Bouras E P, Burton D D, Camilleri M, Stephens D A, Thomforde G M
Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) Program, Gastroenterology Research Unit, Mayo Clinic College of Medicine, Jacksonville, FL, USA.
Neurogastroenterol Motil. 2004 Dec;16(6):729-35. doi: 10.1111/j.1365-2982.2004.00547.x.
Endogenous prostaglandins regulate smooth muscle activity; prostaglandins and cyclooxygenase (COX) inhibitors influence gastrointestinal motility in inflammatory states such as postoperative ileus in animal models. The objective of this study was to evaluate the effects of two COX-2 inhibitors on gastric emptying and intestinal transit in healthy humans. In a double-blind, placebo-controlled, parallel-group study, 66 healthy volunteers were randomized to one of two commercially available oral COX-2 inhibitors (celecoxib and rofecoxib), cisapride (positive control), or placebo. Following 7 days on therapy, study participants underwent a test of gastric emptying and small bowel transit of liquids and solids using scintigraphy. Data were analysed using Kruskal-Wallis (ANOVA on ranks)and Mann-Whitney rank sum tests. There were significant group effects on transit of solids: gastric emptying (ANOVA, P = 0.005) and small bowel transit (ANOVA, P = 0.056). However, neither COX-2 inhibitor significantly accelerated the liquid or solid gastric emptying or small bowel transit compared with placebo. The positive control, cisapride, accelerated gastric emptying of solids (post-lag slope of gastric emptying, P < 0.05), and small bowel transit of solids (t10%, P = 0.016). At maximum clinically approved dosages, celecoxib and rofecoxib have no significant effects on gastric emptying or small intestinal transit in healthy humans. Cisapride accelerates gastric emptying and small bowel transit in healthy humans.
内源性前列腺素调节平滑肌活动；前列腺素和环氧化酶（COX）抑制剂在诸如动物模型中的术后肠梗阻等炎症状态下影响胃肠动力。本研究的目的是评估两种COX-2抑制剂对健康人胃排空和肠道转运的影响。在一项双盲、安慰剂对照、平行组研究中，66名健康志愿者被随机分为两种市售口服COX-2抑制剂（塞来昔布和罗非昔布）、西沙必利（阳性对照）或安慰剂中的一种。治疗7天后，研究参与者使用闪烁扫描术进行了液体和固体的胃排空及小肠转运测试。数据采用Kruskal-Wallis（秩方差分析）和Mann-Whitney秩和检验进行分析。在固体转运方面存在显著的组间效应：胃排空（方差分析，P = 0.005）和小肠转运（方差分析，P = 0.056）。然而，与安慰剂相比，两种COX-2抑制剂均未显著加速液体或固体的胃排空或小肠转运。阳性对照西沙必利加速了固体的胃排空（胃排空的滞后斜率，P < 0.05）和固体的小肠转运（t10%，P = 0.016）。在临床最大批准剂量下，塞来昔布和罗非昔布对健康人的胃排空或小肠转运无显著影响。西沙必利可加速健康人的胃排空和小肠转运。
