Singh S, Bailey R T, Stein H J, DeMeester T R, Richter J E
Creighton University, Omaha, Nebraska.
Am J Gastroenterol. 1992 Apr;87(4):483-8.
Recent studies suggest that psychotropic drugs may help the symptoms associated with spastic esophageal motor disorders. However, the physiologic effects of central nervous system depression (a side effect of such therapy) on esophageal function is not known. Therefore, we studied the effect of alprazolam (Xanax), a popular new benzodiazepine anxiolytic, in 10 healthy volunteers, using a randomized, placebo-controlled design. Stationary esophageal motility, 24-h pH monitoring, and 24-h ambulatory motility monitoring was done while on placebo or one tablet (0.25 mg) of alprazolam taken three times a day. Alprazolam had no significant effect on lower esophageal sphincter pressure or motility in the esophagus. Upper esophageal sphincter pressure, however, was significantly decreased. What is more important, one-third of the healthy volunteers had abnormal amounts of nocturnal acid reflux during the alprazolam phase of the study. This effect was probably due to alprazolam-induced central nervous system depression interfering with normal nocturnal acid clearance mechanisms triggered by arousal from sleep.
近期研究表明，精神药物可能有助于缓解与痉挛性食管运动障碍相关的症状。然而，中枢神经系统抑制（此类治疗的一种副作用）对食管功能的生理影响尚不清楚。因此，我们采用随机、安慰剂对照设计，对10名健康志愿者进行了研究，观察常用新型苯二氮䓬类抗焦虑药阿普唑仑（佳静安定）的作用。在服用安慰剂或每天三次、每次一片（0.25毫克）阿普唑仑期间，进行了静态食管动力检查、24小时pH监测和24小时动态动力监测。阿普唑仑对食管下括约肌压力或食管动力无显著影响。然而，食管上括约肌压力显著降低。更重要的是，在研究的阿普唑仑阶段，三分之一的健康志愿者出现了异常量的夜间酸反流。这种效应可能是由于阿普唑仑引起的中枢神经系统抑制干扰了由睡眠觉醒触发的正常夜间酸清除机制。
