Department of Internal Medicine, Yonsei University College of Medicine, Seoul 120-752, South Korea.
World J Gastroenterol. 2012 Nov 7;18(41):5948-56. doi: 10.3748/wjg.v18.i41.5948.
To evaluate the effect of prokinetic drugs on electrogastrography (EGG) parameters according to symptomatic changes in patients with functional dyspepsia (FD).
Seventy-four patients with FD were prospectively enrolled in this study between December 2006 and December 2010. We surveyed the patients using a questionnaire on dyspeptic symptoms before and after an 8-wk course of prokinetic drug treatment. We also measured cutaneous pre-prandial and post-prandial EGG recordings including percentage of gastric waves (normogastria, bradygastria, tachygastria), dominant frequency (DF), dominant power (DP), dominant frequency instability coefficient (DFIC), dominant power instability coefficient (DPIC), and the ratio of post-prandial to fasting in DP before and after the 8-wk course of prokinetic drug treatment.
Fifty-two patients (70%) achieved symptomatic improvement after prokinetic drug treatment. Patients who had normal gastric slow waves showed symptom improvement group after treatment. Post-prandial DF showed a downward trend in the symptom improvement group, especially in the itopride group. Post-prandial DP was increased regardless of symptom improvement, especially in the itopride group and mosapride group. Post-prandial DFIC and DPIC in the symptom improvement group were significantly increased after the treatment. The EGG power ratio was increased after treatment in the symptom improvement group (0.50 ± 0.70 vs 0.93 ± 1.77, P = 0.002), especially in the itopride and levosulpiride groups.
Prokinetics could improve the symptoms of FD by regulating gastric myoelectrical activity, and EGG could be a useful tool in evaluating the effects of various prokinetics.
根据功能性消化不良(FD)患者症状的变化,评估促动力药物对胃电图(EGG)参数的影响。
本研究前瞻性纳入 2006 年 12 月至 2010 年 12 月间 74 例 FD 患者。我们在促动力药物治疗 8 周前后使用消化不良症状问卷对患者进行调查。我们还测量了餐前和餐后的皮肤 EGG 记录,包括胃电波的百分比(正常胃节律、胃动过缓、胃动过速)、主导频率(DF)、主导功率(DP)、主导频率不稳定性系数(DFIC)、主导功率不稳定性系数(DPIC),以及 DP 在促动力药物治疗前后餐前和餐后的比值。
52 例(70%)患者在促动力药物治疗后症状改善。胃慢波正常的患者在治疗后表现出症状改善。餐后 DF 在症状改善组呈下降趋势,尤其是伊托必利组。无论症状是否改善,餐后 DP 均增加,尤其是伊托必利组和莫沙必利组。症状改善组餐后 DFIC 和 DPIC 在治疗后显著增加。症状改善组的 EGG 功率比在治疗后增加(0.50 ± 0.70 比 0.93 ± 1.77,P = 0.002),尤其是伊托必利和左旋舒必利组。
促动力药物可通过调节胃电活动改善 FD 症状,EGG 可作为评估各种促动力药物疗效的有用工具。