Snape W J, Battle W M, Schwartz S S, Braunstein S N, Goldstein H A, Alavi A
Ann Intern Med. 1982 Apr;96(4):444-6. doi: 10.7326/0003-4819-96-4-444.
Ten patients with diabetic gastroparesis were selected for a randomized, double-blind, controlled trial of metoclopramide. Each patient had longstanding insulin-requiring diabetes mellitus and symptoms of gastric stasis. The patients were evaluated for the symptoms of gastric stasis and radionucleotide gastric emptying was measured before the patients entered the study and after they were given either metoclopramide or placebo treatment. Metoclopramide, 10 mg orally, stimulated an increase in the rate of gastric emptying (56.8% +/- 7.4%) in contrast to the response to placebo (37.6% +/- 7.7%) (p less than 0.01). The overall symptoms and symptoms of vomiting were markedly reduced during metoclopramide treatment in contrast to those during placebo treatment. Before the study five patients were constipated (less than three bowel movements per week); during metoclopramide treatment the patients' bowel habits were improved. There was a poor correlation between improved gastric emptying and decreased symptoms. Metoclopramide may improve symptoms of diabetic gastric stasis through two mechanisms: its peripheral effect on gastric smooth muscle, which increases gastric emptying; and its central effects on the chemoreceptor vomiting zone, which decrease nausea.
选取了10例糖尿病胃轻瘫患者，进行甲氧氯普胺的随机双盲对照试验。每位患者均患有需要长期使用胰岛素治疗的糖尿病且有胃潴留症状。在患者进入研究前以及给予甲氧氯普胺或安慰剂治疗后，对患者的胃潴留症状进行评估，并测量放射性核素胃排空情况。口服10 mg甲氧氯普胺可刺激胃排空率增加（56.8%±7.4%），而安慰剂组的反应为（37.6%±7.7%）（p<0.01）。与安慰剂治疗期间相比，甲氧氯普胺治疗期间总体症状及呕吐症状明显减轻。研究前有5例患者便秘（每周排便少于3次）；在甲氧氯普胺治疗期间，患者的排便习惯得到改善。胃排空改善与症状减轻之间的相关性较差。甲氧氯普胺可能通过两种机制改善糖尿病胃潴留症状：其对胃平滑肌的外周作用，可增加胃排空；以及其对化学感受器触发区的中枢作用，可减轻恶心。
