Department of General Medicine, Kawasaki Medical School, Kurashiki, Japan.
Neurogastroenterol Motil. 2012 Jun;24(6):540-5, e250-1. doi: 10.1111/j.1365-2982.2012.01897.x. Epub 2012 Mar 4.
Improvement in subjective symptoms has been reported in functional dyspepsia (FD) patients administered with acotiamide. Improvement was confirmed in meal-related symptoms, such as postprandial fullness, upper abdominal bloating, and early satiety. We examined the mechanism underlying the effects of acotiamide on gastric accommodation reflex (GAR) and gastroduodenal motility in FD patients.
Thirty-four FD patients (mean age, 40.4 years) were examined ultrasonographically before and after 14-18 days of acotiamide (100 mg t.i.d.) or placebo administration. To assess GAR, expansion rate in cross-sectional area of the proximal stomach was measured after every 100-mL ingestion, using a straw, of up to 400 mL of a liquid meal (consommé soup, 13.1 kcal; 400 mL) in a supine position. Next, we measured gastric emptying rate (GER), motility index (MI, antral contractions), and reflux index (RI, duodenogastric reflux) to assess gastroduodenal motility. Patients also completed a survey based on the seven-point Likert scale both before and after drug administration.
Of the 37 cases, 19 and 18 were administered with acotiamide and placebo A respectively, significant difference was observed in GAR between the acotiamide and placebo groups (21.7%vs 4.4%) after 400 mL ingestion. GER significantly accelerated after treatment in the acotiamide group (P = 0.012), no significant differences were observed in MI and RI between the two groups. Improvement rates were 35.3 and 11.8% for the acotiamide and placebo groups.
CONCLUSIONS & INFERENCES: Acotiamide significantly enhances GAR and GER in FD patients. Acotiamide may have therapeutic potential for FD patients.
已有研究报道，口服阿考替胺可改善功能性消化不良（FD）患者的主观症状。这种改善作用在与进餐相关的症状中得到了证实，如餐后饱胀、上腹胀满和早饱。我们研究了阿考替胺对 FD 患者胃容纳反射（GAR）和胃肠动力的作用机制。
34 例 FD 患者（平均年龄 40.4 岁）在接受阿考替胺（100mg，tid）或安慰剂治疗 14-18 天后，进行超声检查。为评估 GAR，在仰卧位下，每次用吸管摄入 100-400ml 液体餐（鸡汤，13.1kcal；400ml）后，测量近端胃的横截面积扩张率。接下来，我们测量胃排空率（GER）、动力指数（MI，胃窦收缩）和反流指数（RI，十二指肠胃反流），以评估胃十二指肠动力。患者在给药前后还分别根据七点 Likert 量表完成了一项调查。
在 37 例病例中，19 例接受阿考替胺治疗，18 例接受安慰剂 A 治疗。在摄入 400ml 后，阿考替胺组的 GAR 与安慰剂组相比差异有统计学意义（21.7%vs4.4%）。阿考替胺组治疗后 GER 明显加快（P = 0.012），两组间 MI 和 RI 无显著差异。阿考替胺组和安慰剂组的改善率分别为 35.3%和 11.8%。
阿考替胺可显著增强 FD 患者的 GAR 和 GER。阿考替胺可能对 FD 患者具有治疗潜力。
