Effect of transcutaneous electroacupuncture on gastric accommodation and electrogastrogram in patients with functional dyspepsia / 实用医学杂志

Objective To study the effect of transcutaneous electroacupuncture(TEA)on gastric accom-modation and electrogastrogram in patients with functional dyspepsia(FD)and investigate the transcutaneous elec-troacupuncture efficacy and mechanism. Methods 106 cases of FD patients were randomLy divided into TEA group(n=53)and sham-TEA group(n=53)according to the designed random table. 10 health volunteers were recruited for participation in the study for normal control group. All patients fulfilled the Rome Ⅲ criteria of FD. Informed consent was obtained from each participant. All subjects were tested in terms of gastric accom-modation (GA),namely,maximum satiety. For the patients of TEA group,the acupoints of Zusanli(ST36)and Neiguan (PC6)were stimulated. In the sham-TEA group,the sham-acupoint for PC6 was located at about 15-20 cm away from PC6 not on any meridian and the sham-point for ST36 was located at 10-15cm down from and to the lateral side of ST36 not on any meridian.The stimulation parameters used for sham-TEA were the same as the TEA group. Four weeks after treatment with double blind crossover method,we compared the two groups in view of gastric receptivity,electrogastrogram(EGG)andclinicalsymptomscores before and after treatment respectively. Results (1)The GA was 725 ± 46 mL in the normal control group and 539 ± 36 mL in the FD patients.(2)The mean total symptom score was 24.5 ± 2.9 at baseline and significantly decreased to 11.9 ± 2.1(P < 0.001)after TEA. There were significant differences in the symptom scores between the TEA group and sham-TEA group(P<0.001).(3) The percentage of normal slow waves(N%)during fasting and postprandial state in the TEA group were respectively 70.9 ± 2.4% and 68.2 ± 3.1%. The differences were statistically significant between the TEA group,baseline and sham-TEA group(P<0.001).(4)In the TEA group,the postprandial dominant power(46.23 ± 4.03)db and the fasting dominant power(35.35 ± 1.53)db were significantly increased compared to baseline before treatment and sham-TEA group(P < 0.001). Conclusions(1)Gastric accommodation in patients with FD was decreased, showing a higher visceral sensitivity. TEA can improve the GA in FD patients,reducing visceral sensitivity.(2)TEA can increase the percentage of normal slow wave in the FD patients,increase the postprandial dominant power and regulate the abnormal gastric myoelectric activity to promote the gastric motility.

The Pharmacological Effects of Benachio-F(R) on Rat Gastrointestinal Functions

Functional dyspepsia (FD) is a prevalent idiopathic upper gastrointestinal (GI) disorder characterized by diverse symptomatology including epigastric pain or discomfort, postprandial fullness, and early satiety. Although its pathophysiological mechanisms have not yet been fully established, the available studies suggest that the etiology of FD is invariably multifactorial. Benachio-F(R) (BF) is a proprietary liquid formulation of 7 herbal extracts that has been proposed to address this multifactorial etiology using multi-drug phytotherapy. The pharmacological effects of BF, in comparison with those of two other herbal products (Whalmyungsu(R); WM and Iberogast(R); IB) were evaluated in rats. In a laparotomy-induced rat model of delayed GI transit, BF significantly accelerated the delayed gastric emptying caused by morphine, apomorphine, and cisplatin, and also significantly increased mean gastric transit, as compared to the control animals. BF markedly increased gastric accommodation in rats and produced higher gastric volume values than did the control treatment. The effects of BF were generally comparable or superior to those of WM and IB in these models. Furthermore, BF significantly stimulated biliary flow, as compared to the control treatment. These results indicated that BF might have great potential as an effective phytotherapeutic agent capable of reducing GI symptoms and increasing quality of life in FD patients.

Evaluation of proximal gastric function in functional dyspepsia and its subtypes / 中华消化杂志

Objective To evaluate proximal gastric function in patients with functional dyspepsia (FD) met Rome Ⅲ criteria and its subtypes.Methods Thirty FD patients were enrolled,including 15 patients with postprandial distress syndrome (PDS) and 15 patients with epigastric pain syndrome (EPS).A total of 30 healthy volunteers were recruited as control.All the subjects received barostat examination.Minimal distending pressure (MDP),pressure and volume of thresholds for first sensation and maximal tolerance for gastric sensitivity were recorded.When the pressure level was MDP+2 mmHg (1 mmHg=0.133 kPa),average volume at 30 minutes before meal,averaged volume at 60 minutes after meal and maximum accommodation volume after meal were recorded,and receptive diastolic volume was calculated.The gastric hypersensitivity and impaired accommodation were observed.Student's t test or x2 test was performed for statistical analysis.Results MDP,pressure of first-sensation,maximum sensation pressure,volume of first sensation and maximal sensation volume of FD group were (6.17 ±1.95) mmHg,(8.44±2.01) mmHg,(14.62±3.72) mmHg,(123.59±53.26) mL and (451.26±140.44) mL,respectively; which were lower than those of healthy control group ((9.27±1.99) mmHg,(12.04±2.66) mmHg,(19.74±4.18) mmHg,(168.41±73.06) mL and (556.89±124.07) mL),and the differences were statistically significant (t=-6.080,-5.900,-5.011,-2.723 and-2.995,all P＜0.01).The averaged volume at 30 minutes before meal and 60 minutes after meal was (212.19±120.82) mL and (333.97±121.86) mL while those of healthy control group was (191.69±66.19) mL and (385.58±83.05) mL,and there were no significant differences between the two groups (both P＞0.05).The maximum postprandial accommodation volume and receptive diastolic volume of FD group were (405.10±111.29) mL and (190.16±97.22) mL,which were lower than those of healthy control group ((461.10±87.60) mL and (262.83±78.39) mL),and the differences were statistically significant (t=-2.599 and-3.187,both P＜0.05).The maximum postprandial accommodation volume of FD patients was at 15 to 20 minutes after meal and in healthy control it was at five to ten minutes after meal.Among the 30 FD patients,12 patients (40 ％) had gastric hypersensitivity,including eight PDS patients and four EPS patients,and there was no significant difference in the ratio between two groups (P＞0.05) ;nine patients (30 ％) had impaired accommodation,including five PDS patients and four EPS patients,and there was no significant difference in the ratio between two groups (P＞ 0.05).Conclusions Gastric hypersensitivity and impaired accommodation often appear in FD patients,and there is no significant difference between PDS and EPS subtypes.FD patients with different pathophysiologic mechanisms cannot be efficiently distinguished according to Rome Ⅲ criteria.

