中华全科医师杂志
中華全科醫師雜誌
중화전과의사잡지
Chinese Journal of General Practitioners
2015年
10期
760-764
,共5页
马刚%戴伟杰%严伟%张红
馬剛%戴偉傑%嚴偉%張紅
마강%대위걸%엄위%장홍
糖尿病%胃肌轻瘫%苯甲酰胺类%硫辛酸
糖尿病%胃肌輕癱%苯甲酰胺類%硫辛痠
당뇨병%위기경탄%분갑선알류%류신산
Diabetes mellitus%Gastroparesis%Tiapride%Thioctic acid
目的 观察盐酸依托必利联合α-硫辛酸治疗糖尿病胃轻瘫患者(DGP)的疗效以及对患者胃功能的影响.方法 纳入有上消化道症状的DGP患者110例,患者均知情同意.掷骰子法将患者随机分为联合用药组和对照组.联合用药组60例患者,给予盐酸依托必利50 mg饭前口服,3次/d,α-硫辛酸0.6g溶于250 ml 0.9％ NaC1溶液中,避光静脉滴注;对照组50例患者,给予盐酸依托必利50 mg饭前口服,3次/d,均治疗2周.统计患者餐后上腹饱胀、嗳气、反酸、厌食、恶心呕吐等临床症状的积分,计算胃排空率,并检测血浆胃动素和血清胃泌素水平的变化.结果 两组DGP患者治疗后,联合用药组临床症状评分[(4.62±3.46)分比(12.26±3.43)分]、对照组临床症状评分[(5.43±3.65)分比(12.31±3.37)分]均降低,联合用药组患者临床症状改善的总有效率高于对照组(91.6％比78.0％,x2=4.098,P＜0.05).两组DGP患者治疗后,联合用药组胃排空率[(76.9±9.7)％比(37.3±10.2)％]、对照组胃排空率[(57.2±10.4)％比(36.8±11.2)％]均高于治疗前,联合用药组较对照组胃排空改善程度更明显(t =10.221,P＜0.01).治疗后,联合用药组血浆胃动素水平[(554.0 ±67.6) ng/L比(640.2±64.4)ng/L]、血清胃泌素水平[(96.8±22.2) ng/L比(152.6±20.3)ng/L]、对照组血浆胃动素水平[(589.4±48.3) ng/L比(636.3±66.4) ng/L]、血清胃泌素水平[(120.9±19.7) ng/L比(153.5±19.4) ng/L]均低于治疗前,联合用药组血浆胃动素、血清胃泌素水平下降较对照组更为显著(t值分别为3.100、5.959,均P＜0.05).结论 盐酸依托必利和α-硫辛酸联合用药能改善DGP患者的临床症状,提高胃排空率,降低血浆胃动素和血清胃泌素水平,疗效优于依托必利单药治疗.
目的 觀察鹽痠依託必利聯閤α-硫辛痠治療糖尿病胃輕癱患者(DGP)的療效以及對患者胃功能的影響.方法 納入有上消化道癥狀的DGP患者110例,患者均知情同意.擲骰子法將患者隨機分為聯閤用藥組和對照組.聯閤用藥組60例患者,給予鹽痠依託必利50 mg飯前口服,3次/d,α-硫辛痠0.6g溶于250 ml 0.9％ NaC1溶液中,避光靜脈滴註;對照組50例患者,給予鹽痠依託必利50 mg飯前口服,3次/d,均治療2週.統計患者餐後上腹飽脹、噯氣、反痠、厭食、噁心嘔吐等臨床癥狀的積分,計算胃排空率,併檢測血漿胃動素和血清胃泌素水平的變化.結果 兩組DGP患者治療後,聯閤用藥組臨床癥狀評分[(4.62±3.46)分比(12.26±3.43)分]、對照組臨床癥狀評分[(5.43±3.65)分比(12.31±3.37)分]均降低,聯閤用藥組患者臨床癥狀改善的總有效率高于對照組(91.6％比78.0％,x2=4.098,P＜0.05).兩組DGP患者治療後,聯閤用藥組胃排空率[(76.9±9.7)％比(37.3±10.2)％]、對照組胃排空率[(57.2±10.4)％比(36.8±11.2)％]均高于治療前,聯閤用藥組較對照組胃排空改善程度更明顯(t =10.221,P＜0.01).治療後,聯閤用藥組血漿胃動素水平[(554.0 ±67.6) ng/L比(640.2±64.4)ng/L]、血清胃泌素水平[(96.8±22.2) ng/L比(152.6±20.3)ng/L]、對照組血漿胃動素水平[(589.4±48.3) ng/L比(636.3±66.4) ng/L]、血清胃泌素水平[(120.9±19.7) ng/L比(153.5±19.4) ng/L]均低于治療前,聯閤用藥組血漿胃動素、血清胃泌素水平下降較對照組更為顯著(t值分彆為3.100、5.959,均P＜0.05).結論 鹽痠依託必利和α-硫辛痠聯閤用藥能改善DGP患者的臨床癥狀,提高胃排空率,降低血漿胃動素和血清胃泌素水平,療效優于依託必利單藥治療.
