盐酸依托必利联合α-硫辛酸对糖尿病胃轻瘫患者的疗效及对胃泌素、胃动素影响  

Itopride combined with α-lipoic acid for diabetic gastroparesis Curative effect and impact on motilin and gastrin

作　　者：马刚[1] 戴伟杰[1] 严伟[1] 张红[2] 

机构地区：[1]南京医科大学附属淮安第一医院消化科,江苏省淮安市223300 [2]南京医科大学附属淮安第一医院内分泌科,江苏省淮安市223300

出　　处：《世界华人消化杂志》2015年第5期782-787,共6页World Chinese Journal of Digestology

基　　金：国家自然科学基金青年基金资助项目;No.81200595~~

摘　　要：目的:观察盐酸伊托必利联合α-硫辛酸治疗糖尿病胃轻瘫(diabetic gastroparesis,DGP)的疗效以及对胃泌素和胃动素的影响.方法:选取有上消化道症状的DGP患者60例,给予α-硫辛酸和依托必利联合治疗(α-硫辛酸0.6 g+0.9%NaCl溶液250 m L避光静脉滴注14 d+依托必利50 mg饭前口服,3次/d),依托必利组50例(依托必利50 mg饭前口服,3次/d),治疗2 wk,通过餐后上腹饱胀、嗳气反酸、厌食、恶心呕吐等临床症状观察及胃排空率判断疗效,并检测胃动素和胃泌素水平的变化.结果:两组在改善临床症状上均有效,α-硫辛酸和依托必利联合组改善临床症状的总有效率为91.6%,依托必利组改善临床症状的总有效率为78.0%,联合用药组有效率明显高于伊托必利组(P<0.05);α-硫辛酸和依托必利联合组胃排空率的改善较依托必利组显著提高(P<0.05);两组治疗后胃动素、胃泌素均有明显下降,联合用药组下降较伊托必利组更为显著(P<0.05).结论:对于DGP患者,α-硫辛酸和依托必利联合用药能有效改善胃轻瘫症状,提高胃排空率,治疗后胃泌素、胃动素的下降更为显著,疗效显著优于依托必利单药治疗.AIM： To observe the efficacy of itopridehydrochloride combined with α-lipoic acid in the treatment of diabetic gastroparesis（DGP） and their effect on motilin and gastrin. METHODS： Sixty patients with DGP who had gastrointestinal symptoms were treated with α-lipoic acid and itopride（α-lipoic acid 0.6 g ＋ 250 m L 0.9% saline intravenously for 14 d ＋ itopride 50 mg orally before meals, three times a day）, and 50 patients were treated with itopride alone（itopride 50 mg orally before meals, three times a day）. After two weeks of treatment, clinical symptoms including postprandial abdominal fullness, belching, acid reflux, anorexia, nausea and vomiting were observed, the gastric emptying rate was determined, the efficacy was evaluated, and the changes in the levels of motilin and gastrin were detected. RESUTS ： Improvement of clinical symptoms was observed in both groups, and the total effective rate was 91.6% in the combination therapy group and 78.0% in the monotherapy group. Gastric emptying rate was significantly higher in the combination group than in the monotherapy group（P 〈 0. 0 5）. Motilin and gastrin levels were reduced after treatment in both groups, and the decrease was more significant in the combination group. CONCLUSION ： For patients with DGP, α-lipoic acid and itopride combination therapy can better improve symptoms of gastroparesis, increase gastric emptying, and decrease the levels of motilin and gastrin compared withtreatment with itopride alone.

关 键 词：糖尿病胃轻瘫 胃动素 胃泌素 胃排空 依托必利 Α-硫辛酸 

分 类 号：R587.2[医药卫生—内分泌]