Itopride for gastric volume,gastric emptying and drinking capacity in functional dyspepsia

AIM To study the effect of itopride on gastric accommodation, gastric emptying and drinking capacity in functional dyspepsia(FD). METHODS Randomized controlled trial was conducted to check the effect of itopride on gastric accommodation, gastric emptying, capacity of tolerating nutrient liquid and symptoms of FD. We recruited a total of 31 patients having FD on the basis of ROME III criteria. After randomization, itopride was received by 15 patients while 16 patients received placebo. Gastric accommodation was determined using Gastric Scintigraphy. ^(13) C labeled octanoic breadth test was performed to assess gastric emptying. Capacity of tolerating nutrient liquid drink was checked using satiety drinking capacity test. Theintervention group comprised of 150 mg itopride. Patients in both arms were followed for 4 wk. RESULTS Mean age of the recruited participant 33 years(SD = 7.6) and most of the recruited individuals, i.e., 21(67.7%) were males. We found that there was no effect of itopride on gastric accommodation as measured at different in volumes in the itopride and control group with the empty stomach(P = 0.14), at 20 min(P = 0.38), 30 min(P = 0.30), 40 min(P = 0.43), 50 min(P = 0.50), 60 min(P = 0.81), 90 min(P = 0.25) and 120 min(P = 0.67). Gastric emptying done on a sub sample(n = 11) showed no significant difference(P = 0.58) between itopride and placebo group. There was no significant improvement in the capacity to tolerate liquid in the itopride group as compared to placebo(P = 0.51). Similarly there was no significant improvement of symptoms as assessed through a composite symptom score(P = 0.74). The change in QT interval in itopride group was not significantly different from placebo(0.10). CONCLUSION Our study found no effect of itopride on gastric accommodation, gastric emptying and maximum tolerated volume in patients with FD.

Effect of ginger Effect of ginger on gastric motility and symptoms of functional dyspepsiaon gastric motility and symptoms of functional dyspepsia

AIM:To evaluate the effects of ginger on gastric motility and emptying,abdominal symptoms,and hormones that influence motility in dyspepsia.METHODS:Eleven patients with functional dyspepsia were studied twice in a randomized double-blind manner.After an 8-h fast,the patients ingested three capsules that contained ginger(total 1.2 g) or placebo,followed after 1 h by 500 mL low-nutrient soup.Antral area,fundus area and diameter,and the frequency of antral contractions were measured using ultrasound at frequent intervals,and the gastric half-emptying time was calculated from the change in antral area.Gastrointestinal sensations and appetite were scored using visual analog questionnaires,and blood was taken for measurement of plasma glucagon-like peptide-1(GLP-1),motilin and ghrelin concentrations,at intervals throughout the study.RESULTS:Gastric emptying was more rapid after ginger than placebo [median(range) half-emptying time 12.3(8.5-17.0) min after ginger,16.1(8.3-22.6) min after placebo,P ≤ 0.05].There was a trend for more antral contractions(P = 0.06),but fundus dimensions and gastrointestinal symptoms did not differ,nor did serum concentrations of GLP-1,motilin and ghrelin.CONCLUSION:Ginger stimulated gastric emptying and antral contractions in patients with functional dyspepsia,but had no impact on gastrointestinal symptoms or gut peptides.

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.

Relationship between gastrointestinal and extra-gastrointestinal symptoms and delayed gastric emptying in functional dyspeptic patients

AIM: Delayed gastric emptying and an enlarged fasting gastric antrum are common findings in functional dyspepsia but their relationship with gastrointestinal (GI), and the frequently associated extra-GI symptoms remains unclear.This study evaluated the relationship between GI and extra-GI symptoms, fasting antral volume and delayed gastric emptying in functional dyspepsia.METHODS: In 108 functional dyspeptic patients antral volume and gastric emptying were assessed with ultrasonography (US). Symptoms were assessed with standardized questionnaire. The association of symptoms and fasting antral volume with delayed gastric emptying was estimated with logistic regression analysis.RESULTS: Delayed gastric emptying was detected in 39.8% of the patients. Postprandial drowsiness (AOR 11.25; 95%CI 2.75-45.93), nausea (AOR 3.51; 95%CI 1.19-10.32), fasting antral volume (AOR 1.93; 95%CI 1.22-3.05), were significantly associated with delayed gastric emptying. Symptoms, mainly the extra-GI ones as postprandial drowsiness and nausea, combined with fasting antral volume predicted the modality of gastric emptying with a sensitivity and specificity of 78%.CONCLUSION: In functional dyspeptic patients, (1) an analysis of fasting antral volume and of symptoms can offer valuable indication on the modality of gastric emptying,and (2) it seems appropriate to inquire on postprandial drowsiness that showed the best correlation with delayed gastric emptying.

