Early detection and intervention in diabetic gastroparesis:Role of body surface gastric mapping

Diabetic gastrointestinal neuropathy is a diabetes-related complication,associated with a complex interplay of hyperglycemic damage,autoimmune responses,oxidative stress,gastrointestinal hormones,and vascular insufficiency.Patients with diabetes should be monitored and therapeutic intervention introduced to prevent neuropathy due to diabetes prior to“the point of no return”.Determining gastric bioelectrical activity by body surface gastric mapping may be a promising option to monitor diabetic gastrointestinal neuropathy.

A Case of Diabetic Nephropathy with Refractory Gastroparesis and Review of the Literature

Background: Gastroparesis is one of the complications of diabetes mellitus, and long-term gastroparesis seriously affects patients quality of life. Most of the patients can be relieved after lifestyle improvement and medication, but refractory gastroparesis is difficult to relieve, and is still a challenge in clinical treatment. Aim: To report a case of a patient with diabetic nephropathy combined with refractory gastroparesis, and to analyse the mechanism, diagnosis, severity grading, treatment of refractory gastroparesis in conjunction with a review of the literature, and to investigate the causes of recurrent nausea and vomiting in diabetic nephropathy patients with refractory diabetic gastroparesis and the possible effective treatment options. Case Presentation: The patient was hospitalised for recurrent nausea and vomiting and diagnosed with diabetic nephropathy and gastroparesis. Symptoms recurred after medication and peritoneal dialysis, and the patients symptoms were relieved after multifaceted interventions. Conclusion: Diabetic nephropathy and refractory gastroparesis can both manifest as digestive tract symptoms, and in the face of this complex disease, it is necessary to analyse the various etiological factors and take comprehensive treatment measures.

Xiangshaliujunzi Decoction for the treatment of diabetic gastroparesis: A systematic review

AIM: To assess the current clinical evidence of the effectiveness of Xiangshaliujunzi Decoction (XSLJZD) for the treatment of diabetic gastroparesis (DGP).

Combination of symptoms, syndrome and disease: Treatment of refractory diabetic gastroparesis

AIM: To assess effect of combination of symptoms, syndrome and disease on treatment of diabetic gastroparesis with severe nausea and vomiting.

Treatment of refractory diabetic gastroparesis: Western medicine and traditional Chinese medicine therapies

Refractory diabetic gastroparesis(DGP),a disorder that occurs in both type 1 and type 2 diabetics,is associated with severe symptoms,such as nausea and vomiting,and results in an economic burden on the health care system.In this article,the basic characteristics of refractory DGP are reviewed,followed by a discussion of therapeutic modalities,which encompasses the definitions and clinical manifestations,pathogenesis,diagnosis,and therapeutic efficacy evaluation of refractory DGP.The diagnostic standards assumed in this study are those set forth in the published literature due to the absence of recognized diagnosis criteria that have been assessed by an international organization.The therapeutic modalities for refractory DGP are as follows:drug therapy,nutritional support,gastricelectrical stimulation,pyloric botulinum toxin injection,endoscopic or surgical therapy,and traditional Chinese treatment.The therapeutic modalities may be used alone or in combination.The use of traditional Chinese treatments is prevalent in China.The effectiveness of these therapies appears to be supported by preliminary evidence and clinical experience,although the mechanisms that underlie these effects will require further research.The purpose of this article is to explore the potential of combined Western and traditional Chinese medicine treatment methods for improved patient outcomes in refractory DGP.

Effect of Electroacupuncture on Platelet-derived Growth Factor and the Ultrastructure of Mitochondria in Rats with Diabetic Gastroparesis

