高压氧综合治疗糖尿病性胃轻瘫患者的疗效观察

Effects of hyperbaric oxygen combine with domperidone on motilin and gastric emptying time of patients with diabetic gastroparesis

目的观察高压氧(HBO)联合吗丁啉综合治疗对糖尿病性胃轻瘫患者胃动素及胃排空时间的影响。方法采用随机数字表法将2000年10月至2004年10月间连续入院的糖尿病性胃轻瘫患者112例随机分为高压氧组和对照组各46例,HBO组在给予吗丁啉(每次10 mg,每天3次,连用4周)的基础上加用HBO治疗,HBO采用多人氧舱,在舱内停留120 min,压力为0．25 MPa(2．5 ATA),戴面罩吸入纯氧60 min(30 min各2次,中间休息10 min吸入舱内空气),10次为1个疗程,共3个疗程,每疗程间隔3～5d(排除HBO治疗禁忌证)。对照组为单纯吗丁啉,每次10 mg,每天3次,连用4周。45 d分别对两组患者治疗前后胃动素、空腹血糖、胃排空时间及症状的改善各项指标进行研究对比。结果HBO组和对照组总有效率分别为92．9%和76．8%,症状的改善、胃动素及胃排空时间治疗组均优于对照组,差异有显著性(P＜0．05)。结论糖尿病性胃轻瘫患者在服用吗丁啉的基础上应用HBO可降低胃动素、加速胃排空时间,对临床症状的改善具有积极作用。

Objective To explore the influence of HBO combined with domperidone on motilin and gastric emptying time in patients with diabetic gastroparesis （DGP）. Methods 112 patients with diabetic gastroparesis admitted to hospital from October 2000 to October 2004 were randomly divided into HBO group and control group,46 patients in each group. All the patients were treated with domperidone for 4 weeks（ 10 mg, tid） ; while patients in HBO group,also treated with HBO,stayed in 0. 25 MPa（2.5 ATA）HBO chamber for 120 min, wearing masks and inhaling pure oxygen for 60 min, with 10 min interval, 10 days as a course for 3 courses. Before and 45 d after treatment, motilin and gastric emptying time were measured in all the subjects, respectively. Results The total effectively rate in the HBO group and control group was 92.9% and 76.8%, respectively（P 〈 0. 05）. motilin and the gastric emptying time in the HBO group was significantly reduced, compared with those in the control group （P 〈 0. 05）. Conclusions HBO combined with domperidone can markedly improve the serum motilin concentration and gastric emptying time and has positive effcets on DGP patients.