Study of Gastric and Gallbladder Kinetics with Real－time Ultrasonography in Cases of Functional Dyspepsia

Gastric and gallbladder emptying in 113 patients with functional dyspepsia (FD) were evaluated by real-time ultrasonography (RUS) after a liquid-fat meal by the patients, and compared with 15 healthy volunteers. The results showed that in FD group 69 patients (61. 06%) had delayed gastric emptying,and 28 patients (24.77%) had gallbladder hypokinesia. Among them both delayed gastric ernptying and gallbladder hypokinesia were found in 11 patients (9.7%), 44 patients (38.93%)had normal gastric emptying and 85 patients (75.22%) had normal gallbladder emptying.

Changes in patients' symptoms and gastric emptying after Helicobacter pylori treatment

AIM: To investigate the changes in clinical symptoms and gastric emptying and their association in functional dyspepsia(FD) patients.METHODS: Seventy FD patients were enrolled and divided into 2 groups Helicobacter pylori(H. pylori)-negative group(28 patients), and H. pylori-positive group(42 patients). Patients in the H. pylori-positive group were further randomly divided into groups: H. pylori-treatment group(21 patients) and conventional treatment group(21 patients). Seventy two healthy subjects were selected as the control group. The proximal and distal stomach area was measured by ultrasound immediately after patients took the test meal, and at 20, 40, 60 and 90 min; then, gastric half-emptying time was calculated. The incidence of symptoms and gastric half-emptying time between the FD and control groups were compared. The H. pylori-negative and conventional treatment groups were givenconventional treatment: domperidone 0.6 mg/(kg/d) for 1 mo. The H. pylori-treatment group was given H. pylori eradication treatment + conventional treatment: lansoprazole 30 mg once daily, clarithromycin 0.5 g twice daily and amoxicillin 1.0 g twice daily for 1 wk, then domperidone 0.6 mg/(kg/d) for 1 mo. The incidence of symptoms and gastric emptying were compared between the FD and control groups. The relationship between dyspeptic symptoms and gastric half-emptying time in the FD and control groups were analyzed. Then total symptom scores before and after treatment and gastric half-emptying time were compared among the 3 groups. RESULTS: The incidence of abdominal pain, epigastric burning sensation, abdominal distension, nausea, belching, and early satiety symptoms in the FD group were significantly higher than in the control group(50.0% vs 20.8%; 37.1% vs 12.5%; 78.6% vs 44.4%; 45.7% vs 22.2%; 52.9% vs 15.3%; 57.1% vs 19.4%; all P < 0.05). The gastric half-emptying times of the proximal end, distal end, and the whole stomach in the FD group were slower than in the control group(93.7 ± 26.2 vs 72.0 ± 14.3; 102.2 ± 26.4 vs 87.5 ± 18.2; 102.1 ± 28.6 vs 78.3 ± 14.1; all P < 0.05). Abdominal distension, belching and early satiety had an effect on distal gastric half-emptying time(P < 0.05). Abdominal distension and abdominal pain had an effect on the gastric half-emptying time of the whole stomach(P < 0.05). All were risk factors(odds ratio > 1). The total symptom score of the 3 groups after treatment was lower than before treatment(P < 0.05). Total symptom scores after treatment in the H. pylori-treatment group and H. pylori-negative group were lower than in the conventional treatment group(5.15 ± 2.27 vs 7.02 ± 3.04, 4.93 ± 3.22 vs 7.02 ± 3.04, All P < 0.05). The gastric half-emptying times of the proximal end, distal end, and the whole stomach in the H. pylori-negative and H. pylori-treatment groups were shorter than in the conventional treatment group(P < 0.05). CONCLUSION: FD patients have delayed gastric emptying. H. pylori infection treatment helps to improve symptoms of dyspepsia and is a reasonable choice for treatment in clinical practice.

