Department of Gastroenterology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou 510180, Guangdong Province, China.
World J Gastroenterol. 2013 Jul 14;19(26):4214-20. doi: 10.3748/wjg.v19.i26.4214.
To study the effects of low-dose amitriptyline (AMT) on gastrointestinal function and brain-gut peptides in healthy Chinese volunteers.
This was a double-blind, randomised, placebo-controlled, two-period cross-over trial. Twenty-eight healthy volunteers were randomised and administered 1-wk treatments of AMT (12.5 mg tid) or placebo. Before and during the final two days of treatment, gastric emptying, proximal gastric accommodation and visceral sensitivity were measured by drinking-ultrasonography test; the orocecal transit time (OCTT) was measured by lactulose hydrogen breath test, and fasting blood was collected. Plasma levels of ghrelin, motilin and neuropeptide Y (NPY) were measured by enzyme-linked immunosorbent assay kits.
AMT slowed the OCTT (109.2 ± 29.68 min vs 96.61 ± 23.9 min, P = 0.004) but did not affect liquid gastric emptying and had no effect on proximal gastric accommodation. AMT resulted in decreases in the visual analogue scale (VAS) for difficulty in drinking 600 and 800 mL of water (3.57 ± 0.94 vs 2.98 ± 0.85, 5.57 ± 0.82 vs 4.57 ± 0.98, P < 0.01 for both), although it had no significant effect on the VAS for difficulty in drinking 200 mL and 400 mL of water. AMT significantly increased the plasma ghrelin level (442.87 ± 176.79 pg/mL vs 526.87 ± 158.44 pg/mL, P = 0.04) and the neuropeptide-Y level (890.15 ± 131.46 pg/mL vs 965.64 ± 165.63 pg/mL, P = 0.03), whereas it had no effect on the MTL level.
Low-dose AMT could slow OCTT, make the stomach less sensitive and increase the plasma levels of ghrelin and NPY. Thus, we recommend the use of low-dose AMT for functional gastrointestinal disorders.
研究小剂量阿米替林（AMT）对健康中国志愿者胃肠功能和脑肠肽的影响。
这是一项双盲、随机、安慰剂对照、两周期交叉试验。将 28 名健康志愿者随机分为两组，分别接受为期 1 周的 AMT（12.5mg tid）或安慰剂治疗。在治疗的最后两天，通过饮用超声检查测量胃排空、近端胃顺应性和内脏敏感性；通过乳果糖氢呼气试验测量口盲传输时间（OCTT），并采集空腹血。采用酶联免疫吸附试剂盒测定血浆胃饥饿素、胃动素和神经肽 Y（NPY）水平。
AMT 可减缓 OCTT（109.2 ± 29.68 min 比 96.61 ± 23.9 min，P = 0.004），但不影响液体胃排空，对近端胃顺应性无影响。AMT 导致 600 毫升和 800 毫升水的视觉模拟评分（VAS）困难程度降低（3.57 ± 0.94 比 2.98 ± 0.85，5.57 ± 0.82 比 4.57 ± 0.98，均 P < 0.01），尽管对 200 毫升和 400 毫升水的 VAS 困难程度无显著影响。AMT 显著增加了血浆胃饥饿素水平（442.87 ± 176.79 pg/mL 比 526.87 ± 158.44 pg/mL，P = 0.04）和神经肽-Y 水平（890.15 ± 131.46 pg/mL 比 965.64 ± 165.63 pg/mL，P = 0.03），而对 MTL 水平无影响。
小剂量 AMT 可减缓 OCTT，降低胃敏感性，增加血浆胃饥饿素和 NPY 水平。因此，我们建议使用小剂量 AMT 治疗功能性胃肠疾病。