Objective To observe the effect of electroacupuncture(EA)at the pressure points Zu San Li(ST36),San Yin Jiao(SP6)and Liang Men(ST21)on platelet-derived growth factor(PDGF)and the ultrastructure of mitochondria in rats with diabetic gastroparesis(DGP).Methods Sixty Sprague Dawley(SD)rats were randomly separated into a normal control group(NC,n=10)and a modeling group(n=50).Rats in the modeling group received an injection of 2%streptozotocin(STZ)and a high-fat and highglucose diet for eight weeks to establish a DGP rat model.At the same time,blood glucose and a general symptom score were recorded every week.After modeling,30 successfully modeled rats were randomly separated into the following groups:the DGP group(n=10),the EA group(n=10)and the metoclopramide(MP)group(n=10).After three weeks of intervention,the gastrointestinal propulsive rate was measured by measuring the optical density(OD).The concentration of Ca2+was determined by fluorescence immunoassay,and levels of serum insulin(INS)and PDGF were determined by ELISA.The ultrastructure of mitochondria was observed with transmission electron microscopy.Results(1)After intervention,levels of blood glucose and the general symptom score were greatly decreased in the EA group compared to the DGP group(P<0.01).Compared with the DGP group,the gastric emptying rate and the intestinal propulsive rate of the EA group was significantly improved(P<0.01),and there was no statistically significant difference between the EA and the NC groups.(2)Compared with the NC group,the levels of INS in the DGP group markedly decreased(P<0.05),but there was no significant difference of INS levels between the EA and the MP roups.(3)Compared with the DGP group,theconcentration of Ca2+in the EA and the MP groups significantly increased(P<0.01,P<0.05,respectively).(4)Compared with the NC group,the average OD of PDGF in the DGP group was significantly higher(P<0.01).Compared with the DGP group,levels of PDGF in the EA group increased significantly(P<0.01).(5)There were abundant mitochondria with a clear structure and complete cristae in the NC group.However,in the DGP group,mitochondria were severely swollen,partly vacuolated,and cristae were either fractured,absent,or shortened.In the EA group,mitochondria were slightly swollen,with clear cristae.Conclusions Electroacupuncture at the points Zu San Li(ST36),San Yin Jiao(SP6)and Liang Men(ST21)may improve gastric motility in DGP by up-regulating the amount of PDGF and improving the ultrastructure of mitochondria.

Effectiveness and safety of traditional Chinese medicine decoction for diabetic gastroparesis:A network meta-analysis

BACKGROUND Diabetic gastroparesis(DGP)is a prevalent complication of diabetes that impairs people's quality of life and places a significant financial burden on them.The gastrointestinal symptoms of DGP patients can be improved by several Traditional Chinese Medicine(TCM)decoctions that have been shown to be effective in treating the disease.There are still many unanswered questions regarding the identification of appropriate therapeutic agents for the treatment of DGP in clinical practice.AIM To analyze the efficacy of several TCM decoctions in the treatment of DGP using Bayesian network meta-analysis for reference.METHODS PubMed,EMBASE,Cochrane Library,Web of Science,China National Knowledge Infrastructure,The China Biology Medicine DVD,Wanfang,and CQVIP were searched from inception to September 17,2022,to collect randomized controlled trials(RCTs)about TCM decoctions for DGP.Clinical effects and symptom scores were the primary outcomes.Additionally,we assessed motilin(MOT),somatostatin(SS),gastrin(GAS),gastric emptying rate,gastric emptying time,and adverse drug events as secondary outcomes.RESULTS A total of 67 eligible RCTs involving 4790 DGP patients and 7 TCM decoctions were included.The results of network meta-analysis(NMA)and surface under the cumulative ranking curve showed that with western medicine(WM)as a common control,the Banxia Xiexin Decoction(BXXD)+WM was most effective in clinical effects and enhancing early satiety scores;the Simo decoction(SMD)+WM was most effective in improving nausea and vomiting scores and anorexia scores,bloating scores;the Chaishao Liujunzi Decoction(CSLJD)was most effective in MOT,the Zhishi Xiaopi Decoction(ZSXPD)was most effective in SS and upgrading emptying rate;the Jianpi Xiaozhi Decoction was most effective in GAS;the CSLJD+WM was most effective in improving gastric emptying time.CONCLUSION These NMA results suggest that the BXXD+WM and SMD+WM may be one of the potential optimal treatments.Due to various limitations,further large-sample,double-blind,multi-center randomized RCTs are needed.

A meta-analysis of Wendan decoction in the treatment of diabetic gastroparesis

Objective To evaluate the clinical efficacy and safety of Wendan decoction in the treatment of diabetic gastroparesis (DGP). Methods PubMed, MEDLINE, The Cochrane Library, Embase, China Biology Medicine (CBM), Chinese National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP) and Wanfang databases were searched and eligible randomized controlled clinical trials (RCTs) were included. The quality of the RCTs was evaluated by the Cochrane risk of bias assessment tool, and data analysis were performed with Review Manager 5.3. Results A total of 7 studies were included, including 533 patients. Meta analysis results showed that the effective rate of Wendan decoction in the treatment of diabetic gastroparesis was better than that of the control group [RR=1.30, 95%CI (1.20, 1.40), P<0.001], and the improvement of fasting blood glucose (FBG) was better than that of western medicine [MD =-0.43, 95%CI (-0.91,-0.01), P=0.05]. The recurrence rate in the TCM treatment group was lower than that in the western medicine group[RR = 0.29, 95%CI (0.13, 0.62), P=0.002]. Conclusion Compared with western medicine, Wendan decoction has better curative effect on DGP and can reduce its recurrence rate. However, due to the low quality of the included literatures and the possibility of bias, large-scale and high-quality RCTs are still needed for further confirmation.