Role of cholecystokinin and central serotonergic receptors in functional dyspepsia

机能性消化不良的症状被上面的腹的不快或疼痛描绘，早饱足，饭后的充分，膨胀，恶心并且呕吐。它非常是长期的混乱，与症状 3 瞬间每器质性病的年，和没有证据。不正常的活动性，改变的内脏的感觉，和精神分析聚会因素都作为主要 pathophysiological 机制被识别了。这些 pathophysiological 机制交往生产观察症状，这被相信。消化不良基于主导的症状被分成了三亚群。象 Dysmotility 一样消化不良描述其综合征通常与一个胃的感觉运动的机能障碍有关的病人的亚群。大脑勇气肽缩胆囊素(CCK ) 和血清素(5-HT ) 分享某些生理的效果。被显示了胃的倒空减少并且影响饱足。而且， CCK 导致了取决于的厌食可能经由中央小径行动的 serotonergic 功能。我们相信和一只亢奋的应答的海角工作到 CCK 或他们的相互作用的中央 serotonergic 受体的畸形可能为在机能性消化不良(FD ) 的症状的开始负责。

Effect of DA-9701 on gastric emptying in a mouse model: Assessment by ^(13)C-octanoic acid breath test

AIM:To evaluate the effects of DA-9701 on the gastric emptying of a solid meal using the 13C-octanoic acid breath test in a mouse model. METHODS:Male C57BL/6 mice aged > 8 wk and with body weights of 20-25 g were used in this study. The solid test meal consisted of 200 mg of egg yolk labeled with 1.5 L/g 13C-octanoic acid. The mice were placed in a 130 mL chamber flushed with air at a flow speed of 200 mL/min. Breath samples were collected for 6 h. The half-emptying time and lag phase were calculated using a modified power exponential model. To assess the reproducibility of the 13C-octanoic acid breath test, the breath test was performed two times at intervals of one week in ten mice without drug treatment. To assess the gastrokinetic effects of DA-9701, the breath test was performed three times in another twelve mice, with a randomized crossover sequence of three drug treatments:DA-9701 3 mg/kg, erythromycin 6 mg/kg, or saline. Each breath test was performed at an interval of one week. RESULTS:Repeatedly measured half gastric emptying time of ten mice without drug treatment showed 0.856 of the intraclass correlation coefficient for the half gastric emptying time (P = 0.004). The mean cumulative excretion curve for the 13C-octanoic acid breath test showed accelerated gastric emptying after DA-9701 treatment compared with the saline control (P = 0.028). The median half gastric emptying time after the DA-9701 treatment was significantly shorter than after the saline treatment [122.4 min (109.0-137.9 min) vs 134.5 min (128.4-167.0 min), respectively; P = 0.028] and similar to that after the erythromycin treatment [123.3 min (112.9-138.2 min)]. The lag phase, which was defined as the period taken to empty 15% of a meal, was significantly shorter after the DA-9701 treatment than after the saline treatment [48.1 min (44.6-57.1 min) vs 52.6 min (49.45-57.4 min), respectively; P = 0.049]. CONCLUSION:The novel prokinetic agent DA-9701 accelerated gastric emptying, assessed with repeated measurements in the same mouse using the 13Coctanoic acid breath test. Our findings suggest that DA-9701 has therapeutic potential for the treatment of functional dyspepsia.

Relationship between antral distension and postprandial symptoms in functional dyspepsia

AIM: To investigate in patients with functional dyspepsia (FD) after an every-day meal whether (1) gastrointestinal (GI) and extra-GI symptoms had any relation with the degree of antral volume, (2) the onset of postprandial symptoms was associated with, and may predict, delayed gastric emptying. METHODS: In 94 symptomatic FD patients, antral volume variations and gastric emptying were assessed with ultrasonography after a 1050 kcal meal. Symptoms were evaluated with a standardized questionnaire. The association of GI and extra-GI symptoms with antral volumes and gastric emptying were estimated with logistic regression analysis. RESULTS: Forty percent of patients did not report any symptoms after a meal. Compared to the healthy controls, the antrum was more distended in patients throughout the entire observation period and 37 (39.4%) patients had delayed gastric emptying. Only postprandial drowsiness was associated with antral volume variations (AOR = 1.42; P < 0.001) and with delayed gastric emptying (AOR = 3.59; P < 0.03). CONCLUSION: In FD patients, GI symptoms are neither associated with antral distension nor with gastric emptying. Drowsiness is associated with antral distension and delayed gastric emptying. The onset of drowsiness is preceded by an increment of antral distension and the duration of the symptom appears to be related to the persistence of antral distension.

