Minami T, Nishibayashi H, Shinomura Y, Matsuzawa Y
Second Department of Internal Medicine, Osaka University Medical School, Suita, Japan.
J Gastroenterol. 1996 Dec;31(6):855-9. doi: 10.1007/BF02358615.
The prokinetic effects of erythromycin, a macrolide antibiotic, on the gastrointestinal tract as a motilin receptor agonist and its potential value for the treatment of gastrointestinal motility disorders have recently attracted interest. The effects of erythromycin on the clinical symptoms and gastrointestinal motility of patients with chronic idiopathic pseudo-obstruction have not been investigated extensively. We presented a case of chronic idiopathic intestinal pseudo-obstruction, in a 67-year-old man in whom oral erythromycin (900 mg/day) dramatically improved postprandial abdominal distention, nausea, and vomiting. Other agents with prokinetic effects on intestinal motility, i.e., cisapride, domperidone, metoclopramide, and trimebutine maleate did not have a favorable effect. Gastric emptying, measured by the sulfamethizole method; and intestinal transit, evaluated using radio-opaque markers, were markedly improved by treatment with erythromycin. Our experience suggests that the prokinetic effects of erythromycin may be of therapeutic value in chronic idiopathic intestinal pseudo-obstruction.
作为一种胃动素受体激动剂，大环内酯类抗生素红霉素对胃肠道的促动力作用及其在治疗胃肠动力障碍方面的潜在价值最近引起了关注。红霉素对慢性特发性假性肠梗阻患者临床症状和胃肠动力的影响尚未得到广泛研究。我们报告了一例67岁男性慢性特发性肠道假性肠梗阻病例，口服红霉素（900毫克/天）显著改善了餐后腹胀、恶心和呕吐症状。其他对肠道动力有促动力作用的药物，即西沙必利、多潘立酮、甲氧氯普胺和马来酸曲美布汀，均未产生良好效果。通过磺胺甲噻二唑法测量的胃排空；以及使用不透射线标记物评估的肠道转运，经红霉素治疗后均有显著改善。我们的经验表明，红霉素的促动力作用在慢性特发性肠道假性肠梗阻中可能具有治疗价值。
