Thornell E, Jansson R, Svanvik J
Surgery. 1981 Sep;90(3):468-72.
Prostaglandins have been demonstrated to contract the gallbladder and induce fluid secretion into its lumen in experimental animals. Indomethacin is an effective inhibitor of prostaglandin synthetase and has recently been demonstrated to inhibit inflammatory fluid secretion into the gallbladder in experimental cholecystitis. A mechanism by which an increased prostaglandin synthesis will result in a raised intraluminal pressure in the gallbladder in patients with gallstone disease has been suggested. By inhibiting the synthesis of prostaglandins with indomethacin the intraluminal pressure is reduced and the biliary pain relieved. In a double-blind study with a placebo in 40 separate attacks of biliary pain in 37 patients with verified gallstone disease intravenous indomethacin was found to effectively relieve pain within 5 to 30 minutes. No serious side effects were seen, but nausea and vertigo of short duration were noticed in 10 of 21 cases of indomethacin treatment. The drug did not affect blood pressure, but a reduction of the pulse rate was usually seen.
在实验动物中，前列腺素已被证明可使胆囊收缩并促使液体分泌至胆囊腔内。吲哚美辛是前列腺素合成酶的有效抑制剂，最近已证明它能抑制实验性胆囊炎时炎性液体向胆囊内的分泌。有人提出，在患有胆结石疾病的患者中，前列腺素合成增加会导致胆囊腔内压力升高的一种机制。通过用吲哚美辛抑制前列腺素的合成，腔内压力降低，胆绞痛得以缓解。在一项针对37例经证实患有胆结石疾病的患者的40次单独胆绞痛发作进行的双盲安慰剂研究中，发现静脉注射吲哚美辛可在5至30分钟内有效缓解疼痛。未观察到严重的副作用，但在21例接受吲哚美辛治疗的患者中有10例出现了短时间的恶心和眩晕。该药物不影响血压，但通常会出现脉搏率下降。