针刺足三里对FD胃排空及血清Motilin和Ghrelin的影响

目的:观察针刺穴位足三里对功能性消化不良(Functional Dyspepsia,FD)促进胃排空的治疗作用及对照研究血清Motilin和Ghrelin的变化。方法:采用适度夹尾刺激法复制FD大鼠模型,分别予电针刺激足三里穴位及对照性西药治疗,测定各组大鼠摄食量、体重、胃残留率、碳末推进率及血清Motilin和Ghrelin浓度。结果:模型组、西药组和针刺组摄食量与空白组比较均显著下降;西药组与针刺组胃残留率减少;西药组和针刺组相应的碳末推进率较空白组显著升高;模型组大鼠血清Motilin浓度显著下降;模型组大鼠血清Ghrelin相对升高,但无统计学意义。结论:中医手法针刺足三里对胃肠动力有促进作用,可能与恢复功能性消化不良大鼠的Moti-lin、Ghrelin水平有相关性。

柴枳和胃胶囊对功能性消化不良肝郁脾虚证模型大鼠胃排空及胃肠激素的影响

目的:本研究从胃排空的角度探讨柴枳和胃胶囊治疗功能性消化不良(FD)肝郁脾虚证的可能机制。方法:60只SD大鼠随机分为造模组50只和空白对照组10只。造模组大鼠采用限量营养法和夹尾刺激法建立功能性消化不良肝郁脾虚证模型。50只大鼠随机分为模型组、吗丁啉组及柴枳和胃胶囊大、中、小剂量组,每组10只。吗丁啉组给予2.7mg/kg吗丁啉灌胃,柴枳和胃胶囊大、中、小剂量组分别给予0.630、0.315、0.158g/kg剂量的柴枳和胃胶囊灌胃。空白组仅给予纯净水灌胃。检测大鼠体重、水量、食量、血清中一氧化氮(NO)、生长抑素(SS)、胃动素(MTL)含量、胃排空以及离体胃肌条活动指标。结果:柴枳和胃胶囊可降低血清中NO和SS含量,升高MTL含量,提高FD模型大鼠胃排空率,提高离体胃肌条运动振幅,提高食量及增加体重。结论:柴枳和胃胶囊对肝郁脾虚型功能性消化不良大鼠模型有明显的改善作用,其机制可能是通过改变血清中神经递质SS、NO、MTL的含量来实现。

枳术宽中胶囊联合莫沙必利对脾虚气滞型功能性消化不良患者胃肠激素、胃排空情况的影响

目的探究枳术宽中胶囊联合莫沙必利对脾虚气滞型功能性消化不良(FD)患者胃肠激素、胃排空情况的影响。方法选择2019年12月至2022年3月我院收治的102例脾虚气滞型FD患者为研究对象,按照随机数字表法将其分为对照组和观察组,各51例。对照组口服莫沙必利,观察组在对照组治疗基础上加服枳术宽中胶囊,均持续治疗1个月。比较两组的临床疗效、胃肠激素、胃排空情况及不良反应发生情况。结果观察组的治疗总有效率高于对照组(P<0.05)。治疗后,两组的促胃泌素(GAS)、血管活性肽(VIP)、胆囊收缩素(CCK)水平低于治疗前,胃动素(MTL)水平高于治疗前,且观察组优于对照组(P<0.05)。治疗后,两组的胃排空率高于治疗前,且观察组高于对照组(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P=0.402)。结论枳术宽中胶囊联合莫沙必利治疗脾虚气滞型FD患者效果显著,能够有效调节胃肠激素水平,加快胃排空,安全可靠,可于临床推广。

