Schwartz M P, Samsom M, Van Berge Henegouwen G P, Smout A J
Gastrointestinal Research Unit, Department of Gastroenterology, University Medical Center, Utrecht, The Netherlands.
Aliment Pharmacol Ther. 2001 Dec;15(12):1921-8. doi: 10.1046/j.1365-2036.2001.01123.x.
Heightened visceroperception and a decreased duodenal motor response to intraduodenal acid infusion have been reported in functional dyspepsia.
To investigate the effect of treatment with a proton pump inhibitor on sensorimotor impairment in 19 patients with functional dyspepsia.
Patients were assigned double-blind to pantoprazole (n=10) or placebo (n=9) treatment for 2 weeks. Antropyloroduodenal manometry was performed before and after treatment, using a 21-channel catheter, and the responses to intraduodenal infusion of 5 mL of saline and acid were assessed. Nausea, fullness and epigastric pain were scored before and after each infusion.
Acid induced a modest duodenal motor response and suppression of antral pressure waves, not altered by either treatment. However, acid evoked isolated pyloric pressure waves after pantoprazole treatment (P < 0.02), and not after placebo. Saline induced no motor response. Acid (not saline) induced nausea, both before and after treatment in both groups (all P < 0.05). Subgroup analysis of the seven acid-hypersensitive patients (37%) showed a tendency towards a decrease in nausea in all four pantoprazole-treated patients (P=0.07), in contrast to the three placebo-treated patients (P=1.0).
In functional dyspepsia, pantoprazole influenced the acid-induced duodenogastric feedback mechanism, but not the impaired duodenal motor response. Duodenal acid hypersensitivity was decreased to some extent.
据报道，功能性消化不良患者存在内脏感觉增强以及十二指肠对十二指肠内酸灌注的运动反应降低的情况。
研究质子泵抑制剂治疗对19例功能性消化不良患者感觉运动障碍的影响。
患者被双盲分配接受泮托拉唑（n = 10）或安慰剂（n = 9）治疗2周。治疗前后使用21通道导管进行胃窦十二指肠测压，并评估对十二指肠内注入5 mL生理盐水和酸的反应。每次注入前后对恶心、饱胀感和上腹部疼痛进行评分。
酸引起适度的十二指肠运动反应并抑制胃窦压力波，两种治疗均未改变这种情况。然而，泮托拉唑治疗后酸诱发孤立的幽门压力波（P < 0.02），而安慰剂治疗后未出现。生理盐水未诱发运动反应。酸（而非生理盐水）在两组治疗前后均诱发恶心（所有P < 0.05）。对7例酸超敏患者（37%）的亚组分析显示，与3例接受安慰剂治疗的患者（P = 1.0）相比，4例接受泮托拉唑治疗的患者恶心有减轻趋势（P = 0.07）。
在功能性消化不良中，泮托拉唑影响酸诱导的十二指肠-胃反馈机制，但不影响受损的十二指肠运动反应。十二指肠酸超敏性在一定程度上有所降低。
