健脾理气中药对肝郁脾虚型消化不良疾病的疗效研究

目的:分析健脾理气中药治疗肝郁脾虚型消化不良的效果。方法:2019年1月-2020年1月收治肝郁脾虚型消化不良患者168例,随机分为两组,各84例。对照组实施雷尼替丁、多潘立酮治疗;研究组实施健脾理气中药治疗。比较两组临床效果。结果:研究组治疗后胃泌素、胃动素、胆囊收缩素及胃促生长素水平均高于对照组,差异有统计学意义(P<0.05);研究组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。结论:健脾理气中药治疗肝郁脾虚型消化不良的效果确切,一方面对胃泌素以及胃动素分泌有促进作用,另一方面可以使胆囊收缩功能增强,胃促生长素水平得到改善。

复方消化酶胶囊对消化不良疾病的治疗作用

目的对复方消化酶胶囊在消化不良疾病中的治疗效果进行评价。方法选取我院2014年1月至2016年12月收治的200例消化不良疾病患者为研究对象。分成两组,100例实施莫沙必利治疗,设为对照组;100例实施复方消化酶胶囊治疗,设为实验组。全程对两组的治疗工作进行观察和记录,分析和比较两组的治疗效果、症状消化系症状分值以及不良反应。结果(1)两组治疗效果比较:实验组的总有效率较高,与对照组数据差异存在统计学意义(P<0.05);(2)两组的症状积分比较:实验组的消化系症状分值改善理想,与对照组数据差异存在统计学意义(P<0.05);(3)两组不良反应比较:两组的不良反应率差异无统计学意义(P>0.05)。结论应用复方消化酶胶囊对消化不良疾病患者实施治疗,对患者病情症状改善有积极意义,且安全性高。

复方阿嗪米特、莫沙必利联合治疗老年胃肠疾病相关性消化不良疗效分析

目的 探究复方阿嗪米特＋莫沙必利联合方案在老年胃肠疾病相关性消化不良治疗中的应用效果。方法 将2016年4月-2017年4月本院收治的116例老年胃肠疾病相关性消化不良患者随机分为观察组与对照组,每组58例。观察组纳入阿嗪米特＋莫沙必利联合方案治疗患者,对照组纳入单用莫沙必利方案治疗患者,均治疗28 d。记录2组治疗前后消化不良症状总积分,依据治疗后症状积分缓解率评估临床疗效,计算2组不良反应发生率并行组间比较。结果 治疗前,2组消化不良症状总积分比较差异无统计学意义,2组消化不良症状总积分在有效疗程结束后均有不同程度降低,观察组降幅显著优于对照组（P〈0.05）。观察组治疗有效率为87.9%显著高于对照组60.3%（P〈0.05）。结论 复方阿嗪米特联合莫沙必利是治疗老年胃肠疾病相关性消化不良的有效方案,联合用药显著改善患者消化不良症状,提高患者生活质量,临床应用反馈良好,安全性可靠。

复方阿嗪米特联合莫沙必利治疗老年胃肠疾病相关性消化不良的疗效

目的:探讨复方阿嗪米特联合莫沙必利治疗老年胃肠疾病相关性消化不良的疗效。方法:选取2015年3月—2016年8月湖北省荣军医院收治的老年胃肠疾病相关性消化不良患者116例作为研究对象,以随机数字表法分为观察组和对照组,每组58例。对照组患者给予莫沙必利治疗,观察组患者给予复方阿嗪米特联合莫沙必利治疗。观察两组患者的临床疗效、症状消失时间、住院时间、不良反应发生情况,比较两组患者治疗前后的生活质量评分、症状严重程度积分、发病频率的差异。结果:观察组患者的总有效率明显高于对照组,症状消失时间、住院时间明显短于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组患者的生活质量评分、症状严重程度积分、发病频率明显优于对照组,差异均有统计学意义(P<0.05)。两组患者不良反应发生率的差异无统计学意义(P>0.05)。结论:复方阿嗪米特联合莫沙必利治疗老年胃肠疾病相关性消化不良的疗效显著,可有效促进临床症状消退,改善患者生活质量,安全性较高。