ER stress and ER stress-induced apoptosis are activated in gastric SMCs in diabetic rats

AIM: To investigate the gastric muscle injury caused by endoplasmic reticulum (ER) stress in rats with diabetic gastroparesis.

Atrial natriuretic peptide signal pathway upregulated in stomach of streptozotocin-induced diabetic mice

AIM:To investigate atrial natriuretic peptide(ANP) secretion from gastric mucosa and the relationship between the ANP/natriuretic peptide receptor type A (NPR-A)pathway and diabetic gastroparesis. METHODS:Male imprinting control region(ICR)mice (4 wk old)were divided into two groups:control mice, and streptozotocin-induced diabetic mice.Eight weeks after injection,spontaneous gastric contraction was recorded by using physiography in control and streptozotocin-induced diabetic mice.The ANP-positive cells in gastric mucosa and among dispersed gastric epithelial cells were detected by using immunohistochemistry and flow cytometry,respectively.ANP and natriureticpeptide receptor type A(NPR-A)gene expression in gastric tissue was observed by using the reverse transcriptase polymerase chain reaction. RESULTS:The frequency of spontaneous gastric contraction was reduced from 12.9±0.8 cycles/min in the control group to 8.4±0.6 cycles/min in the diabetic mice(n=8,P<0.05).However,the amplitude of contraction was not significantly affected in the diabetic group.The depletion of interstitial cells of Cajal in the gastric muscle layer was observed in the diabetic mice.ANP-positive cells were distributed in the gastric mucosal layer and the density index of ANP-positive cells was increased from 20.9±2.2 cells/field in control mice to 51.8±2.9 cells/field in diabetic mice(n=8, P<0.05).The percentage of ANP-positive cells among the dispersed gastric epithelial cells was increased from 10.0%±0.9%in the control mice to 41.2%± 1.0%in the diabetic mice(n=3,P<0.05).ANP and NPR-A genes were both expressed in mouse stomach, and the expression was significantly increased in the diabetic mice. CONCLUSION:These results suggest that the ANP/ NPR-A signaling pathway is upregulated in streptozotocin-induced diabetic mice,and contributes to the development of diabetic gastroparesis.

C-type natriuretic-peptide-potentiated relaxation response of gastric smooth muscle in streptozotocin-induced diabetic rats

AIM: To study the sensitivity of gastric smooth muscle to C-type natriuretic peptide (CNP) in streptozotocin (STZ)-induced diabetic rats. METHODS: The spontaneous contraction of a gastric smooth muscle strip was recorded by using physiological methods in rats. The expressions of CNP and natriuretic peptide receptor-B (NPR-B) in gastric tissue were examined by using immunohistochemistry techniques in the diabetic rat. RESULTS: At 4 wk after injection of STZ and vehicle, the frequency of spontaneous contraction of gastric smooth muscle was significantly reduced in diabetic rats, and the frequency was decreased from 3.10 ± 0.14 cycle/min in controls to 2.23 ± 0.13 cycle/min (n = 8, P < 0.01). However, the amplitude of spontaneous contraction was not significant different from the normal rat. CNP significantly inhibited spontaneous contraction of gastric smooth muscle in normal and diabetic rats, but the inhibitory effect was significantly potentiated in the diabetic rats. The amplitudes of spontaneous contraction were suppressed by 75.15% ± 0.71% and 58.92% ± 1.32% while the frequencies were decreased by 53.33% ± 2.03% and 26.95% ± 2.82% in diabetic and normal rats, respectively (n = 8, P < 0.01). The expression of CNP in gastric tissue was not changed in diabetic rats, however the expression of NPR-B was significantly increased in diabetic rats, and the staining indexes of NPR-B were 30.67 ± 1.59 and 17.63 ± 1.49 in diabetic and normal rat, respectively (n = 8, P < 0.01).CONCLUSION: The results suggest that CNP induced an inhibitory effect on spontaneous contraction of gastric smooth muscle, potentiated in diabetic rat via up-regulation of the natriuretic peptides-NPR-B-particulate guanylyl cyclase-cyclic GMP signal pathway.

