- 期刊
Efficacy of Cisapride on Gastric Emptying and Dyspeptic Symptoms in Patients with Gastroparesis
Cisapride對胃輕癱患者之胃排空及消化不良症狀之效果
摘要
Cisapride為一不經由阻斷度巴明接受體器(dopaminergic receptor)的消化道蠕動促進劑。其作用乃選擇性地使腸肌神經叢(myenteric plexus)釋放出乙醯膽素(acetylcholine)。 為了評估cisapride的療效，我們對26位經核醫測量確定為胃輕癱同時合併中等度以上消化不良症狀之患者（含17位慢性特發性消化不良症及9位糖尿病患者），以安慰劑為對組照做一隨機安排試驗比較其療效。固體食物的胃排空以2mCi Tc-99m sulfur colloid標記的雞蛋測 定。治療組共14位（9位慢性特發性消化不良症，5位糖尿病患者），接受為期四週每天三餐飯前15分鐘口服10mg cisapride，其餘12位（8位慢性特發性消化不良症，4位糖尿病患者）口服安慰劑。兩組在治療前的性別、體重、症狀的嚴重度及胃排空時間並無統計學上有意義之差異。治療達二週及四週後再對共症狀以積分法做一客觀的評估，並同時在四週時再測定胃排空時間。 結果發現cisapride對胃排空的速率有明顯的增加，與安慰劑比較有統計學上的差異。對症狀的改善亦明顯的優於安慰劑組，尤其是腹脹、上腹痛、易飽及厭食方面統計上的差異更明顯。本研究顯示cisapride為一良好的上消化道蠕動促進劑。
並列摘要
Cisapride, a new prokinetic devoid of anti-dopaminergic properties, acts by enhancing release of acetycholine from the myenteric plexus. To evaluate the effect of cisapride on gastric emptying and dyspeptic symptoms, a randomized placebo-controlled study was done. Twenty-six dyspeptic patients with gastric stasis (17 with chronic idiopathic dyspepsia (CID) and 9 with diabetes, mellitus (DM)) were included. Solid meal radioisotope technique using Tc-99m sulfur colloid labeled-eggs, was used to determine gastric emptying. Fourteen patients (9 CID, 5 DM were treated with cisapride 10mg tid orally for four weeks, while the other 12 patients (8 CID, 4 DM) served as the control. Symptoms were evaluated at baseline and after 2 and 4 weeks of treatment. The gastric emptying study was repeated at the end of the study. Our results showed that cisapride was significantly superior to placebo in accelerating gastric emptying halftime (p=0.002) and in relieving symptoms of epigastric fullness, epigastric pain, anorexia and early satiety (p＜0.05). This study showed that cisapride is a useful gastrokinetic for dyspeptic patients with upper gut dysmotility.
延伸閱讀
- 張光雄（2010）。AB>A+B（「明通漢胃散」止胃痛之效果）。明通醫藥，(406)，1-3。https://doi.org/10.29687/MTMJ.201010.0001
- 高尚君（2019）。質子幫浦抑制劑在治療胃食道逆流之臨床成效及醫療資源耗用之探討〔碩士論文，高雄醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0011-1807201914460000
- 陳昭姿（1988）。Ranitidine（Zantac®）～消化性潰瘍之首選藥品之一～。當代醫學，(177)，581-582。https://doi.org/10.29941/MT.198807.0013
- 黃家麗、董婉君、謝伶瑜（2018）。探討咀嚼口香糖與穴位按壓對結直腸切除術後病人腸道功能恢復之成效。嘉基護理，18(2)，1-11。https://www.airitilibrary.com/Article/Detail?DocID=1816661x-201812-201812270016-201812270016-1-11
- Chang, C. S., Chen, G. H., Kao, C. H., Wang, Y. L., & Wang, S. J. (1992). Domperidone對非潰瘍性消化不良療效之雙盲性試驗. 中華民國消化系醫學會雜誌, 9(2), 137-143. https://doi.org/10.6557/GJTa.199206_9(2).0005