Prophylaxis against prostaglandin-induced gastrointestinal side effects

Prostaglandin F2 alpha was administered intravenous drip in 130 patients with missed, incomplete inevitable and septic abortion, intrauterine death and vesicular mole and for therapeutic termination of midtrimester pregnancies. In 84 patients (control group), no prophylactic antiemetic or antidiarrheal drugs were administered, while in 46 patients (study group), an antiemetic (prochlorperazine) and an antidiarrheal (diphenoxylate hydrochloride with atropine sulfate) drug were administered prophylactically before and during prostaglandin infusion. The incidence in vomiting and diarrhea was statistically much less in the study group (P less than 0.0005 for vomiting and P less than 0.005 for diarrhea). There was no statistically significant difference in the success rate of prostaglandin induction in the two groups.     

思连康与思密达联用治疗小儿腹泻50例疗效评价

目的探讨思连康与思密达联用治疗小儿腹泻的临床疗效。方法 100例小儿腹泻患儿,分成观察组和对照组。对照组给予调整饮食、口服或静脉补液等常规治疗;观察组在对照组用药方式的基础上,加用思连康及思密达治疗。结果观察组总有效率98.00%高于对照组84.00%,差异有统计学意义(P<0.05)。两组腹泻患儿均未见明显不良反应。结论思密达联合思连康治疗小儿腹泻疗效可靠,副作用小。     

中医护理联合止泻方、穴位贴敷干预小儿腹泻随机平行对照研究

[目的]观察中医护理联合止泻方、穴位贴敷干预小儿腹泻疗效。[方法]使用随机平行对照方法,将88例住院患者按抽签法简单随机分为两组。遵医嘱用药止泻方(苍术、冬瓜子各3g,佛手、生麦芽各4g,荷叶、砂仁各5g,山药炒10g),1剂/d,水煎300mL,3次/d;穴位贴敷(白胡椒3g,吴茱萸、丁香各5g,苍术20g),研粉,清水调糊,纳入脐中,敷贴固定,5h/次,1次/d。对照组44例常规护理。治疗组44例中医综合护理:心理护理、皮肤护理、用药护理、针灸、艾灸、按摩。连续治疗5d为1疗程。观测临床症状、便常规、不良反应。连续治疗3疗程,判定疗效。[结果]治疗组痊愈28例,显效9例,有效6例,无效1例,总有效率97.73%。对照组痊愈16例,显效8例,有效12例,无效8例,总有效率81.82%。治疗组疗效优于对照组(P0.05)。[结论]中医护理联合止泻方、穴位贴敷干预小儿腹泻效果显著,值得推广。     

双八面体蒙脱石干混悬剂止泻作用研究

双八面体蒙脱石干混悬剂 ( Dioctahedral Sm ectite for Suspension,DSS) ( 8,4 g/ kg,po) ,对大黄液所致小鼠腹泻有显著止泻作用 ( P<0 .0 1) ;可显著延缓脾虚小鼠的黑粪排出时间 ( P<0 .0 1) ;可显著抑制由新斯的明产生的小鼠小肠推进机能亢进作用 ( P<0 .0 1) ;可显著抑制脾虚小鼠小肠推进功能 ( P<0 .0 1,P<0 .0 5) ;对正常小鼠小肠推进功能无明显影响。DSS( 4 ,2 g/ kg)对连续 po番泻叶液一个月的慢性腹泻大鼠有显著止泻作用 ( P<0 .0 1,P<0 .0 5)     

葛根不同炮制品止泻作用研究

目的:研究并比较葛根生品、麸煨葛根及清炒葛根的止泻作用,为葛根炮制品的临床用药提供客观实验依据。方法:采用胃排空及小肠推进率实验结合腹泻指数的测定,研究葛根生品、麸煨葛根及清炒葛根的止泻作用。结果:与空白组比较,葛根生品、麸煨葛根及清炒葛根在胃排空试验、小肠推进率及腹泻指数测定试验中均具有极显著性差异(P<0.01),各样品随给药剂量的增加,胃内残留率呈增强趋势、小肠推进率呈减弱趋势、腹泻指数呈降低趋势;而样品同剂量之间比较,胃内残留率由高到低为:麸煨葛根>清炒葛根>葛根生品,小肠推进率由高到低为:葛根生品>清炒葛根>麸煨葛根;腹泻指数由低到高:麸煨葛根>清炒葛根>葛根生品。结论:麸煨葛根止泻作用最强,结果为麦麸煨制葛根的临床应用提供试验依据。     