Impact of symptom and gastric accommodation of combination therapy in patients with functional dyspepsia / 重庆医学

Objective To study the impact of symptom score ,gastric emptying test and gastric accommodation of compound az-intamide(CA) combined with mosapride(MSP) drugs in patients with functional dyspepsia(FD) .Methods From February 2012 to March 2013 ,112 cases of hospital patients with FD were divided into the observation group (56 cases) and the control group (56 cases) .The control group was given MSP for treatment ,while the observation group was given MSP and CA .The curative effect , symptom scores and gastric accommodation ,as well as gastric emptying test results condition before and after treatment of two groups were Compared .Results The effective rate and the total effective rate of observation group were 51 .79% ,80 .36% ,which were significantly higher than the control group(32 .14% ,51 .79% )(P<0 .05) ;the improvement rate of the observation group was 8 .93% ,which was significantly lower than the control group 25 .00% (P<0 .05) .After treatment ,the observation group′s symp-tom score was (8 .7 ± 6 .3)points ,which was significantly lower than before treatment (22 .4 ± 7 .9)points ,and the control group af-ter treatment (12 .7 ± 3 .6) points ;the maximum amount of drinking water was (387 .1 ± 105 .8)mL ,which was significantly higher than the pre-treatment of (320 .8 ± 90 .9)mL ,and the control group after treatment of (351 .3 ± 77 .7)mL ;After treatment ,2 h full gastric emptying rate was 66 .07% (37/56) ,5 h full gastric emptying rate was 94 .64% (53/56) ,which were significantly higher than before treatment of 10 .71% (6/56) ,23 .21% (13/56) ,and the control group after treatment of 44 .64% (25/56) ,73 .21% (41/56) ,the differences were statistically significant (P<0 .05) .Conclusion CA combined MSP treat FD can significantly improve pa-tient symptoms ,promote gastric emptying ,and increase patients′gastric accommodation .The effect is significant and is worthy of recommendation .

DA-9701: A New Multi-Acting Drug for the Treatment of Functional Dyspepsia

Motilitone(R) (DA-9701) is a new herbal drug that was launched for the treatment of functional dyspepsia in December 2011 in Korea. The heterogeneous symptom pattern and multiple causes of functional dyspepsia have resulted in multiple drug target strategies for its treatment. DA-9701, a compound consisting of a combination of Corydalis Tuber and Pharbitidis Semen, has being developed for treatment of functional dyspepsia. It has multiple mechanisms of action such as fundus relaxation, visceral analgesia, and prokinetic effects. Furthermore, it was found to significantly enhance meal-induced gastric accommodation and increase gastric compliance in dogs. DA-9701 also showed an analgesic effect in rats with colorectal distension induced visceral hypersensitivity and an antinociceptive effect in beagle dogs with gastric distension-induced nociception. The pharmacological effects of DA-9701 also include conventional effects, such as enhanced gastric emptying and gastrointestinal transit. The safety profile of DA-9701 is also preferable to that of other treatments.

Perfusion nutrient load test: a new method in assessment of gastric accommodation / 中华消化杂志

Objective To investigate the feasibility and reliability of perfusion nutrient load test (P-NLT) in evaluating gastric accommodation and hypersensitivity.Methods Forty-one healthy volunteers randomly received either drinking nutrient load test (D-NLT) or P-NLT (through nasalgastric tube) in separate day within one week.Meanwhile,intragastric pressure (IGP) was recorded and 2D ultrasonography (2DUS) was used to measure both the proximal gastric area (PGA) and proximal gastric volume(PGV) during NLT.Visual analogue scale was used to evaluate satiety during NLT.Ten healthy volunteers experienced second P-NLT within 3 months.Results The amount of nutrition liquid was higher in P-NLT than in D-NLT at minimal and maximal satiety(P <0.01).However,there was no difference in the IGP between P-NLT and D-NLT at minimal and maximal satiety (P>0.05).The PGA and PGV at maximal satiety were significantly higher in P-NLT than DNLT (P <0.01),but no difference existed at minimal satiety between two methods (P >0.05).The amount of nutrition liquid at maximal satiety was significantly correlated with PGA and PGV at maximal satiety in both P-NLT and D-NLT (PGV:r = 0.771 vs r = 0.500;PGA:r = 0.600 vs r =0.430).In P-NLT group,there was no significant difference among age,BMI and gender with respect to IGP and maximal volume (MV) (P >0.05).Whereas no difference was found in threshold volume (TV) and MV between the first and the second P-NLT studies (P >0.05).Conclusions It suggests that P-NLT might be more accurate than D-NLT in predicting gastric accommodation in healthy volunteers without any influence such as swallowing air,taste and psychological disturbance.It has a good repeatability.P-NLT is a potential method in assessment of proximal gastric accommodation and MV might be more suitable for assessment gastric accommodation.