Uchiyama M, Iwafuchi M, Yagi M, Iinuma Y, Kanada S, Ohtaki M, Homma S
Department of Pediatric Surgery, Niigata University School of Medicine, Japan.
J Smooth Muscle Res. 2000 Aug;36(4):117-26. doi: 10.1540/jsmr.36.117.
Effects of trimebutine maleate (TM) on intestinal motility in short bowel syndrome (SBS) were studied in conscious canines in both acute and chronic phases following 80% massive distal small bowel resection (MSBR). TM was administered orally to beagles with MSBR or as controls in the postprandial and fasting states, and given simultaneously with meals. Intestinal motility was measured using bipolar electrodes for approximately 1 month after the electrodes were implanted in each beagle and the data compared between treatment groups. When TM was given with meals, the postprandial period without duodenal migrating myoelectric (or motor) complexes (MMCs) was shorter than in those given meals only. When TM was given in the postprandial state in short bowel beagles, the initial duodenal MMCs occurred earlier, i.e. the postprandial period was shorter. Diarrhea did not occur in these beagles. When TM was given in the fasting state, duodenal MMCs occurred and propagated to the distal intestine. In conclusion, oral TM administration can produce a more appropriate intestinal condition for the next food intake and make enteral nutrition possible even in the acute phase after MSBR. Such feeding can be carried out without overloading gut function as a result of the modulation of gastrointestinal motility by TM.
在80%远端小肠大部切除(MSBR)后的急性和慢性阶段,研究了马来酸曲美布汀(TM)对清醒犬短肠综合征(SBS)肠道动力的影响。将TM口服给予接受MSBR的比格犬或作为对照组,分别在餐后和禁食状态下给药,并与食物同时给予。在每只比格犬植入双极电极后,使用双极电极测量肠道动力约1个月,并比较各治疗组之间的数据。当TM与食物同时给予时,无十二指肠移行性肌电(或运动)复合波(MMCs)的餐后时间比仅给予食物的犬更短。当在短肠比格犬的餐后状态给予TM时,初始十二指肠MMCs出现得更早,即餐后时间更短。这些比格犬未出现腹泻。当在禁食状态给予TM时,十二指肠MMCs出现并向远端肠道传播。总之,口服TM给药可为下一次食物摄入产生更合适的肠道状态,即使在MSBR后的急性期也能使肠内营养成为可能。由于TM对胃肠动力的调节作用,这种喂养可以在不使肠道功能过载的情况下进行。