复方阿嗪米特结合莫沙必利治疗老年胃肠疾病相关性消化不良的效果及安全性

目的探讨复方阿嗪米特结合莫沙必利治疗老年胃肠疾病相关性消化不良的效果及安全性。方法选取2018年1月~2020年1月赣州市人民医院老年病科收治的老年胃肠疾病相关性消化不良患者100例,按照随机数字表法分为联合组(50例)和对照组(50例),联合组应用复方阿嗪米特结合莫沙必利治疗,对照组单独应用莫沙必利治疗。比较两组患者的症状积分、生活质量评分、临床疗效、症状消失时间、住院时间及不良反应发生情况。结果治疗后,两组严重程度积分、症状出现频率均低于治疗前,且联合组低于对照组,差异有统计学意义(P<0.05)。治疗后两组生活质量评分高于治疗前,联合组高于对照组,差异有统计学意义(P<0.05)。联合组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。联合组症状消失时间、住院时间短于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论复方阿嗪米特结合莫沙必利治疗老年胃肠疾病相关性消化不良的疗效显著,安全性较高。

用复方阿嗪米特联合莫沙必利对老年胃肠疾病相关性消化不良患者进行治疗的效果

目的 :研究用复方阿嗪米特联合莫沙必利对老年胃肠疾病相关性消化不良患者进行治疗的临床效果。方法 :从2016年4月至2017年10月期间在唐山市丰润区人民医院就诊的老年胃肠疾病相关性消化不良患者中选取78例患者为研究对象。将其随机分为对照组和观察组。对对照组患者单用莫沙必利进行治疗,对观察组患者用复方阿嗪米特联合莫沙必利进行治疗。用药4周后,对比两组患者的临床疗效和消化不良症状的改善情况。结果 :用药4周后观察组患者消化不良症状的总积分低于对照组患者,其治疗的总有效率高于对照组患者,P <0.05。结论 :用复方阿嗪米特联合莫沙必利对老年胃肠疾病相关性消化不良患者进行治疗可显著改善其消化不良的症状,提高其临床疗效。

关于羔羊消化不良病的诊治分析

本文分析了羔羊消化不良的具体病因,针对性的指出了具体的养殖措施,以期为此后羔羊的养殖工作提供更多的借鉴依据,提高养殖效果。

胃排空的基础与检测

胃排空的基础与检测杨成奎①李冬玲马桓近年来消化道医学动力学的研究取得了进展，功能性消化不良（ｆｕｃｔｉｏｎａｌｄｙｓｐｅｐｓｉａ）性疾病受到了临床医师的重视，胃机械排空功能的检测已经成为第一线诊断方法，影像技术是一个主要方面。八十年代以来国外这方面研...

Gastrointestinal hormone abnormalities and G and D cells in functional dyspepsia patients with gastric dysmotility

AIM: To investigate the relationship between gastric dysmotility,gastrointestinal hormone abnormalities, and neuroendocrine cells in gastrointestinal mucosa in patients with functional dyspepsia (FD).METHODS: Gastric emptying was assessed with solid radiopaque markers in 54 FD patients, and the patients were divided into two groups according to the results, one with delayed gastric emptying and the other with normal gastric emptying. Seventeen healthy volunteers acted as normal controls. Fasting and postprandial plasma levels and gastroduodenal mucosal levels of gastrointestinal hormones gastrin, somatostatin (SS) and neurotensin (NT)were measured by radioimmunoassay in all the subjects.G cells (gastrin-producing cells) and D cells (SS-producing cells) in gastric antral mucosa were immunostained with rabbit anti-gastrin polyclonal antibody and rabbit anti-SS polyclonal antibody, respectively, and analyzed quantitatively by computerized image analysis.RESULTS: The postprandial plasma gastrin levels, the fasting and postprandial plasma levels and the gastric and duodenal mucosal levels of NT were significantly higher in the FD patients with delayed gastric emptying than in those with normal gastric emptying and normal controls. The number and gray value of G and D cells and the G cell/D cell number ratio did not differ significantly between normal controls and the FD patients with or without delayed gastric emptying.CONCLUSION: Our findings suggest that the abnormalities of gastrin and NT may play a role in the pathophysiology of gastric dysmotility in FD patients, and the abnormality of postprandial plasma gastrin levels in FD patients with delayed gastric emptying is not related to the changes both in the number and gray value of G cells and in the G cell/D cell number ratio in gastric antral mucosa.

