Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Graduate Institute of Clinical Medical Sciences, Chang Gung University, Kaohsiung, Taiwan.
J Gastroenterol Hepatol. 2019 Apr;34(4):720-727. doi: 10.1111/jgh.14368. Epub 2018 Jul 29.
Delayed gastric emptying occurs in more than 50% of chronic diabetic patients, and this is associated with significant impairments in quality of life. Traditional therapy for delayed gastric emptying has focused on supportive treatment, and there is no significant effective therapy. The effect of low-energy shock wave on gastric motility is never studied. We investigated low-energy shock wave on gastric motility in a diabetic rat model.
Twenty-eight male Wistar rats were studied and separated in three groups in randomized order as control, diabetic rats received shock wave, and diabetic rats received the sham procedure. Antral area and motility were recorded using the transabdominal ultrasound. Blood was taken for measurement of gastric motility peptides. Subjects were killed for immunohistochemical stain analysis of enteric plexus of the stomach.
We successfully induced 20 diabetic rats and set ultrasound for measuring rat gastric contract and emptying model and demonstrated that 6 weeks of low-energy shock wave could promote gastric contraction and emptying in diabetic rats. Moreover, we demonstrated that shock wave could increase defecation and feces and decrease serum cholesterol and triglycerol. However, no effect on glycohemoglobin and gastric motility peptides was recorded. In the immunohistochemical staining, shock wave increased expression of gastric myenteric neuron plexus.
Low-energy shock wave can increase gastric contraction and emptying by activating axonal regeneration and increasing myenteric plexus, but not related with motility peptides.
超过 50%的慢性糖尿病患者存在胃排空延迟，这与生活质量的显著下降有关。传统的胃排空延迟治疗主要集中在支持治疗上，没有明显有效的治疗方法。低能量冲击波对胃动力的影响从未被研究过。我们研究了低能量冲击波对糖尿病大鼠模型胃动力的影响。
28 只雄性 Wistar 大鼠随机分为三组，分别为对照组、糖尿病大鼠接受冲击波治疗组和糖尿病大鼠接受假手术组。采用经腹超声记录胃窦面积和运动。采集血液测量胃动力肽。处死动物，进行胃肠丛免疫组化染色分析。
我们成功诱导了 20 只糖尿病大鼠，并建立了超声测量大鼠胃收缩和排空模型，结果表明，6 周的低能量冲击波可促进糖尿病大鼠的胃收缩和排空。此外，我们还发现冲击波可以增加排便，减少血清胆固醇和甘油三酯。然而，对血糖和胃动力肽没有影响。免疫组化染色显示，冲击波增加了胃肌间神经元丛的表达。
低能量冲击波通过激活轴突再生和增加肌间神经丛来增加胃收缩和排空，但与动力肽无关。
