Frolkis A W
Dtsch Z Verdau Stoffwechselkr. 1986;46(2):122-9.
The most important pathophysiological mechanism of functional disorders of colon is motility disturbance. The best term for these disturbances is considered to be "colon dyskinesia". Dyskinesia can be classified as primary and secondary, and as hyperand hypokinetic. The following clinical forms are distinguished: with constipation, painless diarrhea, isolated pain syndrome, colica mucosa. Inflammatory diseases of colon are accompanied by chemical changes in feaces: the increase of enterokinase and alkalien phosphatase activity (enzymorrhea), the increase of feacal excretion of protein (proteinorrhea). Both enzymorrhea and proteinorrhea are absent in colon dyskinesia. The investigation of enzymes and protein in faeces can be of great help in differential diagnostics of functional and inflammatory colon diseases. In treating colon dyskinesia psychopharmacological, cholinolytical, spasmolytical and antidiarrrheal preparations are used, as well as some drugs with purgative effect. Clinical and instrumental methods make it possible to determine which type of the motility disturbances predominates. The latter is important for differential prescription of drugs correcting colon motility in colon dyskinesia. Colon motility in man ist actively affected by adrenergic drugs: it is inhibited by adrenomimetics and stimulated by adrenolytics which justifies their prescription in colon dyskinesia. Diazepam and phenobarbital inhibit colon motility. Diphenoxylate and metoclopramide have a normalizing effect.
结肠功能紊乱最重要的病理生理机制是运动障碍。这些障碍的最佳术语被认为是“结肠运动障碍”。运动障碍可分为原发性和继发性，以及运动亢进和运动减退。可区分出以下临床形式：伴有便秘、无痛性腹泻、孤立性疼痛综合征、黏膜绞痛。结肠炎症性疾病伴有粪便中的化学变化：肠激酶和碱性磷酸酶活性增加（酶泻），粪便蛋白质排泄增加（蛋白泻）。结肠运动障碍时既无酶泻也无蛋白泻。粪便中酶和蛋白质的检测对功能性和炎症性结肠疾病的鉴别诊断有很大帮助。在治疗结肠运动障碍时，使用精神药理学、抗胆碱能、解痉和止泻制剂，以及一些具有泻药作用的药物。临床和器械检查方法能够确定哪种类型的运动障碍占主导。后者对于在结肠运动障碍中纠正结肠运动的药物的鉴别性处方很重要。人体内的结肠运动受到肾上腺素能药物的积极影响：肾上腺素能激动剂会抑制它，而肾上腺素能阻滞剂会刺激它，这证明了它们在结肠运动障碍中的处方合理性。地西泮和苯巴比妥会抑制结肠运动。地芬诺酯和甲氧氯普胺具有调节作用。
