Shafik Ahmed, Shafik Ali-A, Sibai Olfat-El, Shafik Ismail-A
Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Cairo 11121, Egypt.
World J Gastroenterol. 2008 Apr 14;14(14):2226-9. doi: 10.3748/wjg.14.2226.
To investigate the mechanism of action of thermal cutaneous stimulation on the gastric motor inhibition.
The gastric tone of 33 healthy volunteers (20 men, mean age 36.7 +/- 8.4 years) was assessed by a barostat system consisting of a balloon-ended tube connected to a strain gauge and air-injection system. The tube was introduced into the stomach and the balloon was inflated with 300 mL of air. The skin temperature was elevated in increments of 3 degree up to 49 degree and the gastric tone was simultaneously assessed by recording the balloon volume variations expressed as the percentage change from the baseline volume. The test was repeated after separate anesthetization of the skin and stomach with lidocaine and after using normal saline instead of lidocaine.
Thermal cutaneous stimulation resulted in a significant decrease of gastric tone 61.2% +/- 10.3% of the mean baseline volume. Mean latency was 25.6 +/- 1.2 ms. After 20 min of individual anesthetization of the skin and stomach, thermal cutaneous stimulation produced no significant change in gastric tone.
Decrease in the gastric tone in response to thermal cutaneous stimulation suggests a reflex relationship which was absent on individual anesthetization of the 2 possible arms of the reflex arc: the skin and the stomach. We call this relationship the "cutaneo-gastric inhibitory reflex". This reflex may have the potential to serve as an investigative tool in the diagnosis of gastric motor disorders, provided further studies are performed in this respect.
探讨热皮肤刺激对胃运动抑制的作用机制。
采用恒压器系统评估33名健康志愿者(20名男性,平均年龄36.7±8.4岁)的胃张力,该系统由连接应变仪和空气注入系统的球囊端管组成。将管子插入胃内,向球囊内注入300 mL空气使其膨胀。皮肤温度以3℃的增量升高至49℃,同时通过记录球囊体积变化来评估胃张力,球囊体积变化以相对于基线体积的百分比变化表示。在用利多卡因分别麻醉皮肤和胃后以及用生理盐水代替利多卡因后重复该测试。
热皮肤刺激导致胃张力显著降低,降至平均基线体积的61.2%±10.3%。平均潜伏期为25.6±1.2毫秒。在分别对皮肤和胃进行20分钟的局部麻醉后,热皮肤刺激未引起胃张力的显著变化。
热皮肤刺激引起的胃张力降低表明存在一种反射关系,而在对反射弧的两个可能部分(皮肤和胃)进行局部麻醉时这种关系不存在。我们将这种关系称为“皮胃抑制反射”。如果在这方面进行进一步研究,这种反射可能有潜力作为诊断胃运动障碍的一种研究工具。