목적 관찰염산의탁필리연합α-류신산치료당뇨병위경탄환자(DGP)적료효이급대환자위공능적영향.방법 납입유상소화도증상적DGP환자110례,환자균지정동의.척투자법장환자수궤분위연합용약조화대조조.연합용약조60례환자,급여염산의탁필리50 mg반전구복,3차/d,α-류신산0.6g용우250 ml 0.9％ NaC1용액중,피광정맥적주;대조조50례환자,급여염산의탁필리50 mg반전구복,3차/d,균치료2주.통계환자찬후상복포창、애기、반산、염식、악심구토등림상증상적적분,계산위배공솔,병검측혈장위동소화혈청위비소수평적변화.결과 량조DGP환자치료후,연합용약조림상증상평분[(4.62±3.46)분비(12.26±3.43)분]、대조조림상증상평분[(5.43±3.65)분비(12.31±3.37)분]균강저,연합용약조환자림상증상개선적총유효솔고우대조조(91.6％비78.0％,x2=4.098,P＜0.05).량조DGP환자치료후,연합용약조위배공솔[(76.9±9.7)％비(37.3±10.2)％]、대조조위배공솔[(57.2±10.4)％비(36.8±11.2)％]균고우치료전,연합용약조교대조조위배공개선정도경명현(t =10.221,P＜0.01).치료후,연합용약조혈장위동소수평[(554.0 ±67.6) ng/L비(640.2±64.4)ng/L]、혈청위비소수평[(96.8±22.2) ng/L비(152.6±20.3)ng/L]、대조조혈장위동소수평[(589.4±48.3) ng/L비(636.3±66.4) ng/L]、혈청위비소수평[(120.9±19.7) ng/L비(153.5±19.4) ng/L]균저우치료전,연합용약조혈장위동소、혈청위비소수평하강교대조조경위현저(t치분별위3.100、5.959,균P＜0.05).결론 염산의탁필리화α-류신산연합용약능개선DGP환자적림상증상,제고위배공솔,강저혈장위동소화혈청위비소수평,료효우우의탁필리단약치료.
Objective To evaluate the efficacy of itopride hydrochloride combined with alpha-lipoic acid in treatment of diabetic gastroparesis.Methods One hundred and ten patients with diabetic gastroparesis were randomly assigned to two groups.Sixty patients received α-lipoic acid plus itopride (α-lipoic acid 0.6 g intravenously for 14 d plus itopride 50 mg orally t.i.d), and 50 cases received oral itopride only.The clinical symptoms including postprandial abdominal fullness, belching, acid reflux, anorexia, nausea and vomiting were observed;the gastric emptying rate was tested, and plasma motilin and serum ganstrin levels were measured groups, before and after two weeks of treatment.Results The clinical symptom scores of combination therapy group (4.62 ± 3.46 vs.12.26-± 3.43) and control groups (5.43-± 3.65 vs.12.31-± 3.37) were improved after treatment.The overall effective rate of combination group was 91.6％ and that of itopride therapy group was 78.0％ (x2 =4.098, P ＜ 0.05).Gastric emptying rate of combination group [(76.9 ± 9.7) ％ vs.(37.3 ± 10.2) ％] was increased more markedly than that ofitopridegroup[(57.2-± 10.4)％ vs.(36.8-± 11.2)％] (t =10.221, P ＜0.05).Plasma motilin and serum ganstrin levels in combination group [(640.2 ± 64.4) ng/L vs.(554.0 ± 67.6) ng/L, (152.6 ± 20.3)ng/L vs.(96.8 ± 22.2)ng/L] were reduced more markedly than those in itopride group [(636.3 ±66.4)ng/L vs.(589.4 48.3)ng/L, (153.5-± 19.4) ng/L vs.(120.9 ± 19.7)ng/L] respectively (t =3.100, 5.959, all P ＜ 0.05).Conclusion For patients with diabetic gastroparesis, α-lipoic acid and itopride combination therapy can significantly improve symptoms and gastric emptying rate, decrease motlin and gastrin levels;and the efficacy of combination therapy is better than that of itopride monotherapy.
