Feldman M, Smith H J
Gastroenterology. 1987 Jan;92(1):171-4. doi: 10.1016/0016-5085(87)90854-7.
Cisapride is a prokinetic agent believed to facilitate acetylcholine release from the myenteric plexus of the gut. The effect of cisapride on gastric emptying of solids was studied in 9 diabetic patients, all of whom had delayed gastric emptying of indigestible solids (gastroparesis). Six patients had chronic nausea and vomiting, and 3 had no symptoms. Cisapride (5 mg) was given intravenously 15 min before ingestion of a 400-kcal test meal and 10 indigestible solid radiopaque markers. On separate days and in random order each patient also received intravenous metoclopramide (10 mg) or placebo 15 min before ingestion of the meal and markers. Mean gastric emptying of radiopaque markers, assessed by serial radiographs of the gastric region, was accelerated by metoclopramide and cisapride, but the difference reached significance only with cisapride (p less than 0.05). There was considerable intersubject variability in gastric emptying responses to cisapride and metoclopramide. No side effects occurred with either drug. This study indicates that acute, intravenous administration of cisapride accelerates gastric emptying of indigestible solids in patients with diabetic gastroparesis.
西沙必利是一种促动力药物，据信可促进肠道肌间神经丛释放乙酰胆碱。对9名糖尿病患者进行了西沙必利对固体食物胃排空影响的研究，所有患者均存在难消化固体食物胃排空延迟（胃轻瘫）。6名患者有慢性恶心和呕吐症状，3名患者无症状。在摄入400千卡测试餐和10个难消化的固体不透X线标志物前15分钟静脉注射西沙必利（5毫克）。在不同日期且随机顺序下，每位患者在摄入餐食和标志物前15分钟还分别接受静脉注射甲氧氯普胺（10毫克）或安慰剂。通过胃部区域的系列X光片评估，不透X线标志物的平均胃排空在甲氧氯普胺和西沙必利作用下均加快，但仅西沙必利使差异具有显著性（p小于0.05）。患者对西沙必利和甲氧氯普胺的胃排空反应存在相当大的个体差异。两种药物均未出现副作用。本研究表明，急性静脉注射西沙必利可加速糖尿病胃轻瘫患者难消化固体食物的胃排空。
