阿米替林对功能性消化不良症状及胃动力的作用

Effect of Amitriptyline on Symptoms, Gastric Emptying and Electrogastrography in Patients with Functional Dyspepsia

目的：研究功能性消化不良（FD）患者的胃排空和胃电特性以及阿米替林对FD的疗效。方法：用双同位素标记SPECT技术和体表胃电图检测42例FD患者服用小剂量阿米替林前后胃运动功能的变化。结果：FD组和对照组液相排空曲线相似，半排空时间（T50）差异无显著性；FD组因相T50较对照组显著延长，胃电节律紊乱率及餐后振幅降低率较对照组显著增加。阿米替林治疗4周后，FD患者的临床症状显著改善，但胃排空异常率及胃电节律无明显改善。结论：阿米替林可能是通过降低胃肠神经的敏感性，而不是通过改善胃排空率或胃电节律发挥作用。临床使用阿米替林以改善FD症状可取得良好效果。

Background/Aims: To investigate the characteristics of gastric emptying and electrogastrography (EGG), and the effect of amitriptyline on symptoms in patients with functional dyspepsia (FD).Methods: Gastric motor functions in 42 FD patients were studied by scintigraphic gastric emptying time (GET) analysis and surface EGG. Second examinations of GET and EGG were performed 4 weeks after adIninistration of amitryptyline. Results: Rates of arrhythmia, degeneration and GET in FD patients were significantly greater or longer than those in the controls. The symptoms in 85.3% patients were relieved significantly after 4 weeks' amitriptyline treatment, but there was no difference in GET and EGG parameters. Conclusions: FD patients have a delayed GET and higher rate of arrhythmia. Tricyclic antidepressants in low dosage can reduce gastric symptoms significantly. A decline of visceral perception may play a role in its therapeutic efficacy.