Dutta U, Padhy A K, Ahuja V, Sharma M P
All India Institute of Medical Sciences, New Delhi, India.
Trop Gastroenterol. 1999 Jul-Sep;20(3):116-9.
Diabetic gastroparesis is a common complication seen in 20-50% of patients due to autonomic neuropathy involving vagal supply. Cisapride, a specific gastrointestinal cholinomimetic agent may thus be effective.
Fifty-one diabetic patients (age 12-65 years) of disease duration > 5 years were assessed for symptomatic gastroparesis, other diabetic complications and glycemic control. Gastric emptying time (GET) was estimated using a solid meal method (99mTc labeled rice based idli) and patients randomized to receive either cisapride or placebo for a period of 2 weeks. Cisapride was administered in a dose of 10 mg TID. GET and symptom scores were reassessed on the therapy after 2 weeks.
Twenty nine of 51 (56.8%) patients had gastroparesis. Mean GET in the gastroparesis group was 141 +/- 66 minutes compared to 24.53 +/- 10 minutes in the non gastroparesis group (p < 0.01). GET decreased by 72% amongst the patients who received cisapride compared to 23% in the placebo group (p < 0.001). Symptom scores also improved in the cisapride group; no adverse effects were noted.
Cisapride improves the symptom score and the solid gastric emptying time in patients suffering from diabetic gastroparesis.
糖尿病胃轻瘫是一种常见并发症，见于20%至50%的患者，由涉及迷走神经供应的自主神经病变引起。西沙必利作为一种特定的胃肠拟胆碱药可能有效。
对51名病程超过5年、年龄在12至65岁的糖尿病患者进行症状性胃轻瘫、其他糖尿病并发症及血糖控制情况的评估。采用固体餐法（基于99mTc标记大米的印度蒸米糕）估算胃排空时间（GET），患者被随机分为两组，分别接受西沙必利或安慰剂治疗，为期2周。西沙必利剂量为10毫克，每日三次。2周治疗后重新评估GET及症状评分。
51名患者中有29名（56.8%）患有胃轻瘫。胃轻瘫组的平均GET为141±66分钟，而非胃轻瘫组为24.53±10分钟（p<0.01）。接受西沙必利治疗的患者GET下降了72%，而安慰剂组下降了23%（p<0.001）。西沙必利组的症状评分也有所改善；未观察到不良反应。
西沙必利可改善糖尿病胃轻瘫患者的症状评分及固体胃排空时间。
