Ballmer P E
Medizinische Universitätsklinik, Inselspital Bern.
Schweiz Med Wochenschr. 1993 Apr 17;123(15):687-93.
Vomiting is a physiological reflex to protect the body from harmful influences, whereas "pathological vomiting" occurs irrespective of its primary purpose or causes secondary disturbances. Artificially induced vomiting and enemas were prophylactic and therapeutic procedures to purge the body that were employed in ancient times and reached their zenith by the end of the 18th century. The act of vomiting is regulated by the vomiting centre, where neural afferents from the chemoreceptor trigger zone, vagal and sympathetic nerve system, and from other trigger areas, are coordinated. Differential diagnosis of vomiting, emphasizing metabolic/endocrine and psychogenic vomiting--including anorexia nervosa and bulimia--are briefly discussed. Symptomatic treatment of vomiting primarily consists of the use of receptor antagonists, e.g. dopamine, histamine and 5-hydroxytryptamine-3 antagonists. Acupuncture/-pressure are also discussed as an alternative treatment method.
呕吐是一种生理反射,可保护身体免受有害影响,而“病理性呕吐”则不论其主要目的如何或是否会引起继发性紊乱都会发生。人工诱导呕吐和灌肠是古代用于净化身体的预防和治疗手段,在18世纪末达到了顶峰。呕吐行为由呕吐中枢调节,来自化学感受器触发区、迷走神经和交感神经系统以及其他触发区域的神经传入在此协调。本文简要讨论了呕吐的鉴别诊断,重点是代谢/内分泌性和心因性呕吐——包括神经性厌食症和贪食症。呕吐的对症治疗主要包括使用受体拮抗剂,如多巴胺、组胺和5-羟色胺-3拮抗剂。本文还讨论了针刺/按压作为一种替代治疗方法。