in patients with FD. METHODS: Included studies were RCTs that compared serotonin agonists, including cisapride and mosapride, with dopamine antagonists, including metoclopramide and domperidone, and an opiate agonist, trimebutine, in patients with FD. Studies were identified by searching the Medline database (January 1951 - January 2005) and Cochrane Library (Issue 4, 2004), and by manual searches. The difference in the probability of patients' responses between the serotonin agonists and control agents was used as a summary statistic for the treatment effect. Meta-regression analysis was used to detect sources of heterogeneity. RESULTS: Five studies were identified. In total, 467 subjects were assigned to a serotonin agonist arm, and 322 subjects were assigned to a control arm. In the overall analysis, the summary statistic was 0.019 (95% confidence interval [CI]: -0.055 to 0.093; P = 0.612), indicating that the patients' responses to serotonin agonists were similar to those to control agents. However, in the stratified meta-analysis of cisapride and mosapride, mosapride had a 6.7% greater probability of producing a response compared with control agents (summary statistic: 0.067; 95% CI: 0.010-0.124; P = 0.021), whereas no significant effect was observed with cisapride. CONCLUSION: The data suggest that mosapride may be more effective than cisapride for the treatment of FD. Although FD is a chronic condition, efficacy was assessed over short periods in the studies used for the present meta-analysis. Long-term RCTs are needed to confirm the effect.