伊托必利、多潘立酮和甲氧氯普胺联合用药对FD患者胃肠功能和Ghrelin表达的影响  

Combined treatment with itopride, domperidone and metoclopramide improves gastrointestinal function and upregulates serum ghrelin level in patients with functional dyspepsia

作　　者：李娜[1] 徐珞[1] 

机构地区：[1]青岛大学医学院病理生理教研室,山东省青岛市266021

出　　处：《世界华人消化杂志》2010年第6期596-600,共5页World Chinese Journal of Digestology

基　　金：国家自然科学基金资助项目;No.30470642;No.30670780;山东省科技攻关基金资助项目;No.2008GG10002006;山东省卫生厅基金资助项目;No.2007HZ026;青岛市科技局基金资助项目;No.05-1-JC-93~~

摘　　要：目的:研究伊托必利、多潘立酮和甲氧氯普胺联合应用对功能性消化不良(FD)患者胃肠功能和Ghrelin含量的影响.方法:以FD患者为研究对象,依据罗马Ⅱ标准,将符合纳入标准的患者120例随机分为6组,分别给予盐酸伊托必利,多潘立酮,甲氧氯普胺,以及联合用药给予盐酸伊托必利+多潘立酮,盐酸伊托必利+甲氧氯普胺和多潘立酮+甲氧氯普胺,观察用药前后各临床症状积分改善程度、胃肠排空率及血清Ghrelin的水平改变.结果:各组FD患者服药后消化不良等症状均明显改善,在症状缓解率,联合用药组明显优于单独用药组(P<0.01);在胃排空率,各联合用药组明显优于单独用药组(54.26%±18.57%,55.12%±18.22%,47.17%±15.21%vs36.23%±11.68%,32.16%±10.08%,32.24%±10.12%,均P<0.01);在肠排空率,联合用药组中伊托必利+多潘立酮组和伊托必利+甲氧氯普胺组明显优于多潘立酮+甲氧氯普胺组(89.27%±11.36%,88.67%±13.25%vs69.16%±19.26%,均P<0.01);单独用药组中伊托必利明显优于多潘立酮或甲氧氯普胺(78.23%±12.56%vs58.96%±12.20%,58.33%±12.57%,P<0.01);但伊托必利单独用药明显优于多潘立酮+甲氧氯普胺联合用药(P<0.05).FD患者血清Ghrelin水平明显降低(P<0.05).经药物治疗后Ghrelin水平明显回升,联合用药组明显高于单独用药组(P<0.05或0.01).结论:伊托必利、多潘立酮和甲氧氯普胺联合用药比单独用药更有效,可显著改善FD患者的胃肠动力,该功能可能与血清ghrelin水平改变有关.AIM： To investigate the effects of combined treatment with itopride, domperidone and metoclopramide on digestive function, gastrointestinal emptying and serum ghrelin level in patients with functional dyspepsia （FD）. METHODS： One hundred and twenty FD patients were divided into six groups according tothe Rome II criteria： those treated with itopride, domperidone and metoclopramide, alone or in double combination. The clinical symptoms, gastrointestinal emptying rate and serum ghrelin level were observed before and after treatment. RESULTS： The symptoms of FD patients were significantly improved after each treatment. The symptomatic relief rates achieved in the combination groups were much better than those in single-drug groups （all P 0.01）. The gastric emptying rates achieved in the combina-tion groups were also much better than those in single-drug groups （54.26% ± 18.57%, 55.12% ± 18.22% and 47.17% ± 15.21% vs 36.23% ± 11.68%, 32.16% ± 10.08% and 32.24% ± 10.12%, respec-tively; all P 0.01）. The intestinal emptying rates in the itopride plus domperidone group and the itopride plus metoclopramide group were much better than that in the domperidone plus meto-clopramide group （89.27% ± 11.36% and 88.67% ± 13.25% vs 69.16% ± 19.26%, respectively; both P 0.01）. The intestinal emptying rate in the ito-pride group was much better than those in the domperidone group and the metoclopramide group （78.23% ± 12.56% vs 58.96% ± 12.20% and 58.33% ± 12.57%, respectively; both P 0.01）. The level of serum ghrelin in FD patients was signifi cantly lower than that in normal controls （P 0.05）. After drug treatment, the level of serum ghrelin rose obviously. The levels of serum ghrelin in combination groups were higher than those in single-drug groups （all P 0.05 or 0.01）. CONCLUSION： Treatment with itopride, domperidone and metoclopramide in double combination achieves better effi cacy in FD patients than treatment with these drugs alone. Combi-nation therapy significantly improves

关 键 词：伊托必利 多潘立酮 甲氧氯普胺 功能性消化不良 胃肠运动 GHRELIN 

分 类 号：R57[医药卫生—消化系统]