Functional oesophago-gastric junction imaging

Despite its role in disease there is still no definitive method to assess oesophago-gastric junction competence （OGJ）. Traditionally the OGJ has been assessed using manometry with lower oesophageal sphincter pressure as the indicator. More recently this has been shown not to be a very reliable marker of sphincter function and competence against reflux. Disorders such as gastro-oesophageal reflux disease and to a lesser extend achalasia still effects a significant number of patients. This review looks at using a new technique known as impedance planimetry to profile the geometry and pressure in the OGJ during distension of a bag. The data gathered can be reconstructed into a dynamic representation of OGJ action. This has been shown to provide a useful representation of the OGJ and to show changes to the competence of the OGJ in terms of compliance and distensibility as a result of endoluminal therapy.

Placebo responses in patients with gastrointestinal disorders

Over the last several years there has been a growing interest in placebo, not only as an inert control in clinical trials, but also in the placebo effect as a group effect as well as a reaction in individual subjects. Methodological factors such as regression to the mean and natural history of the disease play a role in the evaluation of a possible placebo effect. In this report, we discuss several factors including PavIovian conditioning, beliefs outcome, expectations, and other factors as potential mediators of the placebo response. Placebo effects are common in gastrointestinal diseases and there seems to be no clear difference between placebo effects in functional gastrointestinal diseases （functional dyspepsia and irritable bowel syndrome） and organic gastrointestinal disease （duodenal ulcer and inflammatory bowel disease）.

Chronic gastrointestinal symptoms and quality of life in the Korean population

AIM： To evaluate the prevalence of chronic gastroin- testinal symptoms and their impact on health-related quality of life （HRQOL） in the Korean population. METHODS： A cross-sectional survey, using a reliable and valid Rome I] based questionnaire, was per- formed on randomly selected residents, between 18 and 69 years in age. All respondents were interviewed at their homes or offices by a team of interviewers. The impact of chronic gastrointestinal symptoms on HRQOL was assessed using the Korean version of the 36-item Short-Form general health survey （SF-36）. RESULTS： Of the 1807 eligible subjects, 1417 （78.4%： male 762; female 655） were surveyed. Out of the respondents, 18.6% exhibited at least one chronic gastrointestinal symptom. The prevalence of gastro- esophageal reflux disease （GERD）, defined as heart- burn and/or acid regurgitation experienced at least weekly, was 3.5% （95% CI, 2.6-4.5）. The prevalence of uninvestigated dyspepsia, irritable bowel syndrome （IBS） and chronic constipation based on Rome Ⅱ criteria were 11.7% （95% CI, 10.1-13.5）, 2.2% （95% CI, 1.5-3.1）, and 2.6% （95% CI, 1.8-3.5） respectively. Compared with subjects without chronic gastrointesti- nal symptoms （n = 1153）, those with GERD （n = 50）, uninvestigated dyspepsia （n = 166） and IBS （n = 31） had significantly worse scores on most domains of the SF-36 scales. CONCLUSION： The prevalence of GERD, uninvesti- gated dyspepsia and IBS were 3.5%, 11.7% and 2.2% respectively, in the Korean population. The health- related quality of life was significantly impaired in subjects with GERD, uninvestigated dyspepsia and IBS in this community.

Association between cag-pathogenicity island in Helicobacter pylori isolates from peptic ulcer,gastric carcinoma,and non-ulcer dyspepsia subjects with histological changes

AIM： To investigate the presence of the cag-pathogenicity island and the associated histological damage caused by strains with complete cag-PAI and with partial deletions in correlation to the disease status. METHODS： We analyzed the complete cag-PAI of 174 representative Helicobacter pylori （H pylori ） clinical isolates obtained from patients with duodenal ulcer, gastric ulcer, gastric cancer, and non-ulcer dyspepsia using eight different oligonucleotide primers viz cagA1, cagA2, cagAP1, cagAP2, cagE, cagT, LEC-1, LEC-2 spanning five different loci of the whole cag-PAI by polymerase chain reaction （PCR）. RESULTS： The complete screening of the genes comprising the cag-PAI showed that larger proportions of subjects with gastric ulcer （97.8%） inhabited strains with complete cag-PAI, followed by gastric cancer （85.7%）, non-ulcer dyspepsia （7.1%）, and duodenal ulcer （6.9%）, significant differences were found in the percentage distribution of the genes in all the clinical groups studied. It was found that strains with complete cag-PAI were able to cause severe histological damage than with the partially deleted ones. CONCLUSION： The cag-PAI is a strong virulent marker in the disease pathogenesis as it is shown that a large number of those infected with strain with complete cag-PAI had one or the other of the irreversible gastric pathologies and interestingly 18.5% of them developed gastric carcinoma. The presence of an intact cag- PAI correlates with the development of more severe pathology, and such strains were found more frequently in patients with severe gastroduodenal disease. Partial deletions of the cag-PAI appear to be sufficient to render the organism less pathogenic.

