Gastroenterology and Liver Units, Hebrew University-Hadassah Medical Center, Ein-Karem, Jerusalem, POB1200, Israel.
World J Gastroenterol. 2012 May 21;18(19):2309-19. doi: 10.3748/wjg.v18.i19.2309.
The prevalence of obesity is growing to epidemic proportions, and there is clearly a need for minimally invasive therapies with few adverse effects that allow for sustained weight loss. Behavior and lifestyle therapy are safe treatments for obesity in the short term, but the durability of the weight loss is limited. Although promising obesity drugs are in development, the currently available drugs lack efficacy or have unacceptable side effects. Surgery leads to long-term weight loss, but it is associated with morbidity and mortality. Gastric electrical stimulation (GES) has received increasing attention as a potential tool for treating obesity and gastrointestinal dysmotility disorders. GES is a promising, minimally invasive, safe, and effective method for treating obesity. External gastric pacing is aimed at alteration of the motility of the gastrointestinal tract in a way that will alter absorption due to alteration of transit time. In addition, data from animal models and preliminary data from human trials suggest a role for the gut-brain axis in the mechanism of GES. This may involve alteration of secretion of hormones associated with hunger or satiety. Patient selection for gastric stimulation therapy seems to be an important determinant of the treatment's outcome. Here, we review the current status, potential mechanisms of action, and possible future applications of gastric stimulation for obesity.
肥胖的流行率正在呈爆炸性增长，显然需要一种微创且副作用少的治疗方法，以实现持续的体重减轻。行为和生活方式疗法是肥胖症的短期安全治疗方法，但减肥的持久性有限。尽管有前景的肥胖症药物正在开发中，但目前可用的药物要么疗效不足，要么副作用无法接受。手术可导致长期体重减轻，但它与发病率和死亡率相关。胃电刺激 (GES) 作为治疗肥胖症和胃肠道动力障碍疾病的潜在工具受到越来越多的关注。GES 是一种有前途的、微创的、安全的、有效的治疗肥胖症的方法。外部胃起搏旨在改变胃肠道的运动方式，通过改变通过时间来改变吸收。此外，来自动物模型的数据和来自人体试验的初步数据表明，肠道-大脑轴在 GES 的作用机制中起作用。这可能涉及与饥饿或饱腹感相关的激素分泌的改变。胃刺激治疗的患者选择似乎是治疗结果的一个重要决定因素。在这里，我们综述了胃刺激治疗肥胖症的现状、潜在作用机制以及可能的未来应用。
