西沙必利对肠易激综合征患者症状及餐后小肠运动功能的影响。

Effects of cisapride on symptoms and postcibal small-bowel motor function in patients with irritable bowel syndrome.

作者信息

Noor N, Small P K, Loudon M A, Hau C, Campbell F C

机构信息

Dept. of Surgery and Epidemiology, Ninewells Hospital and Medical School, Dundee, Scotland.

出版信息

Scand J Gastroenterol. 1998 Jun;33(6):605-11. doi: 10.1080/00365529850171873.

DOI:10.1080/00365529850171873

PMID:9669632

Abstract

BACKGROUND

Irritable bowel syndrome is a common cause of abdominal pain and discomfort and may be related to disordered gastrointestinal motility. Our aim was to assess the effects of long-term treatment with a prokinetic agent, cisapride, on postprandial jejunal motility and symptoms in the irritable bowel syndrome (IBS).

METHODS

Thirty-eight patients with IBS (constipation-predominant, n = 17; diarrhoea-predominant, n = 21) underwent 24-h ambulatory jejunal manometry before and after 12 week's treatment [cisapride, 5 mg three times daily (n = 19) or placebo (n = 19)].

RESULTS

In diarrhoea-predominant patients significant differences in contraction characteristics were observed between the cisapride and placebo groups. In cisapride-treated diarrhoea-predominant patients the mean contraction amplitude was higher (29.3 +/- 3.2 versus 24.9 +/- 2.6 mm Hg, cisapride versus placebo (P < 0.001); pretreatment, 25.7 +/- 6.0 mm Hg), the mean contraction duration longer (3.4 +/- 0.2 versus 3.0 +/- 0.2 sec, cisapride versus placebo (P < 0.001); pretreatment, 3.1 +/- 0.5 sec), and the mean contraction frequency lower (2.0 +/- 0.2 versus 2.5 +/- 0.4 cont./min, cisapride versus placebo (P < 0.001); pretreatment, 2.5 +/- 1.1 cont./min] than patients treated with placebo. No significant differences in jejunal motility were found in the constipation-predominant IBS group. Symptoms were assessed by using a visual analogue scale before and after treatment. Symptom scores relating to the severity of constipation were lower in cisapride-treated constipation-predominant IBS patients [score, 54 +/- 5 versus 67 +/- 14 mm, cisapride versus placebo (P < 0.05); pretreatment, 62 +/- 19 mm]. Diarrhoea-predominant IBS patients had a higher pain score after cisapride therapy [score, 55 +/- 15 versus 34 +/- 12 mm, cisapride versus placebo (P < 0.05); pretreatment, 67 +/- 19 mm].

CONCLUSION

Cisapride affects jejunal contraction characteristics and some symptoms in IBS.

摘要

背景

肠易激综合征是腹痛和不适的常见原因，可能与胃肠动力紊乱有关。我们的目的是评估促动力剂西沙必利长期治疗对肠易激综合征（IBS）患者餐后空肠动力及症状的影响。

方法

38例IBS患者（便秘型，n = 17；腹泻型，n = 21）在接受12周治疗[西沙必利，每日3次，每次5mg（n = 19）或安慰剂（n = 19）]前后进行24小时动态空肠测压。

结果

在腹泻型患者中，西沙必利组和安慰剂组的收缩特征存在显著差异。在接受西沙必利治疗的腹泻型患者中，平均收缩幅度更高（西沙必利组为29.3±3.2mmHg，安慰剂组为24.9±2.6mmHg，P < 0.001；治疗前为25.7±6.0mmHg），平均收缩持续时间更长（西沙必利组为3.4±0.2秒，安慰剂组为3.0±0.2秒，P < 0.001；治疗前为3.1±0.5秒），平均收缩频率更低（西沙必利组为2.0±0.2次/分钟，安慰剂组为2.5±0.4次/分钟，P < 0.001；治疗前为2.5±1.1次/分钟）。便秘型IBS组的空肠动力无显著差异。治疗前后采用视觉模拟量表评估症状。西沙必利治疗的便秘型IBS患者中，与便秘严重程度相关的症状评分更低[评分，西沙必利组为54±5mm，安慰剂组为67±14mm，P < 0.05；治疗前为62±19mm]。腹泻型IBS患者在西沙必利治疗后疼痛评分更高[评分，西沙必利组为55±15mm，安慰剂组为34±12mm，P < 0.05；治疗前为67±19mm]。