Superior mesenteric artery syndrome in a diabetic patient with acute weight loss

Superior mesenteric artery(SMA)syndrome is an un- common disease resulting compression of the third portion of the duodenum from the superior mesenteric artery.This disease shares many common manifestations with diabetic gastroparesis,including postprandial fullness,nausea,vomiting,and bloating.Therefore,it is often overlooked in diabetic patients.Here,we report a 41-year-old man with poorly controlled diabetic mellitus who developed SMA syndrome due to rapid weight loss. The diagnosis was confirmed by computed tomography and an upper gastrointestinal series.His condition improved after parenteral nutrient,strict sugar control, and gradual weight gain.

Diabetic gastroenteropathy:An underdiagnosed complication

This article is an extensive review that provides an update on the pathophysiology,symptoms,diagnosis,and treatment of diabetic gastroenteropathy.There is no reported prevalence,but it has been described that patients with type 1 diabetes have a cumulative incidence at 10 years of 5.2%,and type 2 patients,1%.Also,in the group of type 1 diabetes,it has been observed that women are more likely to present this condition(5.8%vs 3.5%).Many factors are associate with its development(e.g.,hyperglycemia,vagal dysfunction,loss of expression of neural nitric oxide synthase in the myenteric plexus,alterations in the Cajal interstitial cell network,and oxidative stress).Gastrointestinal discomfort could be perceived 70% higher in diabetic patients,describing that 25%of diabetic patients experience gastrointestinal symptoms.Diabetic enteropathy could affect any portion of the gastrointestinal tract,but esophageal alterations were described in more than 60% of diabetic patients,also 60% of them present constipation,and 20%,diarrhea.Gastric emptying scintigraphy is useful to evaluate gastroparesis,therefore,gastric retention of more than 60%at 2 h has a sensitivity of 100% and specificity of 20% for diagnosis;however,other studies such as breath tests,with a sensitivity of 89% and a specificity of 80%,or the endoscopic capsule contribute to the diagnosis.There is no cure;however,management must be multidisciplinary,focused on slowing the progression of diabetic gastroenteropathy,reducing symptoms,and restoring function;that includes nutritional recommendation,maintain glucose levels kept below 180 mg/dL,use of prokinetics,anti-emetics;nowadays,it has been special interest in surgical treatment,such as pyloroplasty,also gastric electrical stimulation appears to be another alternative.

Gastric nNOS reduction accompanied by natriuretic peptides signaling pathway upregulation in diabetic mice

AIM: To investigate the relationship between neuronal nitric oxide synthase (nNOS) expression and the natriuretic peptide signaling pathway in the gastric fundus of streptozotocin (STZ)-induced diabetic mice.

Effect of acupuncture combined with Chinese medicine on the expression of interstitial cells of Cajal, substance P and nerve nitric oxide synthase in diabetic mice with gastroparesis antrum

Objective To explore the effect of acupuncture combined with Chinese medicine on expression of interstitial cells of Cajal（ICC）, substance P（SP） and nerve nitric oxide synthase（nNOS） in diabetic gastroparesis mice. Methods Eighty Kunming male mice were randomly divided into normal group（group A, 15 mice）, diabetic gastroparesis model mice group（group B, 12 mice）, acupuncture combined with Chinese medicine group（group C, 12 mice）, Chinese medicine group（group D, 13 mice） and western medicine group（group E, 13 mice）. The mice were intraperitoneally injected with steptozotocin and fed with high-fat diet-induced irregular except the normal group mice, that made mouse model of diabetic gastroparesis. And then, the ACM group were treated by acupuncture at the acupoints of Housanli（后三里 ST 36） and Zhōngw n（中脘 CV 12） combined with Chinese medicine, the CM group were only treated by Chinese medicine; the WM group were treated by domperidone and vitamin B 6. Numbers and expression of ICC, SP and n NOS were detected by immunohistochemical methods. Results After treatment, compared with normal group, ICC and SP indexes of model group were significantly reduced. Compared with model group, all indexes in ACM and CM groups were improved significantly（P0.05, P0.01）, but only the positive area and average optical density value in c-Kit and SP in WM group increased obviously（P0.05）. Compared with ACM group, no significant difference in c-Kit and SP of CM group were observed（P0.05）, but expression of nNOS were increased markedly（P0.01）. Besides, c-Kit and SP expressions of WM group were significantly induced was increased remarkably（P0.01）. Conclusion Acupuncture combined with Chinese medicine have much better therapeutic effects for diabetic gastroparesis mice, which may be due to repairing ICC damage, upregulating the expression of SP and lowering the expression of nNOS.

