Farthing M J
St Bartholomew's and the Royal London School of Medicine and Dentistry, London, UK.
Digestion. 1996;57 Suppl 1:107-13. doi: 10.1159/000201412.
Octreotide inhibits intestinal motility and secretions of the gastro-intestinal tract and pancreas and mediators of diarrhoea and so is very useful in managing refractory diarrhoea. It is safe and effective in 75-80% of the 10-20% of cancer chemotherapy patients who develop severe diarrhoea, and is useful in the management of persistent diarrhoea associated with neuroendocrine tumours, particularly VIPoma and carcinoid tumours, congenital microvillus atrophy, some patients with the short bowel syndrome (giving them a reduced need for intravenous fluids), and AIDS-related diarrhoea that does not respond to antibiotics or conventional anti-diarrhoeal drugs. Some studies suggest a 50% effectiveness in graft-versus-host disease. Preliminary studies suggest that octreotide is also of value in persistent diarrhoea caused by neuromuscular disorders of the gut, particularly diabetes mellitus and systemic sclerosis, suggesting that it may have wider application in the future. Octreotide may prove useful as a tool for studying the pathogenesis of diarrhoea of diverse aetiologies, particularly those associated with disturbances of intestinal motility, such as irritable bowel syndrome.
奥曲肽可抑制肠道蠕动以及胃肠道和胰腺的分泌，还能抑制腹泻介质，因此在治疗难治性腹泻方面非常有用。在10% - 20%发生严重腹泻的癌症化疗患者中，75% - 80%使用奥曲肽是安全有效的，它也有助于治疗与神经内分泌肿瘤相关的持续性腹泻，特别是血管活性肠肽瘤和类癌肿瘤、先天性微绒毛萎缩、一些短肠综合征患者（可减少他们对静脉输液的需求）以及对抗生素或传统止泻药无反应的艾滋病相关性腹泻。一些研究表明奥曲肽在移植物抗宿主病中的有效性为50%。初步研究表明，奥曲肽对肠道神经肌肉疾病（特别是糖尿病和系统性硬化症）引起的持续性腹泻也有价值，这表明它未来可能有更广泛的应用。奥曲肽可能被证明是研究多种病因腹泻发病机制的有用工具，特别是那些与肠道蠕动紊乱相关的腹泻，如肠易激综合征。
