Son H J, Rhee P L, Kim J J, Koh K C, Paik S W, Rhee J C
Department of Medicine, Sung Kyun Kwan University, Seoul, Korea.
Korean J Intern Med. 1997 Jun;12(2):188-92. doi: 10.3904/kjim.1997.12.2.188.
The mechanism of pain sensation in patients with ulcer-like functional dyspepsia is unclear and there are no guidelines for its treatment. Whilst much research and many pharmacological treatments have provided symptomatic relief of ulcer-like functional dyspepsia through control of acid secretion, the role of acid in ulcer-like functional dyspepsia is unknown. We carried out this study to investigate the role of hypersensitivity to acid in the sensation of pain in ulcer-like functional dyspepsia by direct administration of acid into stomach.
Twelve patients with ulcer-like functional dyspepsia (5 male, 7 female, mean age 41.0 years old, 7 with mild chronic superficial gastritis, 2 with metaplastic gastritis and 3 with normal endoscopic findings) and seven healthy control subjects (3 male, 4 female, mean age 36.0 years old, 7 with normal endoscopic findings) participated in the study. After overnight fasting, a nasogastric sump tube was inserted and its tip was positioned in the antrum under fluoroscopic guidance. Normal saline or 0.1N hydrochloric acid was administered in random and single blind cross over fashion. The test was considered positive only if similar pain developed-similar to that experienced by the patient under nonstudy condition- during the administration.
Five patients (41.7%) developed pain with 0.1N hydrochloric acid administration, but none with normal saline (p < 0.05). None of the healthy controls developed pain upon administration of 0.1N hydrochloric acid or normal saline.
We suggest that acid hypersensitivity plays a role in the sensation of pain in ulcer-like functional dyspepsia.
溃疡样功能性消化不良患者的疼痛感觉机制尚不清楚，且尚无其治疗指南。虽然大量研究和多种药物治疗通过控制胃酸分泌为溃疡样功能性消化不良提供了症状缓解，但胃酸在溃疡样功能性消化不良中的作用尚不清楚。我们进行这项研究是为了通过直接向胃内注入酸来研究酸超敏反应在溃疡样功能性消化不良疼痛感觉中的作用。
12例溃疡样功能性消化不良患者（男5例，女7例，平均年龄41.0岁，7例有轻度慢性浅表性胃炎，2例有化生型胃炎，3例内镜检查正常）和7名健康对照者（男3例，女4例，平均年龄36.0岁，7例内镜检查正常）参与了该研究。过夜禁食后，插入鼻胃引流管，在荧光镜引导下将其尖端置于胃窦部。以随机、单盲交叉方式给予生理盐水或0.1N盐酸。仅当给药期间出现与患者在非研究状态下经历的疼痛相似的疼痛时，该试验才被视为阳性。
5例患者（41.7%）在给予0.1N盐酸时出现疼痛，但给予生理盐水时均未出现疼痛（p<0.05）。给予0.1N盐酸或生理盐水后，健康对照者均未出现疼痛。
我们认为酸超敏反应在溃疡样功能性消化不良的疼痛感觉中起作用。