孤啡肽对DGP胃动力的影响

目的:探讨糖尿病胃轻瘫(DGP)大鼠血浆孤啡肽(OFQ)的变化与胃轻瘫的关系及意义.研究孤啡肽对DGP胃排空的作用.方法:SPF级雄性Wistar大鼠90只随机分为正常对照组(n=15)和实验组(n=75).正常对照组以普通饲料喂养20wk,实验组以高脂高糖饲料喂养6wk后小剂量链脲佐菌素(STZ)腹腔注射加高糖高脂饲料及饮食失节法继续诱导20wk,建立糖尿病模型.应用放射性核素胃排空法筛检出DGP及糖尿病(DM)大鼠模型.采用酶联免疫法测定空腹血浆OFQ,而后将DGP再随机分为3组,分别给予OFQ0.6,6.0,60.0nmol/kg静脉注射,每日1次,连续5d,再次测定胃排空.结果:正常对照组、DM组及DGP组胃半排空时间(GET1/2)分别为(61.9±4.6),(66.5±2.3),(168.9±10.6)min,DGP组GET1/2较正常对照组、DM组显著延迟,差异有统计学意义(P<0.05).DGP组血浆OFQ较正常对照组、DM组显著降低,差异有统计学意义[(5.30±1.70)ng/Lvs(9.83±5.70),(8.90±3.50)ng/L,P<0.05].相关性分析显示,血浆OFQ水平与胃轻瘫之间呈负相关关系(r=-0.6726,P=0.004).DGP大鼠静脉注射OFQ0.6,6.0,60.0nmol/kg后胃半排时间较前有明显缩短[(136±7)vs(166±8)min,(101±12)vs(162±11)min,(112±10)vs(158±12)min,P<0.05],治疗前后差异有统计学意义(P<0.05),其中6.0nmol/kg的剂量已经接近或达到最大治疗效果,增加OFQ剂量并不能相应提高其治疗效果.结论:OFQ在DGP中起着重要的调节作用,与DGP胃半排时间呈负相关.静脉注射OFQ可以明显缩短DGP大鼠的GET1/2,其中6.0nmol/kg的剂量已经接近或达到最大治疗效果.

曲美布汀联合多潘立酮治疗DGP引起的胃轻瘫的临床效果

目的:探讨曲美布汀联合多潘立酮治疗糖尿病胃轻瘫(diabetic gastroparesis,DGP)的临床疗效.方法:按照随机数字表法将武汉市普爱医院收治的86例DGP患者均分为实验组和对照组,实验组给予曲美布汀联合多潘立酮治疗,对照组仅给予多潘立酮治疗,比较两组患者疗程结束后临床疗效、治疗前后胃固体半排空时间(gastric solid half emptying time,GET1/2)、不良反应发生情况以及随访2 mo复发情况.结果:实验组患者治疗总有效率显著高于对照组(93.02%vs 74.42%),差异具有统计学意义(P<0.05);两组患者治疗后GET1/2均显著下降,与治疗前比较,(124.49 min±23.05min vs 225.62 min±21.88 min,199.46 min±23.49 min vs 222.62 min±19.08 min),差异具有统计学意义(P<0.05);实验组患者治疗后GET1/2显著低于对照组(124.49 min±23.05min vs 199.46 min±23.49 min),差异具有统计学意义(P<0.05);两组患者用药后不良反应发生率比较(0.00%vs 4.65%),差异无统计学意义(P>0.05);实验组患者随访2 mo复发率显著低于对照组(13.95%vs 51.16%),差异有统计学意义(P<0.05).结论:曲美布汀联合多潘立酮治疗可有效改善DGP患者临床症状及GET1/2,临床疗效显著,应用和推广价值较高.

