Prather C M, Camilleri M, Zinsmeister A R, McKinzie S, Thomforde G
Gastroenterology Research Unit, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Gastroenterology. 2000 Mar;118(3):463-8. doi: 10.1016/s0016-5085(00)70251-4.
BACKGROUND & AIMS: This study evaluated the effects of a partial 5-hydroxytryptamine (5-HT)(4) agonist, tegaserod, on gastric small bowel and colonic transit in constipation-predominant irritable bowel syndrome (IBS).
After a 1 week run-in period, 24 patients with constipation-predominant IBS were randomized to 1 week of tegaserod, 2 mg twice daily, or placebo treatment. Scintigraphic gastric emptying, small bowel transit, and colonic transit were determined before administration of study drug and after 1 week on the medication. Colonic transit was also measured using radiopaque markers and a single radiograph on day 5.
Gastric emptying was unaltered by tegaserod. Proximal colonic filling at 6 hours, a measure of orocecal transit, was accelerated by tegaserod (70.4% +/- 1.3% [mean +/- SEM] vs. placebo, 46.4 +/- 1.9; P = 0.015). Proximal colonic emptying half-time and geometric center at 48 hours were also accelerated by tegaserod compared with baseline, but not compared with placebo. Mean colonic transit time was similar in both groups at baseline and after drug administration (tegaserod, 59.5 +/- 2.1 hours; placebo, 62.1 +/- 2.1 hours).
Tegaserod accelerates orocecal transit, tends to accelerate colonic transit, and deserves further study in patients with constipation-predominant IBS.
本研究评估了部分5-羟色胺（5-HT）（4）激动剂替加色罗对以便秘为主的肠易激综合征（IBS）患者胃、小肠和结肠转运的影响。
经过1周的导入期后，24例以便秘为主的IBS患者被随机分为两组，分别接受为期1周的替加色罗治疗（每日2次，每次2 mg）或安慰剂治疗。在服用研究药物前及用药1周后，通过闪烁扫描法测定胃排空、小肠转运和结肠转运情况。在第5天，还使用不透X线标志物和单次X光片测量结肠转运。
替加色罗未改变胃排空情况。替加色罗可加速6小时时近端结肠充盈，这是口盲肠转运的一项指标（70.4%±1.3%[平均值±标准误]，而安慰剂组为46.4±1.9；P = 0.015）。与基线相比，替加色罗也加速了48小时时近端结肠排空半衰期和几何中心，但与安慰剂组相比无差异。两组在基线和用药后平均结肠转运时间相似（替加色罗组为59.5±2.1小时；安慰剂组为62.1±2.1小时）。
替加色罗可加速口盲肠转运，倾向于加速结肠转运，在以便秘为主的IBS患者中值得进一步研究。
