Division of Gastroenterology, Department of Internal Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Gastroenterol Hepatol. 2012 Jun;27(6):1017-26. doi: 10.1111/j.1440-1746.2011.06999.x.
The aim of this study was to assess the effects of gastric electrical stimulation (GES) on symptoms and gastric emptying in patients with gastroparesis, and the effects of GES on the three subgroups of gastroparesis.
A literature search of clinical trials using high-frequency GES to treat patients with gastroparesis from January 1995 to January 2011 was performed. Data on the total symptom severity score (TSS), nausea severity score, vomiting severity score, and gastric emptying were extracted and analyzed. The statistic effect index was weighted mean differences.
Ten studies (n = 601) were included in this study. In the comparison to baseline, there was significant improvement of symptoms and gastric emptying (P < 0.00001). It was noted that GES significantly improved both TSS (P < 0.00001) and gastric retention at 2 h (P = 0.003) and 4 h (P < 0.0001) in patients with diabetic gastroparesis (DG), while gastric retention at 2 h (P = 0.18) in idiopathic gastroparesis (IG) patients, and gastric retention at 4 h (P = 0.23) in postsurgical gastroparesis (PSG) patients, did not reach significance.
Based on this meta-analysis, the substantial and significant improvement of symptoms and gastric emptying, and the good safety we observed, indicate that high-frequency GES is an effective and safe method for treating refractory gastroparesis. DG patients seem the most responsive to GES, both subjectively and objectively, while the IG and PSG subgroups are less responsive and need further research.
本研究旨在评估胃电刺激（GES）对胃轻瘫患者症状和胃排空的影响，以及 GES 对胃轻瘫三个亚组的影响。
对 1995 年 1 月至 2011 年 1 月期间使用高频 GES 治疗胃轻瘫患者的临床试验进行文献检索。提取并分析总症状严重程度评分（TSS）、恶心严重程度评分、呕吐严重程度评分和胃排空数据。统计效应指标为加权均数差。
本研究纳入了 10 项研究（n = 601）。与基线相比，症状和胃排空均有显著改善（P < 0.00001）。结果表明，GES 显著改善了糖尿病性胃轻瘫（DG）患者的 TSS（P < 0.00001）和 2 小时（P = 0.003）及 4 小时（P < 0.0001）胃潴留，而在特发性胃轻瘫（IG）患者中仅在 2 小时（P = 0.18）胃潴留和在术后胃轻瘫（PSG）患者中在 4 小时（P = 0.23）胃潴留方面未达到显著改善。
基于本荟萃分析，症状和胃排空的显著改善以及观察到的良好安全性表明，高频 GES 是治疗难治性胃轻瘫的有效且安全的方法。DG 患者在主观和客观上对 GES 的反应最为明显，而 IG 和 PSG 亚组的反应性较差，需要进一步研究。