调气和胃汤联合针刺治疗脾虚气滞型功能性消化不良疗效及对患者胃肠激素的影响

目的:观察调气和胃汤联合针刺对脾虚气滞型功能性消化不良患者胃排空及血清胆囊收缩素(CCK)、胃动素(MTL)和生长激素释放肽(Ghrelin)水平的影响。方法:将98例脾虚气滞型功能性消化不良患者采用随机法分为对照组(n=49)和观察组(n=49)。对照组给予枸橼酸莫沙必利片联合针刺治疗,观察组在枸橼酸莫沙必利片基础上给予调气和胃汤联合针刺治疗,两组均连续治疗4周。比较两组胃肠动力指标、中医症状积分、肠道菌群及血清CCK、生长抑素(SS)、胃蛋白酶Ⅰ等相关因子水平,统计两组疗效。结果:治疗后,两组胃半排空和胃排空时间较治疗前缩短,小肠推进率较治疗前升高,2h存留率较治疗前降低(P<0.05);观察组治疗后胃半排空和胃排空时间短于对照组,小肠推进率高于对照组,2h存留率低于对照组(P<0.05)。治疗后,两组血清CCK、SS较治疗前降低,MTL、Ghrelin、胃蛋白酶Ⅰ、神经肽S受体1(NPSR1)较治疗前升高(P<0.05);观察组治疗后血清CCK、SS低于对照组,MTL、Ghrelin、胃蛋白酶Ⅰ、NPSR1高于对照组(P<0.05)。治疗后,两组肠杆菌、肠球菌、酵母菌数量较治疗前降低,且观察组治疗后更低(P<0.05)。治疗后,两组胃脘痞闷或胀痛、纳呆、早饱、疲乏、便溏、嗳气等中医症状积分较治疗前降低,且观察组治疗后中医症状积分低于对照组(P<0.05)。观察组总有效率为95.92%(47/49)高于对照组的83.67%(41/49),差异有统计学意义(P<0.05)。结论:调气和胃汤联合针刺可减轻脾虚气滞型功能性消化不良患者症状,调节胃肠激素和肠道菌群,促进胃排空,提高疗效。

升阳益胃汤对功能性消化不良患者近端胃舒张及胃排空功能的影响

目的:观察升阳益胃汤对功能性消化不良患者近端胃舒张以及胃排空功能的影响。方法:选择103例功能性消化不良患者为研究对象,采用随机数字表法分为观察组52例与对照组51例。对照组采用多潘立酮片治疗,观察组在对照组基础上联合升阳益胃汤治疗。均连续治疗2周。比较2组临床疗效及不良反应,比较2组治疗前后中医证候评分、近端胃舒张功能指标、胃排空功能以及血清胃动素(MTL)、胃泌素(GAS)水平。结果:观察组总有效率94.00%,高于对照组76.47%(P<0.05)。治疗后,2组胃脘胀痛或痞闷、疲乏无力、面色萎黄、嗳气呃逆、纳差食少、大便稀溏等中医证候评分均下降(P<0.05),且观察组低于对照组(P<0.05)。治疗后,2组胃底气体评分均降低(P<0.05),且观察组低于对照组(P<0.05)。治疗后,试餐饮用完毕后10 min(T_(2))、30 min(T_(3))、60 min(T_(4))时,2组近端胃容积均减小(P<0.05),且T_(3)、T_(4)时,观察组近端胃容积小于对照组(P<0.05)。治疗后,2组胃排空率均升高(P<0.05),且观察组高于对照组(P<0.05)。治疗后,2组MTL、GAS均升高(P<0.05),且观察组高于对照组(P<0.05)。结论:升阳益胃汤可有效改善功能性消化不良患者近端胃舒张、胃排空功能,缓解临床症状,提高临床疗效。

