替勃龙联合西沙必利改善绝经期妇女胆囊动力

Combination of tibolone and cisapride promoted gallbladder emptying in menopause patients with functional dyspepsia

目的 :探讨绝经期功能性消化不良患者胆囊收缩功能变化以及小剂量雌孕雄激素—替勃龙对绝经期FD患者胆囊收缩功能的影响。方法 :15例健康志愿者服用西沙必利 5mg ,tid ,服药前、后 4周B超检测胆囊收缩功能。 91例绝经期功能性消化不良患者随机分为 3组 ,分别给予小剂量替勃龙 2 .5mg/d ;西沙必利 5mg ,tid ;替勃龙 +西沙必利 (剂量同前 )治疗 4周 ,观察治疗前后胆囊收缩功能变化。结果 :西沙必利可显著增加青年健康志愿者餐后胆囊收缩 ,使餐后胆囊排空率增加 19.7% ,P<0 .0 5。与青年健康志愿者比较 ,绝经期FD患者餐前胆囊排空率无显著改变 ,但餐后胆囊排空对西沙必利无反应。替勃龙与西沙必利联合应用时 ,可明显提高绝经期FD患者的餐后胆囊排空率 11.2 % ,P <0 .0 5。结论 :胆囊收缩能力储备的下降可能是绝经期FD的发病机制之一 ,替勃龙联合西沙必利有助于改善绝经期妇女的胆囊动力。

Objective: To inspect the change of gallbladder contraction in the menopause patients with functional dyspepsia (MPFD) and investigate the effect of tibolone,a compound with the effects of estrogen,progestogen and androgen,on the gallbladder emptying of MPFD. Methods: 15 young healthy volunteers were treated with cisapride 5mg three times a day.91 MPFD were divided into 3 groups at random.They were treated with tibolone 2.5mg once a day;cisapride 5mg three times a day and combination of both drugs respectively.The gallbladder emptying in three groups' patients was measured before and after 4 weeks' treatment. Results: Postprandial gallbladder volume in the volunteers was significantly reduced and gallbladder ejection fraction was enhanced 19.7% after taking cisapride ( P <0.05).Compared with young healthy volunteers,preprandial gallbladder ejection fraction of MPED was not significantly different.However,no response for cisapride was observed in postprandial gallbladder ejection fraction of MPED.Postprandial gallbladder ejection fraction of MPFD was remarkably enhanced 11.2% ( P <0.05) by the combination of tibolone and cisapride. Conclusion: The down-reservation of gallbladder ejection in MPFD may contribute to their symptoms.Postprandial gallbladder ejection fraction of MPFD could be improved by the combination of tibolone and cisapride.