Hongo M
Nihon Heikatsukin Gakkai Zasshi. 1982 Mar;18(1):39-43.
The effect of nifedipine, one of calcium antagonists, was studied on esophageal function of 10 patients with achalasia. Lower esophageal sphincter pressure (LESP) was measured with constantly perfused catheter before and after sublingual administration of 10 mg nifedipine. Nifedipine decreased LESP both in achalasia patients and normal controls except one patient. The fall of LESP by nifedipine seems to correlate with initial resting LESP. A clinical trial of nifedipine on patients with achalasia was carried out taking nifedipine sublingually in a daily dosage of 30 to 60 mg before meal. Nifedipine therapy gave good results in 8 patients, and poor response in one and no effects in one patient. Nifedipine improved symptoms of achalasia, but did not improve the degree of esophageal dilatation. Side effect was observed in only one patient, which was flushing of extremities caused by vasodilation, and it is not hazardous to continue nifedipine therapy. Sublingual administration of nifedipine in patients with achalasia is very useful way of medical treatment in two respects, 1) nifedipine decreases LESP, and 2) sublingual administration does not need to pass through the drug through esophagogastric junction which pressure is abnormally high in achalasia patients.
对10例贲门失弛缓症患者，研究了钙拮抗剂之一硝苯地平对食管功能的影响。在舌下含服10mg硝苯地平前后，用恒压灌注导管测量食管下括约肌压力（LESP）。除1例患者外，硝苯地平使贲门失弛缓症患者和正常对照者的LESP均降低。硝苯地平引起的LESP下降似乎与初始静息LESP相关。对贲门失弛缓症患者进行了硝苯地平的临床试验，患者于餐前舌下含服硝苯地平，每日剂量为30至60mg。硝苯地平治疗使8例患者效果良好，1例反应不佳，1例无效。硝苯地平改善了贲门失弛缓症的症状，但未改善食管扩张程度。仅1例患者观察到副作用，即血管扩张引起的四肢潮红，继续硝苯地平治疗并无危害。对贲门失弛缓症患者舌下含服硝苯地平在两方面是非常有用的治疗方法，1）硝苯地平降低LESP，2）舌下含服无需使药物通过食管胃交界处，而贲门失弛缓症患者该处压力异常高。