四磨汤对功能性消化不良大鼠CNP/NPR-B/cGMP信号通路的影响

目的 通过研究四磨汤对功能性消化不良(functional dyspepsia, FD)模型大鼠CNP/NPR-B/cGMP信号通路的影响,进一步探讨其作用机制。方法 将Wistar大鼠随机分为对照组、模型组、低浓度四磨汤组、中浓度四磨汤组、高浓度四磨汤组以及莫沙必利组。参考文献中的方法使用夹尾刺激联合不规则饮食14 d制备FD大鼠模型。造模结束后,四磨汤低、中、高浓度组大鼠分别灌胃1.8、2.4、3.6 g/(kg·d)剂量的四磨汤药液,莫沙必利组灌胃0.305 mg/(kg·d)剂量的莫沙必利药液,对照组和模型组给予等体积蒸馏水,给药14 d。观测大鼠体质量变化;酚红法检测大鼠胃排空率;碳粉法检测大鼠小肠推进率;ELISA法检测血清中胃动素(motilin, MTL)、胃泌素(gastrin, GAS)、胃窦平滑肌C型利钠肽(C-type natriuretic peptide, CNP)、环磷酸鸟苷(cyclic guanosine monophosphate, cGMP)的含量;RT-qPCR和Western blot分别检测胃窦平滑肌CNP、B型尿钠肽受体(type B urinary natriuretic peptide receptor, NPR-B)的基因和蛋白表达。结果 与对照组比较,模型组大鼠体质量降低(P<0.05),胃排空率与小肠推进率明显减弱(P<0.05),血清MTL、GAS含量降低(P<0.05),胃窦平滑肌CNP、cGMP含量升高(P<0.05),CNP、NPR-B的m RNA和蛋白表达增加(P<0.05)。与模型组相比,四磨汤各剂量组大鼠体质量显著增加(P<0.05),胃排空率和小肠推进率显著提高(P<0.05),血清MTL和GAS含量显著增加(P<0.05),胃窦平滑肌CNP、cGMP含量降低(P<0.05),CNP、NPR-B的mRNA和蛋白表达降低(P<0.05)。结论 四磨汤通过抑制CNP/NPR-B/c GMP信号通路以促进胃肠动力可能是其治疗FD的作用机制之一。

化浊解毒疏肝方联合治疗对肝郁型功能性消化不良患者的影响

目的:观察肝郁型功能性消化不良患者治疗后胃动力学超声造影情况。方法:选取2019年10月至2021年10月石家庄市人民医院门诊收治的肝郁型功能性消化不良(FD)患者96例作为研究对象,简单随机化法分为观察组和对照组,每组48例。均予以常规干预,对照组患者给予枸橼酸莫沙必利片治疗,观察组在对照组基础上给予化浊解毒疏肝方治疗。比较2组患者临床疗效,治疗前后中医症状积分、血清炎症介质及全胃腔容积、胃排空率超声情况。结果:治疗后,观察组临床总有效率为97.92%,对照组的临床总有效率为85.42%,观察组临床总有效率显著高于对照组(P<0.05)。治疗后,2组患者厌食、早饱、反酸、上腹疼痛、恶心呕吐等中医症状积分降低,血清肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)、白细胞介素-10(IL-10)水平降低,且观察组低于对照组(P<0.05)。2组患者全胃腔容积、胃排空率改善,且观察组全胃腔容积低于对照组,胃排空率高于对照组(P<0.05)。结论:化浊解毒疏肝方治疗肝郁型FD可改善胃肠炎症,促进胃肠运动,进而改善胃肠功能。

山楂-麦芽提取物、益生菌及其联合对高蛋白饮食小鼠胃肠道功能的影响

该研究建立高蛋白饮食诱导的食积小鼠模型,并使用干酪乳杆菌LH23、山楂-麦芽提取物以及两者联合对食积小鼠进行干预。结果表明:山楂-麦芽提取物与干酪乳杆菌联合作用于食积小鼠可使粪便含水量提高12.82%(P<0.01),胃残留率降低0.68%(P<0.05),小肠推进率提高19.48%(P<0.01),改善程度优于单独作用。同时两者联合干预还可以提高食积小鼠的胃泌素(gastrin,GAS)水平,提高率为21.28%(P<0.05);降低食积小鼠生长抑素(somatostatin,SS)水平,降低率为16.5%(P<0.05)。综上,山楂-麦芽提取物与干酪乳杆菌联合干预可通过减少高蛋白饮食小鼠胃内食物残留、促进肠道蠕动等作用显著改善高蛋白饮食诱导的食积症状。

