Trapnell B C, Mavko L E, Birskovich L M, Falko J M
Arch Intern Med. 1986 Nov;146(11):2278-9.
Gastroparesis diabeticorum is a common complication that develops in patients with diabetes mellitus. Although the pathogenesis remains unclear, the clinical symptoms of nausea, vomiting, and gastric dilatation frequently respond to metoclopramide hydrochloride, an agent that stimulates gastric emptying in addition to acting centrally as an antiemetic. Occasionally, patients are encountered whose severe gastroparesis is unresponsive to oral metoclopramide and who require intravenous therapy or drainage procedures (eg, pyloroplasty or gastrojejunostomy). Rectal administration of metoclopramide successfully controlled the clinical symptoms of gastroparesis diabeticorum in an outpatient after failure of oral dosing, thus avoiding the need for intravenous therapy. Gastric emptying studies and serum metoclopramide levels following a 25-mg rectal dose of metoclopramide hydrochloride verified the efficacy of therapy.
糖尿病性胃轻瘫是糖尿病患者常见的并发症。虽然其发病机制尚不清楚，但恶心、呕吐和胃扩张等临床症状通常对盐酸甲氧氯普胺有反应，该药物除了作为中枢性止吐药外，还能刺激胃排空。偶尔会遇到一些患者，他们的严重胃轻瘫对口服甲氧氯普胺无反应，需要静脉治疗或引流手术（如幽门成形术或胃空肠吻合术）。在口服给药失败后，直肠给药甲氧氯普胺成功控制了一名门诊患者糖尿病性胃轻瘫的临床症状，从而避免了静脉治疗的需要。给予25毫克直肠剂量的盐酸甲氧氯普胺后的胃排空研究和血清甲氧氯普胺水平证实了治疗的有效性。