Do patients with non-ulcer dyspepsia respond differently to Helicobacter pylorieradication treatments from those with peptic ulcer disease? A systematic review

AIM: It is controversial whether patients with non-ulcer dyspepsia (NUD) respond differently to Helicobacter pylori (H pylori) eradication treatment than those with peptic ulcer disease (PUD). To review the evidence for any difference in H pylorieradication rates between PUD and NUD patients. METHODS: A literature search for full articles and meeting abstracts to July 2004 was conducted. We included studies evaluating the efficacy of a proton pump inhibitor (P) or ranitidine bismuth citrate (RBC) plus two antibiotics of clarithromycin (C), amoxicillin (A), metronidazole (M), or P-based quadruple therapies for eradicating the infection. RESULTS: Twenty-two studies met the criteria. No significant difference in eradication rates was found between PUD and NUD patients when treated with 7-d RBCCA, 10-d PCA or P-based quadruple therapies. When the 7-d PCA was used, the pooled H pylori eradication rate was 82.1% (431/525) and 72.6% (448/617) for PUD and NUD patients, respectively, yielding a RR of 1.15 (95%CI 1.01-1.29). However, the statistically significant difference was seen only in meeting abstracts, but not in full publications. CONCLUSION: There is no convincing evidence to suggest that NUD patients respond to H pylori eradication treatments differently from those with PUD, although a trend exists with the 7-d PCA therapy.

Subtypes of functional dyspepsia

Functional dyspepsia is a common clinical condition characterised by chronic or recurrent upper abdominal pain or discomfort commonly associated with a variety of associated gastrointestinal symptoms and a normal endoscopy. To standardise research-based approaches, an initial categorisation of into sub groups was agreed to, based on clusters of symptoms. However the early expectation that these subgroups would be associated with distinct pathophysiologies amenable to specific therapy has not been realised. A classification based on the most troublesome symptom has been suggested but the utility of this is also unclear. More recent data suggest that some of the pathophysiologic dysfunctions may be associated with specific symptoms and so provide a better tool for grouping patients. But this approach remains incomplete as current insights into the pathogenesis are still too limited for this to be satisfactory. In conclusion, no classification provides for an adequate treatment-based approach to the syndrome of functional dyspepsia. As a consequence treatment remains largely empiric.

Gastrointestinal manifestations of systemic mastocytosis

Systemic mastocytosis (SM) is a rare disease with abnormal proliferation and infiltration of mast cells in the skin, bone marrow, and viscera including the mucosal surfaces of the digestive tract. Gastrointestinal (GI) symptoms occur in 14%-85% of patients with systemic mastocytosis. The GI symptoms may be as frequent as the better known pruritis, urticaria pigmentosa, and flushing. In fact most recent studies show that the GI symptoms are especially important clinically due to the severity and chronicity of the effects that they produce. GI symptoms may include abdominal pain, diarrhea, nausea, vomiting, and bloating. A case of predominantly GI systemic mastocytosis with unique endoscopic images and pathologic confirmation is herein presented, as well as a current review of the GI manifestations of this disease including endoscopic appearances. Issues such as treatment and prognosis will not be discussed for the purposes of this paper.

Visceral response to acute retrograde gastric electrical stimulation in healthy human

AIM: To investigate the visceral response to acute retrograde gastric electrical stimulation (RGES) in healthy humans and to derive optimal parameters for treatment of patients with obesity.METHODS: RGES with a series of effective parameters were performed via a bipolar mucosal electrode implanted along the great curvature 5 cm above pylorus of stomach in 12 healthy human subjects. Symptoms associated with dyspepsia and other discomfort were observed and graded during RGES at different settings, including long pulse and pulse train. Gastric myoelectrical activity at baseline and during different settings of stimulation was recorded by a multi-channel electrogastrography.RESULTS: The gastric slow wave was entrained in all the subjects at the pacing parameter of 9 cpm in frequency, 500 ms in pulse width, and 5 mA in amplitude.The frequently appeared symptoms during stimulation were satiety, bloating, discomfort, pain, sting, and nausea. The total symptom score for each subject significantly increased as the amplitude or pulse width was adjusted to a higher scale in both long pulse and pulse train. There was a wide diversity of visceral responses to RGES among individuals.CONCLUSION: Acute RGES can result in a series of symptoms associated with dyspepsia, which is beneficial to the treatment of obesity. Optimal parameter should be determined according to the individual sensitivity to electrical stimulation.

