Grudell A B M, Camilleri M, Burton D D, Stephens D A
Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic College of Medicine, Rochester, MN, USA.
Aliment Pharmacol Ther. 2006 Oct 1;24(7):1037-43. doi: 10.1111/j.1365-2036.2006.03102.x.
In consensus guidelines, proton pump inhibitors (PPIs) are recommended for the treatment of functional dyspepsia. It is unclear whether PPIs change gastric volume or emptying.
To assess the effect of a PPI, rabeprazole, on gastric volume and emptying and postprandial symptoms.
In a double-blind, parallel-group placebo-controlled trial, 13 healthy participants were randomized to rabeprazole, 20 mg b.d., or placebo. On day 3, fasting gastric volume was measured using intravenous (99m)Tc-pertechnate and single photon emission computed tomography (SPECT). After the last dose of study medication, an (111)In-chloride egg meal (300 kcal) was ingested, and postprandial gastric volume and emptying were measured by SPECT. Symptom ratings using a visual analogue scale (fullness, nausea, bloating, abdominal pain, aggregate score) were obtained at baseline and 15, 30, 45, 60 and 75 min postprandially. Group comparisons were performed using Mann-Whitney rank sum test.
There were no statistically significant differences in gastric volume or emptying in the two groups. However, there was a borderline increase in gastric volume with rabeprazole compared with placebo. Rabeprazole treatment reduced aggregate postprandial symptoms, particularly fullness, 30 min after the meal (P = 0.01).
In healthy participants, rabeprazole, 20 mg b.d., did not significantly change gastric emptying, but reduced symptoms and had a borderline effect on gastric volume postprandially. The mechanism of reduced postprandial symptoms with a PPI requires further study.
在共识指南中，质子泵抑制剂（PPI）被推荐用于治疗功能性消化不良。目前尚不清楚PPI是否会改变胃容量或排空。
评估PPI雷贝拉唑对胃容量、排空及餐后症状的影响。
在一项双盲、平行组、安慰剂对照试验中，13名健康参与者被随机分为雷贝拉唑组（每日2次，每次20mg）或安慰剂组。在第3天，使用静脉注射（99m）锝过锝酸盐和单光子发射计算机断层扫描（SPECT）测量空腹胃容量。在最后一剂研究药物服用后，摄入（111）铟氯化物蛋餐（300千卡），并通过SPECT测量餐后胃容量和排空。在基线以及餐后15、30、45、60和75分钟使用视觉模拟量表（饱胀感、恶心、腹胀、腹痛、综合评分）进行症状评分。使用Mann-Whitney秩和检验进行组间比较。
两组在胃容量或排空方面无统计学显著差异。然而，与安慰剂相比，雷贝拉唑组胃容量有临界性增加。雷贝拉唑治疗可减轻餐后综合症状，尤其是餐后30分钟时的饱胀感（P = 0.01）。
在健康参与者中，每日2次、每次20mg的雷贝拉唑并未显著改变胃排空，但可减轻症状，且对餐后胃容量有临界性影响。PPI减轻餐后症状的机制需要进一步研究。