不同因素对大黄泻下与止泻双向调节效应的影响

目的：观察不同条件对大黄泻下和止泻双向调节效应的影响。方法：采用正常ICR小鼠、复方地芬诺酯复制便秘小鼠模型和腹泻小鼠模型,造模2 h后各给药组分别以不同剂量的生大黄细粉、不同炮制品（生大黄、熟大黄和大黄炭）和不同时间煎煮而成的生大黄粗粉灌胃给药1次,而正常和模型组则给予等体积的生理盐水,观察各组小鼠给药后6 h内的排便总数、排便指数和腹泻指数。结果：1）不同给药剂量：0.2 g/kg生大黄和0.67～3 g/kg大黄炭对腹泻小鼠有止泻作用,0.8 g/kg生大黄和5 g/kg大黄炭能明显加重腹泻。2）不同炮制品：当生大黄剂量大于等于0.72 g/kg时能使正常小鼠泻下,大于等于1.8 g/kg时使便秘小鼠通便,0.8 g/kg时加重腹泻小鼠腹泻;0.67～3 g/kg大黄炭和3 g/kg熟大黄对腹泻小鼠均有止泻作用。3）不同煎煮时间：1.5 g/kg生大黄粗粉在2～10 min内对正常和便秘小鼠的泻下作用随煎煮时间延长而逐渐升高,在10～180 min内随煎煮时间延长泻下作用强度逐渐减弱,其中,煎煮10 min时泻下作用最强,180 min时最弱。结论：机体的状态和药物的不同剂量、炮制方法和煎煮时间均可影响大黄的泻下与止泻的双向调节效应。     

Medical management of motility disorders in patients with intestinal failure: a focus on necrotizing enterocolitis, gastroschisis, and intestinal atresia

Background

Intestinal failure (IF) is the dependence upon parenteral nutrition to maintain minimal energy requirements for growth and development. It may occur secondary to a loss of bowel length, disorders of motility, or both. Short bowel syndrome (SBS) is a malabsorptive state resulting from surgical resection, congenital defect, or diseases associated with loss of absorptive surface area. A particularly vexing problem is associated with whole bowel and/or segmental intestinal dysmotility. Motility disorders within the context of SBS and IF may relate to rapid intestinal transit secondary to loss of intestinal length, dysmotility associated with loss or poor antegrade peristalsis, or gastroparesis. Therapy may be classified into medical (prokinetic and antidiarrheal agents) and surgical to deal with the overdistended poorly motile bowel.

Methods

We performed a systematic review of the literature pertaining to IF, SBS, and dysmotility in the pediatric population with gastroschisis, necrotizing enterocolitis, and intestinal atresia. In addition to the available treatment options, we have provided a review of the literature and a summary of the available evidence.

Conclusion

Despite relatively poor level of evidence regarding the application of promotility and antidiarrheal medications in patients with SBS and IF, these agents continue to be used. Herein, we provide a review of the physiology and pathophysiology of intestinal motility/dysmotility and available strategies for the use of promotility and antidiarrheal agents in patients with IF/SBS.     

刘文峰以温清并用止泻汤治疗慢性腹泻经验

介绍刘文峰教授运用自拟温清并用止泻汤治疗慢性腹泻的临床经验。该方温补清利并用,适用于治疗慢性腹泻虚中夹实、寒热错杂者。并举验案1则以说明。     

Role of the Rosa canina L. leaf extract as an antidiarrheal drug in rodents

Objectives:

The objective of the study was to investigate the effect of the leaf extract of Rosa canina L. against experimental diarrhea induced by castor oil in rodents.

Materials and Methods:

The methanol extract of Rosa canina L. (30 and 60 mg/kg body weight) was administered orally to two groups of mice (five animals per group) in order to evaluate the activity of the extract against the castor oil-induced diarrhea model in mice. Two other groups received normal saline and diphenoxylate (5 mg/kg) as positive control. The effect of the extract on intestinal transit and castor oil-induced intestinal fluid accumulation (enteropooling) was assessed. The effects of the extract on the isolated rabbit jejunum and on the isolated rat ileum were studied.

Results:

The preliminary phytochemical screening of the leaf extract of Rosa Canina L. revealed the presence of alkaloids, flavonoids, glycosides, saponins, and volatile oil. Intraperitoneal LD50 of the extract was found to be 455.19 ± 23 mg/kg in mice. The antidiarrheal effect of the methanolic extract exhibited a concentration-dependent inhibition of the spontaneous pendular movement of the isolated rabbit jejunum and inhibited acetylcholine-induced contraction of the rat ileum. A dose-dependent decrease in gastrointestinal transit was observed with extracts (30 and 60 mg/kg), which also protected mice against castor oil-induced diarrhea and castor oil-induced fluid accumulation, respectively.

Conclusions:

The presence of some of the phytochemicals in the leaf extract may be responsible for the observed effects, and also the basis for its use in traditional medicine as an antidiarrheal drug.