糖胃康对DGP大鼠非酶糖基化终产物(AGEs)的影响

目的:观察糖胃康对DGP大鼠非酶糖基化终产物(AGEs)的影响。方法:将60只大鼠分为模型组、正常组、对照组、糖胃康高、中、低剂量组,每组10只,模型组、对照组及糖胃康高、中、低剂量组分别给以高热量饮食喂养,正常组大鼠予标准饮食喂养。1月后糖胃康高、中、低剂量组分别以浓度为48 g/kg、24 g/kg、12 g/kg药液10 mL/kg灌胃;模型组,正常组给予等量生理盐水灌胃。对照组每天糖脉康灌胃,10 mL/kg。8周后Brownlee法测定大鼠胃平滑肌AGEs含量。结果:糖胃康各治疗组、模型组和糖脉康对照组大鼠胃平滑肌AGEs含量均明显高于正常组(P<0.01);糖胃康高、中、低剂量组及糖脉康对照组大鼠胃平滑肌AGEs含量均显著低于模型组(P<0.05或P<0.01);糖胃康中、低剂量组与糖脉康对照组组间无显著性差异(P>0.05);糖胃康高剂量组大鼠胃平滑肌AGEs含量明显低于糖胃康中、低剂量组和糖脉康组(P<0.01或P<0.05)。结论:糖胃康有显著抑制DGP大鼠非酶糖基化终产物的作用,且呈一定的量效关系。

Gastrointestinal complications of diabetes mellitus

Diabetes mellitus affects virtually every organ system in the body and the degree of organ involvement depends on the duration and severity of the disease,and other co-morbidities.Gastrointestinal(GI) involvement can present with esophageal dysmotility,gastro-esophageal reflux disease(GERD),gastroparesis,enteropathy,non alcoholic fatty liver disease(NAFLD) and glycogenic hepatopathy.Severity of GERD is inversely related to glycemic control and management is with prokinetics and proton pump inhibitors.Diabetic gastroparesis manifests as early satiety,bloating,vomiting,abdominal pain and erratic glycemic control.Gastric emptying scintigraphy is considered the gold standard test for diagnosis.Management includes dietary modifications,maintaining euglycemia,prokinetics,endoscopic and surgical treatments.Diabetic enteropathy is also common and management involves glycemic control and symptomatic measures.NAFLD is considered a hepatic manifestation of metabolic syndrome and treatment ismainly lifestyle measures,with diabetes and dyslipidemia management when coexistent.Glycogenic hepatopathy is a manifestation of poorly controlled type 1 diabetes and is managed by prompt insulin treatment.Though GI complications of diabetes are relatively common,awareness about its manifestations and treatment options are low among physicians.Optimal management of GI complications is important for appropriate metabolic control of diabetes and improvement in quality of life of the patient.This review is an update on the GI complications of diabetes,their pathophysiology,diagnostic evaluation and management.

Analysis of the Relationship between Helicobacter pylori Infection and Diabetic Gastroparesis

Background： Whether Helicobacter pylori infection is associated with diabetic gastroparesis （DGP） is unclear. This study aimed to investigate the potential correlation between H. pylori infection and DGP. Methods： In this study, 163 patients with type 2 diabetes mellitus and 175 nondiabetic patients who were treated in our department were divided into DGP, simple diabetes, non-DGP （NDG）, and normal groups based on their conditions. The H. pyh）ri infection rate in each group was calculated. H. pylori eradication therapy was performed for patients with H. pylori infection in each group. The eradication rates were compared between the groups, and the improvements in gastroparesis-associated symptoms were compared before and after treatment in patients with DGP. Results： The tl. pylori infection rate was 74.6% in the DGP group, which was significantly higher than that in the simple diabetes （51.1%, P 〈 0.01）, NDG （57.7%, P 〈 0.05）, and normal groups （48.0%, P 〈 0.01）. With increased disease course, the incidence of DGP and the H. pylori infection rate gradually increased （P 〈 0.05）. In the DGP group, the incidences of upper abdominal pain and distention, early satiety, and anorexia were 75.5%, 66.0%, and 67.9%, respectively, before eradication treatment; and 43.4%, 35.8%, and 39.6%, respectively, after eradication treatment, and the difference was statistically significant （P 〈 0.01）. In patients with DGP with successful H. pylori eradication, the number of barium strips discharged after eradication was 5.9 ± 1.0, which was significantly larger than that before treatment （4.1 ± 0.7, P 〈 0.01）. In addition, the number of barium strips discharged was significantly larger in patients with DGP with successful H. pylori eradication than those with failed H. pylori eradication （P 〈 0.01 ）. Conclusions： DGP development might be associated with H. pylori infection. H. pylori eradication can effectively improve dyspepsia-associated symptoms and delayed gastric emptying in patients with DGP.