针刺联合辨证中药汤剂治疗功能性消化不良患者的临床效果探讨

目的探究针刺联合辨证中药汤剂治疗功能性消化不良患者的临床效果。方法随机选取2019年3月—2021年5月东北林业大学医院收治的100例功能消化不良患者为研究对象,根据使用治疗的药物不同分为对照组和研究组,每组50例。对照组使用常规西药治疗,研究组使用针刺联合辨证中药汤剂治疗。比较两组患者治疗前后胃动力指标、消化不良症状评分、抑郁焦虑情绪评分及不良反应发生情况。结果治疗后,两组患者胃动力指标均升高研究组胃动力指标高于对照组,差异有统计学意义(P<0.05);治疗后,研究组消化不良症状评分低于对照组,差异有统计学意义(P<0.05);治疗后,研究组抑郁评分为(32.59±3.25)分低于对照组的(44.17±4.37)分,差异有统计学意义(t=15.035,P<0.05);研究组焦虑评分为(30.45±3.26)分低于对照组的(43.73±4.32)分,差异有统计学意义(t=17.351,P<0.05);治疗后,研究组不良反应总发生率为12.00%低于对照组的18.00%,差异无统计意义(χ^(2)=0.706,P>0.05)。结论针刺联合辨证中药汤剂治疗功能性消化不良患者能提高胃动力,改善消化不良症状,缓解抑郁焦虑情绪且安全可靠。

异功散对功能性消化不良大鼠胃肠动力和肠黏膜屏障功能的影响

目的观察异功散对功能性消化不良(FD)大鼠胃肠动力和肠黏膜屏障功能的影响,探讨其可能作用机制。方法将60只雄性SD大鼠随机分为对照组、模型组、多潘立酮组、异功散低剂量组、异功散中剂量组和异功散高剂量组,每组10只。除对照组外,其余组大鼠采用不规则喂食夹尾刺激法建立FD模型。刺激14 d后,多潘立酮组给予多潘立酮3.5 mg/(kg·d)灌胃,异功散低、中、高剂量组分别给予3 g/(kg·d)、6 g/(kg·d)、12 g/(kg·d)的异功散灌胃,对照组和模型组给予生理盐水灌胃,均1次/d,持续14 d。观察各组大鼠的一般情况、体重增量和食物摄入量,检测胃排空率和小肠推进率,HE染色观察胃窦组织的病理形态,ELISA法检测血清胃动素(MTL)、胃泌素(GAS)、血管活性肠肽(VIP)和降钙素基因相关肽(CGRP)水平,Western blot法检测十二指肠组织中闭合蛋白(Occludin)、紧密连接蛋白1(ZO-1)、连接黏附分子1(JAM-1)表达情况。结果与对照组比较,模型组大鼠活动减少,毛发润泽度、反应力均较差,体重增量、食物摄入量、胃排空率、小肠推进率、血清MTL和GAS水平及十二指肠组织中Occludin、ZO-1、JAM-1蛋白相对表达量均明显降低(P均<0.05),血清VIP和CGRP水平均明显增高(P均<0.05);大鼠胃窦黏膜层可见大量炎性细胞浸润,胃黏膜变薄、破裂。与模型组比较,多潘立酮组和异功散中、高剂量组大鼠灌胃后活动、毛发润泽度、反应力均明显改善,体重增量、食物摄入量、胃排空率、小肠推进率、血清MTL和GAS水平及十二指肠组织中Occludin、ZO-1、JAM-1蛋白相对表达量均明显增高(P均<0.05),血清VIP和CGRP水平均明显降低(P均<0.05);胃窦黏膜层仅见少量炎性细胞浸润。结论异功散可能通过调节脑肠肽的分泌和紧密连接相关蛋白的表达来改善胃肠动力、保护肠黏膜屏障,从而对FD起到保护作用。

针灸联合常规西药治疗功能性消化不良伴抑郁的效果观察

目的:观察针灸联合常规西药治疗功能性消化不良伴抑郁的效果。方法:选取2019年1—11月北京市昌平区中西医结合医院收治的92例功能性消化不良伴抑郁患者作为研究对象,采用随机数字表分为观察组与对照组,各46例。对照组采取常规西药治疗,观察组在对照组基础上采取针灸治疗。比较两组治疗效果。结果:治疗后,两组餐后饱胀不适、早饱、上腹不适积分低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率高于对照组,差异有统计学意义(P=0.028)。治疗后,两组汉密尔顿抑郁量表评分低于治疗前,且观察组低于对照组,胃排空率高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:针灸联合常规西药治疗功能性消化不良伴抑郁的效果显著,可减轻患者消化不良症状,促进胃排空,减轻抑郁程度。