高频与低频胃肠起搏治疗胃肠动力紊乱性疾病疗效的比较

Comparison of therapeutic efficacy between low-frequency and high-frequency gastrointestinal pacing on gastrointestinal motility disorders

目的 对高频胃肠起搏与低频起搏治疗胃肠动力紊乱性疾病的疗效进行比较。方法 82例胃肠动力紊乱 性疾病患者,完全随机分为2组,低频起搏组50例,采用1.1～1.2IGF(intrinsicgastricslowwavefrequency)的类正弦基波叠加 一系列双极脉冲方波(10Hz)进行起搏;高频起搏组(对照组)32例,采用12.0次/min的类正弦基波叠加一系列双极脉冲方 波(30Hz)进行起搏。胃起搏1次/d,每次45min,共15d。分别记录治疗前、治疗中及治疗后的临床症状变化。结果 治 疗后低频起搏组的总有效率为92%,高频起搏组的总有效率为91%。高频起搏组治疗后“恶心、呕吐”的改善较低频起搏 组更为明显(P<0.05),而低频起搏组“早饱、嗳气”的缓解则较高频起搏组更显著(P<0.05),但2组间症状总积分的比较 差异无显著性(P>0.05)。结论 高频起搏组与低频起搏组比较在消除患者症状方面有一定差异,胃肠起搏的疗效与起 搏参数有关。

Objective To compare the therapeutic efficacy between low-frequency and high-frequency gastrointestinal pacing in gastrointestinal motility disorders. Methods Eight-two patients with gastrointestinal motility disorders were randomly divided into two groups: low-frequency group (n=50), gastric pacing with a sinusoidal-like baseline wave of low-frequency [1.1-1.2 intrinsic physiologic slow-wave frequency (IGF)] superimposed with a series of high-frequency pulses (10 Hz), and high-frequency group (control group, n=32), gastric pacing with a similar-like sinusoidal baseline wave of 12.0 cycles/min superimposed with a series of high frequency pulses (20 Hz). Surface gastric pacing was performed once for 45 min after meals daily for 15 d. Dyspepsia symptoms were recorded and evaluated before treatment and at 15 d after treatment. Results Total efficacy in low-frequency group and high-frequency group were 92% and 91%, respectively. High-frequency gastric pacing showed a higher release rate for nausea and vomiting than low-frequency gastric pacing (P<0.05), and low-frequency gastric pacing showed a higher release rate for belching and early satiety than high-frequency gastric pacing (P<0.05). However, there was no significant difference in total symptom score (TSS) in groups (P>0.05). Conclusion There are some differences in the improvement of clinical symptoms between high-frequency and low-frequency groups. The therapeutic efficacy of surface gastrointestinal pacing may be associated with the pacing parameters.