Schemann M, Michel K, Zeller F, Hohenester B, Rühl A
Department of Human Biology, Technische Universität München, 85354 Freising, Germany.
Phytomedicine. 2006;13 Suppl 5:90-9. doi: 10.1016/j.phymed.2006.03.020. Epub 2006 Jun 12.
Functional dyspepsia (FD) is a disorder that involves impaired gastric accommodation, antral hypomotility, and upper abdominal pain. The herbal drug STW 5 (Iberogast) is used to successfully treat FD patients. Here, we report in vitro data revealing the mode of action of STW 5 and its individual herbal extracts on gastric motility. STW 5 evoked a relaxation of the proximal stomach but increased antral motility. Both effects are myogenic. The extracts of Angelica root, chamomile flower and liquorice root mimicked the inhibitory effects in the proximal stomach whereas the extracts of greater celandine herb, Melissa leaf, caraway fruit and bitter candy tuft increased motility of the proximal stomach. All extracts increased motility in the antrum comparable to the effects of STW 5. We conclude that the differential effects of STW 5 on proximal and distal stomach motor activity are not caused by solely spasmolytic or anti-spasmolytic effects of the individual components. It is suggested that the individual extracts target transduction mechanisms that are specifically expressed in the proximal vs. distal stomach. We present a rationale for the differential effect of STW 5 which is a result of the combined actions of its individual components and reason that the inhibitory effects in the proximal and the excitatory effects in the distal stomach may contribute to symptom relief in FD patients treated with STW 5 (Iberogast).
功能性消化不良（FD）是一种涉及胃容受性受损、胃窦动力不足和上腹部疼痛的病症。草药制剂STW 5（伊贝戈斯特）可成功治疗FD患者。在此，我们报告体外实验数据，揭示STW 5及其各单味草药提取物对胃动力的作用模式。STW 5可使胃近端松弛，但增加胃窦动力。这两种效应均为肌源性。当归根、洋甘菊花和甘草根的提取物模拟了对胃近端的抑制作用，而白屈菜全草、蜜蜂花、香菜果和屈曲花的提取物则增加了胃近端的动力。所有提取物增加胃窦动力的作用与STW 5的作用相当。我们得出结论，STW 5对胃近端和远端运动活性的不同作用并非仅由各成分的解痉或抗解痉作用所致。提示各单味提取物靶向胃近端和远端特异性表达的转导机制。我们阐述了STW 5产生不同作用的原理，这是其各成分联合作用的结果，并推断胃近端的抑制作用和胃远端的兴奋作用可能有助于缓解接受STW 5（伊贝戈斯特）治疗的FD患者的症状。