Development and validation of a simple and multifaceted instrument,GERD-TEST,for the clinical evaluation of gastroesophageal reflux and dyspeptic symptoms

To evaluate the psychometric properties of a newly developed questionnaire, known as the gastroesophageal reflux and dyspepsia therapeutic efficacy and satisfaction test (GERD-TEST), in patients with GERD.METHODSJapanese patients with predominant GERD symptoms recruited according to the Montreal definition were treated for 4 wk using a standard dose of proton pump inhibitor (PPI). The GERD-TEST and the Medical Outcome Study Short Form-8 Health Survey (SF-8) were administered at baseline and after 4 wk of treatment. The GERD-TEST contains three domains: the severity of GERD and functional dyspepsia (FD) symptoms (5 items), the level of dissatisfaction with daily life (DS) (4 items), and the therapeutic efficacy as assessed by the patients and medication compliance (4 items).RESULTSA total of 290 patients were eligible at baseline; 198 of these patients completed 4 wk of PPI therapy. The internal consistency reliability as evaluated using the Cronbach’s α values for the GERD, FD and DS subscales ranged from 0.75 to 0.82. The scores for the GERD, FD and DS items/subscales were significantly correlated with the physical and mental component summary scores of the SF-8. After 4 wk of PPI treatment, the scores for the GERD items/subscales were greatly reduced, ranging in value from 1.51 to 1.87 and with a large effect size (P < 0.0001, Cohen’s d; 1.29-1.63). Statistically significant differences in the changes in the scores for the GERD items/subscales were observed between treatment responders and non-responders (P < 0.0001).CONCLUSIONThe GERD-TEST has a good reliability, a good convergent and concurrent validity, and is responsive to the effects of treatment. The GERD-TEST is a simple, easy to understand, and multifaceted PRO instrument applicable to both clinical trials and the primary care of GERD patients.

Endoscopic Management in Fibrous Dysplasia of Ethmoid Sinus:One Case Report and Literatures Review

Introduction Fibrous dysplasia （FD） is a sporadic real bone structures and marrow are skeletal disorder in which norreplaced by fibro-osseous tissuet. It is classified into three types： monostotic FD, polyostotic FD, and McCune-Albright syndrome. The monostotic is the most common form of FD. The disease primarily affects the long bones of the patients, and may also develop in the craniofacial region. However, FD in the paranasal sinuses is uncommon. The case in this report was diagnosed as FD in the ethmoid sinus which is a rarely seen case.

胃肠舒泰颗粒对小鼠肠推进和大鼠胃液分泌及对在体兔肠平滑肌的影响

目的 :观察胃肠舒泰颗粒 (胃肠舒泰 )对正常小鼠大肠推进和对吗啡引起的小鼠小肠推进功能抑制的影响 ,以及对正常大鼠胃液分泌和在体兔肠平滑肌的影响。方法 :昆明小鼠 110只 ,对小鼠大肠推进及对吗啡引起的小肠推进 ,分别随机分为 5及 6组 :阴性对照组、(模型对照组 )和胃肠舒泰小、中、大剂量组与普瑞博思组 ,观察各组大肠推进率及以吗啡为抑制剂的小肠推进率 ;SD大鼠 5 0只 ,分 5组 ,观察该药对大鼠胃液分泌的影响 ;大耳白兔 4 0只 ,观察该药对在体兔肠平滑肌的影响。结果 :胃肠舒泰可促进正常小鼠大肠推进率 ,不能拮抗吗啡引起的小鼠小肠推进 ,可升高正常大鼠胃蛋白酶排出量及增强兔肠平滑肌运动的频率与幅度。结论 :胃肠舒泰具有促胃肠动力作用 ,并可升高正常大鼠胃蛋白酶排出量 ,这可能是其治疗胃肠动力障碍性消化不良疾病的药理学基础之一。