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中枢介导的自主神经刺激对人体上消化道转运的作用:两种刺激的比较研究

Action of centrally mediated autonomic stimulation on human upper gastrointestinal transit: a comparative study of two stimuli.

作者信息

O'Brien J D, Thompson D G, Burnham W R, Holly J, Walker E

机构信息

Department of Gastroenterology, London and Oldchurch Hospital.

出版信息

Gut. 1987 Aug;28(8):960-9. doi: 10.1136/gut.28.8.960.

Abstract

Two well established experimental stressors, hand immersion in cold water, and mental stimulation with dichotomous listening, were applied to 37 normal subjects after the ingestion of a standard meal. Orocaecal transit was measured by serial exhaled breath hydrogen sampling. Cold water significantly delayed transit compared with warm water control (warm water 71.8 +/- 3.6 mins v cold water 93.2 +/- 5.7 mins p less than 0.01), with significant rises in blood pressure pulse rate perceived discomfort and plasma catecholamines. In contrast mental stimulation was unaccompanied by any change in transit (control; 67.4 +/- 4.7 v test 64.3 +/- 5.3 mins p greater than 0.1) despite a significant rise in pulse rate, skin conductance and plasma catecholamines. Repeated cold water immersion studies in eight individuals produced consistent orocaecal transit and autonomic responses, whereas mental stimulation showed reduced autonomic responses on repeat testing, suggesting that tolerance to the stimulus had occurred. The results of these studies show stimulus specific gastrointestinal response patterns to autonomic stimuli, and appear to have important implications for the design of future studies of human gastrointestinal autonomic physiology and for the investigation of patients with stress related gut dysfunction.

摘要

在37名正常受试者摄入标准餐后,施加了两种已被充分证实的实验应激源,即手浸入冷水中和采用两耳分听法进行精神刺激。通过连续采集呼出气体中的氢气来测量口盲肠传输时间。与温水对照相比,冷水显著延迟了传输时间(温水71.8±3.6分钟,冷水93.2±5.7分钟,p<0.01),同时血压、脉搏率、感知不适和血浆儿茶酚胺显著升高。相比之下,尽管脉搏率、皮肤电导率和血浆儿茶酚胺显著升高,但精神刺激并未伴随传输时间的任何变化(对照;67.4±4.7分钟,测试64.3±5.3分钟,p>0.1)。对8名个体进行的重复冷水浸泡研究产生了一致的口盲肠传输和自主反应,而精神刺激在重复测试时显示出自主反应降低,表明对该刺激产生了耐受性。这些研究结果显示了对自主刺激的刺激特异性胃肠道反应模式,似乎对未来人类胃肠道自主生理学研究的设计以及对与应激相关的肠道功能障碍患者的调查具有重要意义。

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