Mathias J R, Ferguson K L, Clench M H
Department of Internal Medicine, University of Texas Medical Branch, Galveston 77550.
Dig Dis Sci. 1989 May;34(5):761-6. doi: 10.1007/BF01540350.
In this informal initial study, four female patients with intractable chronic abdominal pain, daily nausea, intermittent vomiting, and altered stool habits due to "functional" disease were investigated. A gonadotropin-releasing hormone (GnRH) analog agonist, leuprolide acetate (Lupron) [D-leu6, Desgly-NH2(10), Proethylamide9], was administered once daily (0.5 mg subcutaneously) for three months. At the end of the three-month period, three subjects were symptom-free and the fourth experienced only mild and intermittent pain. The leuprolide regimen was continued for an additional three months, and estrogen (0.625 mg orally) and calcium (1000 mg orally) were given daily to prevent osteoporosis. The patients remained symptom-free. A challenge with progesterone then induced recurrence of mild symptoms in each subject. Withdrawing leuprolide induced the baseline symptoms in all patients within three to five days. This regimen has now been continued for up to 15 months, and all four patients have remained generally symptom-free. Progesterone has also been given every three months to induce menses. A fifth patient, with Roux-en-Y syndrome, has also been treated with leuprolide. She is symptom-free after six months and has gained weight. In this initial observation period in patients with severe functional (neuromuscular) bowel disease, the GnRH analog agonist leuprolide controlled pain, nausea, and vomiting.(ABSTRACT TRUNCATED AT 250 WORDS)
在这项非正式的初步研究中，对4名因“功能性”疾病而患有顽固性慢性腹痛、每日恶心、间歇性呕吐及大便习惯改变的女性患者进行了调查。给予促性腺激素释放激素（GnRH）类似物激动剂醋酸亮丙瑞林（Lupron）[D-亮氨酸6，去甘氨酰胺（10），丙乙酰胺9]，每日一次（皮下注射0.5毫克），持续三个月。在三个月疗程结束时，3名受试者症状消失，第四名受试者仅经历轻微的间歇性疼痛。亮丙瑞林治疗方案又持续了三个月，并每日给予雌激素（口服0.625毫克）和钙（口服1000毫克）以预防骨质疏松。患者仍无症状。随后用黄体酮激发，每名受试者均出现轻度症状复发。停用亮丙瑞林后，所有患者在三至五天内出现基线症状。该治疗方案现已持续长达15个月，所有4名患者总体上仍无症状。每三个月还给予黄体酮以诱导月经来潮。一名患有Roux-en-Y综合征的第五名患者也接受了亮丙瑞林治疗。六个月后她无症状且体重增加。在对严重功能性（神经肌肉）肠病患者的这一初步观察期内，GnRH类似物激动剂亮丙瑞林控制了疼痛、恶心和呕吐。（摘要截选至250字）
