Misra S P, Broor S L
Department of Gastroenterology, G.B. Pant Hospital, New Delhi, India.
J Clin Gastroenterol. 1990 Dec;12(6):624-7. doi: 10.1097/00004836-199012000-00005.
The pathogenesis of symptoms in patients with essential dyspepsia is not known. Since treatment with H2-receptor antagonists has provided symptomatic relief in some reports, we carried out the present study to investigate whether gastric acid is responsible for symptoms in these patients. Fifty patients with essential dyspepsia and 25 healthy control subjects were studied. After an overnight fast, a nasogastric tube was passed and its tip positioned in the antrum under fluoroscopic control. Normal saline or 0.1 M hydrochloric acid was infused in a randomized, double-blind fashion. Eleven (22%) patients developed pain with acid infusion, but none with normal saline (p less than 0.005). In 10 of these 11 patients, pain recurred on rechallenge with acid infusion but was promptly relieved with infusion of 1 M sodium bicarbonate. None of the healthy controls developed pain on infusion of acid or saline. These observations suggest that acid has a definite role in the pathogenesis of symptoms in some patients with essential dyspepsia, although other factors may also be important.
功能性消化不良患者症状的发病机制尚不清楚。鉴于在一些报告中，使用H2受体拮抗剂治疗可缓解症状，我们开展了本研究，以调查胃酸是否与这些患者的症状有关。对50例功能性消化不良患者和25例健康对照者进行了研究。经过一夜禁食后，插入一根鼻胃管，并在荧光镜控制下将其尖端置于胃窦部。以随机、双盲方式输注生理盐水或0.1M盐酸。11例（22%）患者在输注酸时出现疼痛，但输注生理盐水时均未出现疼痛（p<0.005）。在这11例患者中的10例中，再次输注酸时疼痛复发，但输注1M碳酸氢钠后疼痛迅速缓解。健康对照者在输注酸或生理盐水时均未出现疼痛。这些观察结果表明，尽管其他因素可能也很重要，但酸在一些功能性消化不良患者症状的发病机制中具有明确作用。
